Antidepressant drugs| How to take antidepressants

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What are Antidepressant drugs

What are Antidepressant drugs: Antidepressants are the most common treatment for depressive disorders.These drugs have a fairly wide margin of safety, with few contraindications and side effects that are easily reversible.

Do not confuse depression with sadness. Nowadays we often use the phrase “I am depressed” when in reality it is not like that. While depression is a serious psychiatric illness that a specialist must diagnose, sadness is a natural and normal state of mind that does not require any type of treatment.

The loss of a loved one, a job, economic hardship or health can make us sad, but that does not mean that we are depressed or need to medicate unnecessarily. An antidepressant drug is a medication that can not be taken at the slightest setback but must always be the psychiatrist who, after assessing it, decide if it really is a depression that needs treatment. Never take antidepressant drugs without medical supervision.

The choice of the antidepressant drug that the psychiatrist makes will depend on:

1.The severity of the depressive disorder.

2.The accompanying symptoms that the patient experiences (anxiety, inhibition, presence of delusions …)

3.Possible pathological features of the personality prior to the onset of depression or the abruptness of the onset of symptoms.

4.The consumption of other medications.

Different types of antidepressants

Depending on the symptoms the psychiatrist will choose one or another family of antidepressants. Next, we explain what these 6 antidepressant drugs consist of.

Tricyclic antidepressants
Tricyclic antidepressants

Tricyclic antidepressants

The tricyclic antidepressant is one of the oldest groups of antidepressant drugs that exist. They inhibit the reuptake of serotonin, noradrenaline, dopamine, acetylcholine and histamine in a non-specific manner, which cause several side effects and can cause dependence. Although they are old drugs they give good results and they are still used in clinical practice and their therapeutic effect is seen after one month of treatment.

Its main side effects are dry mouth, tachycardia, postural hypotension, drowsiness and decreased libido.

1.Examples: amitriptyline, clomipramine, doxepin, imipramine, nortriptyline and trimipramine.

Heterocyclic or atypical antidepressants

The heterocyclic or atypical antidepressants are also a group of second generation drugs, similar in structure to the tricyclics, but with fewer side effects. Nowadays it is used less in pursuit of SSRIs.

1.Examples: mirtazapine, trazodone, mianserin, and maprotiline. Mirtazapine and trazodone have a greater sedative effect, so they are sometimes prescribed at low doses to help you fall asleep.

Selective serotonin reuptake inhibitors (SSRIs)

They are the type of antidepressant most used today in clinical practice, partly because acting specifically on serotonin do not produce as many side effects as tricyclic antidepressants. Its mood stabilizing effect usually occurs after 2-4 weeks of treatment.

The main side effects of SSRIs are nausea, dizziness, anxiety or light drowsiness.

1.Examples : citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine and sertraline.

Selective serotonin and noradrenaline reuptake inhibitors (SNRI)

They are drugs similar to SSRIs but act on both serotonin and norepinephrine. Its effect is seen somewhat fasterthan in the case of SSRIs.

The side effects are similar, in addition to alterations of the libido, erectile dysfunction, disorders of ejaculation or anorgasmia.

Examples: desvenlafaxine, duloxetine, and venlafaxine. Reboxetine acts only on noradrenaline and can cause dizziness, hypotension, dry mouth and profuse sweating.

Non-selective and irreversible inhibitors of monoamine oxidase (MAOI)

MAOIs are a group of antidepressants that have been used for years. They usually respond well to patients suffering from atypical depression or who are accompanied by intense anxiety and phobias, as well as depressive disorders resistant to other treatments.

Its main side effects are dizziness, drowsiness, weakness, dry mouth, nausea and sexual disorders. One of the dangers of MAOIs is that they can trigger a hypertensive crisis if certain drugs or some foods rich in tyramine are taken that are prohibited during treatment with MAOIs. Among them we find cheese, canned fish, wine, chocolate, coffee or beans.

Examples : IMAO antidepressants are phenelzine, nialamide and tranylcypromine.

Selective and reversible inhibitors of monoamine oxidase (RIMA)

RIMA are selective and reversible inhibitors of monoamine oxidase, which produces less cardiovascular effects , but sometimes its effect is less than that of MAOIs. 
They can trigger some of these symptoms: insomnia, vertigo, nausea, headache and confusion.

Examples : moclobemide.

How to take antidepressants

How to take antidepressants

At the beginning of taking an antidepressant and until it starts to take effect, you must have good control good control over the patient, given that in case of severe depression may increase the risk of suicide. This is because while the depression is severe the patient does not have the strength or will to commit suicide, even if he has ideas of death. However, when the drug begins to take effect, apathy disappears before suicidal ideation and at that time there is a serious risk of suicide.

It should be noted, however, that this only occurs in severe depressions in which there are suicidal ideas, which does not happen in most cases, nor do these ideas occur if they were not present before the start of antidepressant treatment.

What you should know…

An antidepressant drug is a medication that can not be taken at the slightest setback, but must always be the psychiatrist who, after assessing it, decide if it really is a depression that needs treatment.

Based on these symptoms the psychiatrist will choose one or another family of antidepressants. Never take antidepressant drugs without medical supervision.

At the beginning of taking an antidepressant and until it starts to take effect, you must have good control over the patient.

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