The Use of Medications in the Treatment of Depression

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What are the types of treatment for depression?
A physician can treat depression by prescribing any number of lifestyle changes and medical therapies, including:

Lifestyle changes

  • Stopping the intake of alcohol and/or sedatives
  • Exercising regularly
  • Eating a healthy diet

Medical therapies

  • Switching current medications (such as antihypertensives, contraceptives, and steroids) to reduce side effects that may be causing depression
  • Diagnosing and treating other conditions known to cause depression (such as hypothyroidism)
  • Counseling (psychotherapy: cognitive-behavioral, interpersonal, and other forms)
  • Light therapy (exposure to white fluorescent light to reduce symptoms of seasonal affective disorder)
  • Antidepressant medication
  • Electroconvulsive therapy (controlled electrical discharge to induce seizure-like activity in the brain)
  • Combinations of therapy
  • Hypericum (St. Johns Wort®) for a single episode of mild depression

Ongoing research

  • Norepinephrine Reuptake Inhibitor
    • Reboxetine
  • Substances "P" antagonists
  • Vagal nerve stimulation
  • Deep brain stimulation

What conditions can be treated with antidepressant medications?
Antidepressants can be used for the treatment of:

  • Major depression (symptoms of depression that persist for more than two weeks)
  • Panic disorder
  • Chronic pain
  • Bed wetting (enuresis)
  • Chronic depression (dysthymia)
  • Migraines
  • Chronic fatigue syndrome
  • Eating disorders

How effective are antidepressants in the treatment of depression?
All antidepressant medications are effective in treating depression. Antidepressants have been shown to be 60 to 70 percent effective for treating depression, although it may take more than one medication being tried. The effectiveness of individual types of antidepressants can vary from patient to patient.

How are antidepressant medications prescribed?
Antidepressants are chosen based on:

  • Any medical illnesses that are present
  • Side effects from previous treatments with antidepressants or concern over side effects that may occur
  • Effectiveness of medication in other family members
  • Medications being taken for other conditions
  • Effectiveness of a medication in controlling a past episode of depression
  • The presence of another psychiatric disorder (such as panic disorder)
  • Cost

What are the types of antidepressants?
Selective Serotonin Reuptake Inhibitors include:

  • Fluoxetine (Prozac®)
  • Sertraline (Zoloft®)
  • Paroxetine (Paxil® or Pexeva®)
  • Fluvoxamine (Luvox®)
  • Citalopram (Celexa®)
  • Escitalopram (Lexapro®)

Selective serotonin reuptake inhibitors (SSRIs) have advantages over other antidepressants including fewer side effects and effectiveness at lower dosages. Generics are now available, reducing the expense. Side effects can include sexual dysfunction, nausea and diarrhea, and headache.

Tricyclics include:

  • Amitriptyline (Elavil®)
  • Amoxapine (Asendin®)
  • Clomipramine (Anafranil®) (for obsessive-compulsive disorder)
  • Desipramine (Norpramin®)
  • Doxepin (Sinequan®)
  • Imipramine (Tofranil®)
  • Nortriptyline (Pamelor®)
  • Protriptyline (Vivactil®)
  • Trimipramine (Surmontil®)

Tricyclics (TCA) can be helpful for reducing pain, providing weight gain, and improving sleep. They can cause dizziness, constipation, and urinary retention.

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Last Updated: 11/21/2008

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