sign in sign up
<<
Home , Antidepressant, Escitalopram, Medication

Antidepressant

There is a lot of misinformation about medication and there is no simple explanation as to how it works. Medication can be important in the treatment of moderate to severe and in some conditions. This fact sheet looks at what do, how they work and where to get more information and help.

How do antidepressants work? People with more severe forms of depression ( and depression with ) Research shows that more severe forms do generally need to be treated with medication. of depression are associated with specific This may include one or a combination changes in the , including changes to of mood stabilisers, anti-psychotic some and chemical message and antidepressants. systems. In these forms of depression, there are alterations in the activity of the brain in areas Which antidepressants are the which may cause a . This is associated with the symptoms and most useful? disability seen with depression. Antidepressant Making a decision about which antidepressant medication is thought to influence the activity is best for a person can be complex. The decision of and noradrenaline in some areas of is made in consultation with a doctor, after careful the brain. However, depression is not simply a assessment and consideration. People can help deficiency of these chemicals. Different types of the doctor’s assessment by providing as much antidepressants work in slightly different ways, information as possible about themselves and but they all have an influence on parts of the their . Important factors include brain related to emotions and motivation. the person’s age, symptoms, other and, if female, whether they are pregnant When is antidepressant or . medication used? There are many different types of antidepressant Antidepressant medication may be prescribed, medication which have been shown to work, but along with psychological treatments, when a their effectiveness differs from person to person. person experiences a moderate to severe episode Your doctor may wish to prescribe a particular of depression. Sometimes, antidepressants are antidepressant to tailor it to your particular prescribed when other treatments have not been symptoms. Antidepressants take at least two successful or when psychological treatments are weeks before they start to help, and it may also not possible due to the severity of the illness or a take some time for the doctor to find the most lack of access to the treatment. suitable medication and dosage.

beyondblue.org.au 1300 22 4636 1 of 4 Age Antidepressant medication is generally not recommended for use by itself in people with Depression is common and can affect people bipolar disorder as it can trigger . of all ages, however, generally medication is not recommended as the first choice for the treatment of depression in children and “I resisted medication for years; young people. inaccurately believing it was ‘weak’ or I would turn into a ‘vegetable’. The Therapeutic Goods Administration (Australia’s regulatory agency for medical drugs) Many misconceptions exist regarding and manufacturers of antidepressants do not medication. In my case, medication recommend antidepressant use for depression propelled my recovery and helped me in young people under the age of 18. There are, to utilise psychological treatments however, no government (i.e. Pharmaceutical effectively.” Benefits Scheme) restrictions placed on the prescription of antidepressants and doctors are April, 25 not prevented from prescribing them if they feel they are needed. There is concern that a small percentage of Types of antidepressants young people up to the age of 24 years taking There are many different types of antidepressant Selective Serotonin Inhibitors (SSRIs) medication. Your doctor may need to find the for the treatment of depression may experience medication and dose which is most effective an increase in suicidal thoughts and behaviour. for you. Keep in mind antidepressants take time Research shows the risk to be roughly 4 per before they start to help (at least two weeks). cent compared to 2 per cent for those taking a Below is a description of the different classes dummy pill). of antidepressants. Please note, this list only A young person will require close medical includes the generic medication names and not supervision and monitoring in the early stages the pharmaceutical brand names. Please look on of treatment if an antidepressant is prescribed. your medication packaging to find the name of the medication you are taking (this is usually Chronic illness written in lowercase). Like any medication, antidepressants can There are differences in effects and side-effects produce side-effects. In some cases, taking of the antidepressants listed below, which antidepressants can affect existing symptoms can be discussed with your prescribing health or treatments for other illnesses. It is important professional. for people to let doctors know about any illness they may have and any medication they Selective Serotonin Reuptake Inhibitors are taking. (SSRIs) This class includes ; ; and breastfeeding ; ; ; . The decision to take medication while pregnant SSRIs are: or breastfeeding is an individual one. It should • the most commonly prescribed be made in consultation with a doctor after antidepressants in Australia considering the risks and benefits to both the mother and baby. The lowest effective dose • often a doctors’ first choice for most types of should be used. depression If a woman is breastfeeding, generally specific • generally well tolerated by most people types of medications are preferred. While a • generally non-sedating. number of factors will influence the choice of antidepressant, a group of antidepressants Serotonin and Noradrenalin Reuptake called , as well as sertraline, citalopram Inhibitors (SNRIs) and fluvoxamine are most commonly prescribed for women who are breastfeeding. This class includes ; ; . SNRIs: Studies show that paroxetine is generally not recommended at this time.1,2 • have fewer side-effects compared to the older antidepressants (such as Antidepressants and bipolar disorder Antidepressants) People who have bipolar disorder and experience • are often prescribed for severe depression an episode of depression will often be given a • are safer if a person overdoses. mood stabiliser alone. It can take time for mood stabilisers to work. Sometimes antidepressants are used along with mood stabilisers to help ease the symptoms.

beyondblue.org.au 1300 22 4636 2 of 4 Reversible Inhibitors of (RIMAs) Things to note The class includes . RIMAs: • All of these drugs have been shown to have effect as antidepressants for • have fewer side-effects more severe depression however • are non-sedating their effectiveness differs from person to person. • may be less effective in treating more severe forms of depression than other antidepressants • When symptoms are directly due to depression, the person is likely to begin • are helpful for people who are experiencing to improve after 4-6 weeks of effective anxiety or sleeping difficulties. . For example, although SSRIs commonly make difficulties TriCyclic Antidepressants (TCAs) or worse initially, they are The class includes ; ; associated with improved sleep 4-6 dothiepin; ; . TCAs are: weeks later. • effective, but have more harmful side-effects • TCAs are commonly prescribed for their than newer drugs (i.e. SSRIs) wide range of general benefits, but are also the most toxic antidepressants if • more likely to cause low pressure – so taken in large quantities. this should be monitored by a doctor • SSRIs or clomipramie (TCA) would be • more risky if a person were to overdose. the first choice if obsessive compulsive disorder symptoms were prominent. Noradrenaline-Serotonin Specific Antidepressants (NaSSAs) This class includes . NaSSAs are: • helpful when there are problems with anxiety, sleeping or poor appetite Monoamine Oxidase Inhibitors (MAOIs) • generally low in sexual side-effects, but may This class includes . MAOIs are cause . prescribed only under exceptional circumstances as they require a special diet and have adverse effects. Noradrenalin Reuptake Inhibitors (NARIs) This class includes . NARIs are: This class includes . Tetracyclics: • designed to act selectively on one type of brain chemical – noradrenalin • operate via noradrenaline and serotonin systems • less likely to cause sleepiness or drowsiness than some other antidepressants • include side-effects such as sedation and • more likely to: • can cause a rare side-effect to arise, so • make it difficult for people to sleep occasional blood tests are necessary. • cause increased sweating after the initial doses What are the ? • cause sexual difficulties after the initial doses Antidepressants can make people feel better, but they won’t change their personality or • cause difficulty urinating after the initial doses make them feel happy all the time. They will • cause increased heart rate after the not improve unhappiness due to a predicament initial doses. or an event. Like taking any other medication, some people will experience some side- effects. Common side-effects, depending on “Medication is not an instant fix. It which medication is taken, include nausea, takes time and often works alongside , anxiety, sweating, dizziness, agitation, weight gain, dry mouth and sexual difficulties other strategies/treatments. In (e.g. difficulty becoming/staying aroused). addition, you should be aware you will Some of the side-effects can be short-lived, probably have side-effects, but they do but people who experience such symptoms ease over time and eventually, you will should tell their doctor, as there may be ways feel like you again.” of minimising them. The likelihood of a particular side-effect happening varies between individuals Gina, 38 and medications.

beyondblue.org.au 1300 22 4636 3 of 4 It is not uncommon for people with depression Everyone needs to find the treatment that’s to have suicidal thoughts. Treating the depression right for them. Just because a treatment has effectively will reduce the likelihood of a person been shown to work scientifically, doesn’t mean hurting him or herself. In the period of time it will work equally well for every individual. Some between the person starting antidepressant people will have complications, side-effects or medication and responding to treatment – find that the treatment does not fit in with their which can be more than two weeks – the person lifestyle. It can take time, strength and patience should still be monitored by the doctor and his to find a treatment that works. or her progress reviewed, as the risk of suicidal After seeking appropriate advice, the best behaviour may even be slightly increased. approach is to try a treatment you’re comfortable with and one that works for most people. If you How long are antidepressants do not recover quickly enough, or experience usually needed? problems with the treatment, discuss this Like any medication, the length of time a person with your health professional and consider needs to take antidepressants for depends on trying another. how severe the illness is and how they respond to treatment. Some people only need to take References them for a short time (usually 6-12 months) 1 Reference: Beyond Blue (2011). Clinical practice with psychological treatments and self-help guidelines for depression and related disorders – techniques being sufficient in stopping its return. anxiety, bipolar disorder and puerperal psychosis – Others may need to take them over the long term in the perinatal period. A guideline for primary care to prevent recurrence. health professionals. Melbourne: Beyond Blue http:// www.nps.org.au/publications/health-professional/ People often want to stop taking antidepressants health-news-evidence/2013/ssris-pregnancy quickly because they are concerned they are addictive. This may be because they confuse 2 NPS MedicineWise (2013). Is it safe to use SSRIs during them with , a group of medications pregnancy?. [online] Available at: http://www.nps.org. that are used to help a person feel relaxed and, au/publications/health-professional/health-news- evidence/2013/ssris-pregnancy [Accessed 22 Dec. 2014]. in some cases, fall/stay asleep. Sedatives are designed to be used only for a short time. If This fact sheet was reviewed and updated in December used for long periods of time, sedatives may 2016. Clinical information might change after this date. cause withdrawal insomnia and anxiety and This fact sheet is not a substitution for medical advice be needed in higher doses in order for them to from your doctor. have the same effect. Sedatives may be craved and become addictive. This is not the case with antidepressants. Where to find more information Stopping some antidepressants quickly (e.g. some Beyond Blue SSRIs and SNRIs) can lead to a discontinuation syndrome, which consists of flu-like symptoms. beyondblue.org.au For many people, this will last for several days Learn more about anxiety, depression and can be avoided if the medications likely and prevention, or talk through to do this are stopped gradually, on a doctor’s your concerns with our Support Service. Our recommendation and under supervision. trained mental health professionals will listen, However, in some cases these symptoms can provide information, advice and brief counselling, last for weeks, months or even years. Sometimes and point you in the right direction so you can discontinuation symptoms are severe, including seek further support. , agitation, dizziness and confusion. 1300 22 4636 Stopping medication should only be done Email or chat to us online at gradually, on a doctor’s recommendation and beyondblue.org.au/getsupport under supervision. @beyondblue @beyondblueofficial “No one treatment has been helpful by @beyondblue company/beyondblue itself for me. It’s been a combination of medication with talk therapy, as well Head to Health as lifestyle changes such as getting headtohealth.gov.au regular and modifying my Head to Health can help you find free and low- diet (i.e. cutting down on and cost, trusted online and phone mental health carbohydrate intake).” resources.

Greg, 42 Donate online: beyondblue.org.au/donations

© Beyond Blue Ltd. BL /0125 05/20

beyondblue.org.au 1300 22 4636 4 of 4