Antidepressants increase the availability of certain chemicals in the brain that regulate mood and behavior. They do this by regulating the levels of serotonin, norepinephrine, and other neurotransmitters.
There are several major types of antidepressants. Each class works in a slightly different way.
Types of Antidepressants
Antidepressants work by changing the way your brain uses certain chemicals (called neurotransmitters) to better regulate mood and behavior. These include serotonin, norepinephrine, and dopamine.
Selective serotonin reuptake inhibitors (SSRIs) are the most commonly prescribed antidepressants and are often used to treat depression. SSRIs, such as fluoxetine (Prozac) and paroxetine (Paxil), help boost your body’s levels of serotonin and norepinephrine.
SSRIs are also used to treat anxiety and bipolar disorder, and they may be given to children who have depression. Some SSRIs are available as generic versions, which save you money.
Another type of antidepressant is a monoamine oxidase inhibitor (MAOI). MAOIs block the enzyme monoamine oxidase, which breaks down serotonin, norepinephrine, and dopamine.
MAOIs aren’t usually recommended for most people with depression, but they’re effective for those who have a very severe case of depression that doesn’t respond to other drugs. But they can cause serious side effects, require dietary restrictions and may interact with other medications.
A third type of antidepressant is a tricyclic antidepressant (TCA). TCAs, such as imipramine (Tofranil), desipramine (Norpramin), and nortriptyline (Pamelor) are older drugs that have higher rates of side effects than newer antidepressants. However, some healthcare providers prescribe them to treat chronic pain and insomnia. If you’re thinking of trying an antidepressant, it’s best to talk with your doctor about which is right for you. They’ll take into account your health history and any other medication you are taking.
Selective Serotonin Reuptake Inhibitors
SSRIs are antidepressants that help ease symptoms of depression by increasing levels of serotonin in the brain. This helps the areas of your brain that regulate mood and send messages to other parts of your body work correctly. SSRIs also may be more effective for some people than other types of antidepressants, and they often have fewer side effects.
SSRIs inhibit the reuptake (removal) of serotonin from the presynaptic cell, thereby increasing extracellular levels that remain available to bind to postsynaptic receptors in the neuron. They have varying degrees of selectivity for the serotonin transporter and do not possess any affinity for other monoamine transporters such as norepinephrine or dopamine.
They are often prescribed to treat depression and other psychiatric disorders, including anxiety disorders, obsessive-compulsive disorder, post-traumatic stress disorder, and other conditions. The choice of SSRI for each patient is based on various factors, including tolerability, drug interactions, previous response history, and efficacy for the selected indication.
A study has found that patients who are taking SSRIs or other drugs that increase the level of serotonin in the body are more likely to develop suicidal thoughts or behaviors. This phenomenon is known as serotonin syndrome.
This is a rare but serious reaction to antidepressants. It can occur when you take a new SSRI or an increased dose, and it most often occurs when you take SSRIs with other medications that raise your level of serotonin.
Serotonin and Norepinephrine Reuptake Inhibitors
Serotonin and norepinephrine reuptake inhibitors (SNRIs) are antidepressants that work on two brain chemicals called neurotransmitters. These neurotransmitters communicate nerve signals between neurons and regulate mood and behavior. SSRIs and SNRIs are used to treat a wide range of mental health conditions, including depression and anxiety disorders.
SSRIs increase serotonin levels in the brain, which can help relieve symptoms of depression and other mental health conditions. SNRIs also affect norepinephrine, which is part of the fight-or-flight reaction and helps control the body’s natural reaction to stress.
The SNRIs dually inhibit the reuptake of both serotonin and norepinephrine, which increases their concentration in the synaptic clefts and increases their stimulation. They have a similar mechanism of action to tricyclic antidepressants (TCAs) and are associated with fewer serious side effects, such as nausea, dry mouth, anxiety, insomnia, restlessness, sexual dysfunction, headaches, and, in rare cases, elevated blood pressure.
Each SNRI has its own chemical makeup, which can lead to different side effects, but most people experience mild to moderate side effects while taking them. They may also interact with some other medications, including supplements and over-the-counter drugs, so it’s important to tell your doctor about any medication you are currently taking.
SNRIs can cause withdrawal symptoms in some people, such as dizziness, nausea, and headaches, so it’s important to talk with your doctor before stopping treatment. SNRIs can also increase your blood pressure, so it’s important to inform your doctor of your high blood pressure.
Atypical Antidepressants
Atypical antidepressants are medications that don’t fit into the other four major classes of antidepressants – selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), tricyclic antidepressants (TCAs) and monoamine oxidase inhibitors (MAOIs). These medicines have different mechanisms of action, but they all have the ability to alter your brain chemistry so that you feel better.
Like other antidepressants, atypical drugs take time to work. Most begin to work around four weeks after you start taking them, but it can take longer to feel the effects.
Your doctor will likely try a few different drugs before they find one that works for you. Your doctor may also recommend that you stop taking your current medications, herbs, or supplements before starting a new one to prevent serious side effects.
The side effects of antidepressants vary, but they can include dry mouth, dizziness, sleep problems, nausea, and weight gain. In some cases, they can cause a condition called serotonin syndrome, which can lead to high fever, confusion, tremors, restlessness, and other symptoms.
Some atypical antidepressants increase your risk of suicidal thoughts and behavior. They may have warnings about this on the package label, and your doctor may suggest you talk with a mental health professional about them.
Atypical antidepressants can be used to treat depression, anxiety disorders, and PTSD. They’re typically not the first choice for treating depression, but doctors will often prescribe them when other antidepressants haven’t helped.
Tricyclic Antidepressants
Tricyclic antidepressants (often abbreviated to TCAs) are a group of medications that have a strong history of treating anxiety and depression. They are named after their chemical structure — which contains three rings of atoms — and they are usually a second-line drug next to selective serotonin reuptake inhibitors (SSRIs).
TCAs work by preventing the reabsorption of neurotransmitters that affect mood, such as serotonin and norepinephrine. These chemicals are made naturally by your body and influence how you feel and react.
SSRIs are the most commonly prescribed antidepressants in Australia and they produce fewer side effects than tricyclics. SSRIs are also generally well-tolerated and effective.
Although most people with depression respond to SSRIs, some may experience unpleasant side effects when taking them. If you have these side effects, it is important to talk to your GP or mental health specialist about what you can do to treat them.
In rare cases, antidepressants can cause serotonin syndrome – a serious medical condition that results from an overdose of drugs that increase your serotonin levels. This can lead to confusion, restlessness, agitation, fever, sweating, tremors and other symptoms.
Tricyclic antidepressants can have harmful side effects if they are taken with certain medicines, such as epinephrine (Epi-Pen) and cimetidine (Tagamet). These interactions can be dangerous, so it is essential to tell your doctor about all of the drugs and medicines you take.
Monoamine Oxidase Inhibitors
Monoamine oxidase inhibitors (MAOIs) are effective antidepressants that are used to treat depression, anxiety disorders and other conditions. They work by inhibiting the action of monoamine oxidase, which is an enzyme that removes neurotransmitters from the brain.
MAOIs are the first antidepressants to be developed, and they can help some people who don’t respond well to other medications. However, they have side effects and can cause drug interactions. They are typically prescribed as a last resort to help people with depression who have tried other antidepressants and still haven’t found relief.
They also have a risk of serotonin syndrome, which is very dangerous. It can cause confusion, fever, muscle rigidity, seizures, liver or kidney problems, and changes in blood pressure and heart rhythms.
When you take an MAOI, it’s important to avoid eating foods and drinks that have high levels of tyramine. Tyramine can increase the amount of MAOI in your body and make it more difficult for you to get rid of it.
Depending on the type of MAOI you take, there are a few ways to avoid this problem. One way is to avoid tyramine-containing foods like meat, fish, poultry, and eggs. Another is to follow a strict diet, which includes avoiding foods and beverages that contain caffeine and chocolate.
MAOIs are not usually recommended for the treatment of major depression because they can cause serious side effects and interactions with certain foods and medicines. They’re also not the most common antidepressants, so it’s important to discuss your options with a healthcare professional.
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TEDxMaastricht - Lawrence Sherman - "Turning clinical education inner out and upside down"
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IUHealth
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Digivision Media /InstaTapesMedia
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