Understanding Depression and antidepressant medications

Approximately 121 million people are affected by depression worldwide, which causes the illness to be the leading cause of disability, according to the World Health Organization (WHO).

"In my experience as a practicing psychiatrist, I've seen that many people with depression don't realize that they have the condition or that it's treatable," Mitchell Mathis, M.D., deputy director of the Division of Psychiatry Products at the Food and Drug Administration said.

Some who suffer from depression don't recognize the symptoms, or they attribute them to lack of sleep or a poor diet. Others realize they are depressed, but they feel too fatigued or ashamed to seek help.

"Studies have shown that the best way to treat a patient with the more severe form of major depressive disorder is through both therapy and prescribed antidepressant medication," Mathis said.

In order to diagnose the disease, medical professional use the number, severity, and duration of symptoms listed in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. These symptoms include depressed mood, fatigue, loss of energy, feelings of worthlessness or excessive guilt, and recurring thoughts of death or suicide.

Different types of antidepressants work to normalize naturally occurring brain chemicals called neurotransmitters. There are several different classes of antidepressants including Selective Serotonin Reuptake Inhibitors, with examples including Prozac, Celexa, and Paxil, Serotonin and Norepinephrine Reuptake Inhibitors, with examples including Effexor and Cymbalta, Tricyclic Antidepressants, with examples including Elavil, Tofranil, and Pamelor, and Monoamine Oxidase Inhibitors, with examples including Nardil and Parnate. Remeron and Wellbutrin are considered unique antidepressants and do not fall into these categories.

In order to prescribe the correct antidepressants, physicians use a patient history and mental status exam. This can evaluate symptoms and rule out medical causes of depression.

Approximately 60 to 70 percent of patients respond to the first antidepressant that is prescribed or to an increased dosage of the drug, according to Mathis. Regular doses must be taken for at least three to four weeks before a full therapeutical effect can be experienced. If patients begin to feel better they should never stop taking their medication because depression is a chronic illness and require daily treatment.

Side effects from the drugs can include headache, night sweats, nausea, agitation, sexual problems, dry mouth, and constipation, and most people with suffer from at least one of these side effects.

These side effects are the most common reason that individuals stop taking their antidepressant medication.

Serious risks from the medication can include suicidal thinking. This risk is especially dangerous in children and adolescents taking antidepressants and has recently been extended to include young adults up through age 24.

Eric Snipes, LPC, a counselor at Family Counseling Center in Kennett, said that people should be careful with antidepressants and not believe that the medicines will be able to solve all of their personal problems.

"The drugs will not be a fix-all and can sometimes set people up for failure, who have the misconception," Snipes said.

These medications can be a good thing if prescribed by a doctor and the person honestly needs them, according to Snipes.

The medication's effectiveness depends on the individual using the antidepressants, according to Nikolay Horozov, M.D., a psychiatrist at Family Counseling Center of Kennett.

"If a person is Bipolar and is prescribed antidepressants then it can cause the patient to become more nervous," Horozov said.

All patients should take the list of side effects under consideration when taking the medications. These are side effects such as sexual problems, gastric intestinal problems, an increase in risk of suicide in teenagers and young adults, and apathetic moods where individuals are not depressed but just do not care, according to Horozov.