Depression: Treatment Through Talking Therapy and Antidepressants

Depression Treatment 1 in every 7 person will experience at least a short period of depression at some stage in their life.

Depression Treatment

Treatment will help you recover faster from depression. The two main treatments are talking therapy and antidepressant medicines. Both treatments together is often the best way to treat depression. Talking therapies aim to treat depression by helping change the way you think about and react to situations and relationships. Antidepressant medicines help relieve depressed feelings.

Antidepressants

Antidepressants are medicines that treat depression. They work to balance some of the natural chemicals in our brains. They can take 6-8 weeks to build up their effect to work fully. A normal course of antidepressants lasts at least six months after symptoms have eased. There are several types of antidepressants. Antidepressants may cause mild side effects that usually do not last long. These may include headache, nausea, sleep problems, restlessness, and sexual problems. You and your doctor may have to try a few before finding what works best for you.

Types of Antidepressants

  • Selective Serotonin Reuptake Inhibitors (SSRIs): This generation of antidepressants is now the most common class used for depression. Examples include citalopram, escitalopram, paroxetine, fluoxetine, and sertraline. Two newer medicines, classified as “serotonin modulators and stimulators” or SMS’s (meaning they have some similar properties as SSRIs but also affect other brain receptors) are vilazodone and vortioxetine. Side effects are generally mild but can be bothersome in some people. They include nausea, stomach upset, sexual problems, fatigue, dizziness, insomnia, weight change, and headaches.
  • Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs): These are a newer type of antidepressant. This class includes venlafaxine, desvenlafaxine, duloxetine and levomilnacipran. Side effects include upset stomach, insomnia, sexual problems, anxiety, dizziness, and fatigue.
  • Tricyclic Antidepressants (TCAs): They are some of the first medications used to treat depression. Examples are amitriptyline, desipramine, doxepin, imipramine, nortriptyline, protriptyline, and trimipramine. Side effects include stomach upset, dizziness, dry mouth, changes in blood pressure, changes in blood sugar levels, and nausea.
  • Monoamine Oxidase Inhibitors (MAOIs): These were among the earliest treatments for depression. Examples are phenelzine, tranylcypromine, isocarboxazid. Although MAOIs work well, they’re not prescribed very often because of the risk of serious interactions with some other medications and certain foods. Foods that can negatively react with the MAOIs include aged cheese and aged meats.
  • Other medications: Bupropion is a unique antidepressant that is thought to affect the brain chemicals norepinephrine and dopamine. Side effects are usually mild, including upset stomach, headache, insomnia, and anxiety. Bupropion may be less likely to cause sexual side effects than other antidepressants.
    Mirtazapine is also a unique antidepressant that is thought to affect mainly serotonin and norepinephrine through different brain receptors than other medicines. It is usually taken at bedtime because it often causes drowsiness. Side effects are usually mild and include sleepiness, weight gain, elevated triglycerides, and dizziness.
Tell your doctor if you have any side effects. You should also let your doctor know if you take any other medicines, vitamins, or supplements.

Points to Remember

  • Take the medications.
  • Keep track of side effects and discuss them with your physician.
  • Antidepressants are not addicting or habit forming. They do not make people “high,” and they do not lead to serious withdrawal symptoms once you stop them.
  • It may take two to ten weeks to feel the full benefits of antidepressants.
  • Continue to take the medication even when you feel better.
  • Don’t stop the medications before talking with your primary care provider.