There are many approaches to overcoming depression and the one most favoured by many in the medical profession appears to be medication and herein lies a brief discussion of what medication is available for depression and what side effects can be expected1.
The Case for Medication
Although alternative remedies can help the depressive and psychotherapy is effective, it has to be remembered that some people experience extremely severe and deep depression. If a person is so badly affected that he or she is too depressed to talk, there is a strong argument to be made that therapy will be of no use.
This is where prescribed medication can improve the symptoms and set the patient on the road to recovery. Some people worry that they might be on anti-depressants for the rest of their lives, but as one Researcher put it:
In terms of the treatment of true clinical depression, the tablets don't always have to be taken for life, it is possible, after a variable period of treatment for the brain to sort itself out (the mechanism for which is not well understood) and for people to be weaned off the tablets and 'cured'.
The Different Types of Anti-depressants Available
For ease of understanding it might be as well to separate the newer medication from the older.
Into the category of the older type of anti-depressants falls the tricyclics which are so named for their chemical structure and used to be the most commonly prescribed. MAOI (monoamine oxidase inhibitors) would have been prescribed for the atypical depression with symptoms such as oversleeping, panic attacks, anxiety and phobias.
SSRIs (selective serotonin reuptake inhibitors) are probably the most commonly prescribed anti-depressants. Some examples are fluoxatine (Prozac), fluvoxamine (Luvox), paroxetine (Paxil), and sertraline (Zoloft).
Two new medications that affect the serotonin and norepinephrine neurotransmitters are venlafaxine (Effexor) and nefazodone (Serzone). These are reputed to have fewer side effects.
Another option is bupropion (Wellbutrin) which acts on dopamine and norepinephrine and is given to individuals who have had no success with other medications.
Common to all anti-depressants are the following side effects (It should be stressed that not all people experience the above symptoms and not necessarily at the same time):
- Dry mouth
- Loss of sex drive
- Loss of sexual ability
- Urinary difficulties
Further possible side effects with specific medication:
Tricyclics - These may complicate specific heart problems.
MAOIs - Dizziness when changing position and rapid heartbeat is common.
Newer SRRIs - Gastrointestinal problems and headaches are among the most common. Some people experience insomnia, anxiety and agitation.
There have been reports of worrying side effects for some who have been prescribed venlafaxine; details can be found here. Also, a good article about finishing with medication can be found here, and a useful index of drugs, uses and side effects etc, can be found at Medline.
Another useful UK reference is at Netdoktor. This site also has a message board facility to communicate with other sufferers, providing a potential source of on-line support.