Posts Tagged ‘depression’

Antidepressants are medicines that are used to treat depression. Your doctor can prescribe them for you. They can improve your sleep, mood, appetite and concentration. It may take several weeks for them to start working. There are several types of antidepressants. You and your doctor may have to try several before finding what will work best for you.

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Antidepressants sometimes cause unwanted side effects. For example, when you first start your antidepressant you may feel tired, have trouble sleeping or even feel sick to your stomach. The side effects usually go away in a short period. Tell your doctor if you have any side effects. You should also let your doctor know if you take any other drugs, vitamins or any herbal supplements.

It is important to keep taking your medicines, even after you feel better. Do not stop taking your antidepressants without talking to your pharmacist. You often need to stop antidepressants gradually.

Most typical antidepressants have a delayed action (2–6 weeks) and are usually administered for anywhere from months to years. Antidepressants are often used to treat other conditions, such as obsessive compulsive disorder, anxiety disorders, chronic pain, eating disorders, and some hormone-mediated disorders as dysmenorrhea. Alone or together with anticonvulsants (e.g., Depakote or Tegretol), antidepressants can be used to treat attention-deficit hyperactivity disorder (ADHD) and substance abuse by addressing underlying depression. Also, antidepressants have been used for hypercytorism, with mixed reviews, and are sometimes used to treat migraines or snoring.

Here is a list of different types of antidepressants.

1) TCAs (Tricyclic antidepressants)

Tricyclic antidepressants are the oldest class of antidepressant drugs. Tricyclics block the reuptake of neurotransmitters as serotonin and noradrenaline (norepinephrine). Tricyclic antidepressants are used less commonly now due to the development of safer and more selective drugs.

Tricyclic antidepressants include: Secondary Amine Tricyclic Antidepressants as Protriptyline (Vivactil), Desipramine (Norpramin), Nortriptyline (Pamelor, Aventyl) and Tertiary Amine Tricyclic Antidepressants as Imipramine (Tofranil), Clomipramine (Anafranil), Trimipramine (Surmontil), Amitriptyline (Elavil, Endep) and Doxepin (Adapin, Sinequan)

Side effects of Tricyclic antidepressants include increased drowsiness, heart rate, dry mouth, blurred vision, constipation, urinary retention, confusion, dizziness, and sexual dysfunction. Toxicity occurs at approximately ten times normal dosages; !!ATTENTION!! these drugs are often lethal in overdoses, as they lead to a fatal arrhythmia. However, tricyclic antidepressants are still used because of their effectiveness, especially in severe cases of major depression.

2) SSRIs(Selective serotonin reuptake inhibitors)

SSRIs are a family of antidepressants that consider the current standard of drug treatment. This family of drugs includes: Sertraline (Zoloft), Fluoxetine (Prozac), Paroxetine (Paxil), Citalopram (Celexa), Fluvoxamine (Luvox) and Escitalopram (Lexapro, Cipralex).

Within side effects of Selective serotonin reuptake inhibitors there should be mentioned: anxiety, drowsiness, dry mouth, decreased appetite, nervousness, insomnia, agitation, headaches and decreased ability to function sexually such as loss of libido, failure to reach orgasm and erectile dysfunction. Though safer than first generation antidepressants, SSRIs may not work on as many patients as previous classes of antidepressants, suggesting the role of norepinephrine in depression is still important. The Food and Drug Administration requires Black Box warnings on all SSRIs, which state that they double suicidal rates (from 2 in 1,000 to 4 in 1,000) in children and adolescents. The increased risk for suicidality and suicidal behaviour among adults under 25 approaches that seen in children and adolescents.

3) SNRIs (Serotonin-norepinephrine reuptake inhibitors) are a newer form of antidepressants. They work on both norepinephrine and 5-HT. They are:

Duloxetine (Cymbalta), Venlafaxine (Effexor), Desvenlafaxine (Pristiq) and Milnacipram (Ixel).
Theese antidepressants usually have similar side effects to the SSRIs, though there may be a withdrawal syndrome on discontinuation that may necessitate dosage tapering.

4) NaSSAs (Noradrenergic and specific serotonergic antidepressants)

Noradrenergic and specific serotonergic antidepressants (NaSSAs) work to increase norepinephrine (noradrenaline) and serotonin neurotransmission by blocking presynaptic alpha-2 adrenergic receptors. And at the same time they block certain serotonin receptors. NaSSAs include Mirtazapine (Remeron, Zispin, Avanza) and Mianserin (Tolvon). Side effects of Noradrenergic and specific serotonergic antidepressants include drowsiness, increased appetite, and weight gain.

5) NRIs (Norepinephrine (noradrenaline) reuptake inhibitors)

Norepinephrine (noradrenaline) reuptake inhibitors (NRIs) act via norepinephrine (also known as noradrenaline). NRIs are used because of their positive effect on the concentration and motivation in particular. NRIs include: Mazindol (Sanorex, Mazanor), Viloxazine (Vivalan), Atomoxetine (Strattera) and Reboxetine (Edronax)

6) MAOIs (Monoamine oxidase inhibitor)

Monoamine oxidase inhibitors (MAOIs) are usually used when other antidepressant medications are ineffective.
MAOIs include: Phenelzine (Nardil), Tranylcypromine (Parnate), Isocarboxazid (Marplan), Selegiline (Emsam, Eldepryl)and Moclobemide (Manerix, Aurorix).

MAOIs are rarely prescribed anymore. The reason is that there are potentially fatal interactions between this class of antidepressants and certain foods (especially those containing tyramine), red wine, as well as certain drugs . However, this does not apply to Emsam, the transdermal patch form of selegiline, which due to its bypassing of the stomach has never been reported to induce such terrible side effects. MAOIs work by blocking the enzyme monoamine oxidase which breaks down the neurotransmitters serotonin, dopamine, and noradrenaline (norepinephrine). Monoamine oxidase inhibitors are as effective as tricyclic antidepressants, although they can have a higher incidence of dangerous side effects (as a result of inhibition of cytochrome P450 in the liver). Modern generation of Monoamine oxidase inhibitors has been introduced; moclobemide (Manerix), known as RIMA ( a reversible inhibitor of monoamine oxidase A), acts in a selective andmore short-lived manner and does not require a special diet. As one of the side effects is weight gain and could be extreme.

Side effects of MAOIs (monoamine oxidase inhibitors): Rare side effects of MAOIs like phenelzine (Nardil) and tranylcypromine (Parnate) include heart attack, hepatitis, stroke, and seizures. Serotonin syndrome is a side effect of MAOIs when combined with other certain drugs.

There are also some other groups of antidepressants: NDRIs (Norepinephrine-dopamine reuptake inhibitors ) such as Bupropion (Wellbutrin, Zyban). SSREs (Selective serotonin reuptake enhancers) such as Tianeptine ( Coaxil, Stablon, Tatinol). Melatonergic agonists such as Agomelatine ( Melitor, Valdoxan, Thymanax).

Some antidepressants were found to work better in some patients when used in combination with another drug. Theese drugs are called “Augmenter drugs” such as Trazodone (Desyrel), Nefazodone (Serzone), Gepirone (Ariza), Buspirone (Buspar), Tandospirone (Sediel).

Lithium is often used in conjunction with other medications, depending on whether mania or depression is being treated. Lithium’s potential side effects include nausea, tremors, thirst, light-headedness and diarrhea. Some of the anticonvulsants, such as lamotrigine (Lamictal),sodium valproate (Epilim) and carbamazepine (Tegretol) are also used as mood stabilizers, particularly in bipolar disorder.

Antipsychotics such as olanzapine (Zyprexa), risperidone (Risperdal) and quetiapine (Seroquel) are prescribed as mood stabilizers and to treat anxiety. Their use as mood stabilizers is a recent phenomenon, and controversial among some patients. Antipsychotics may also be prescribed to augment an antidepressant, to increase the blood concentration of another drug, or to relieve the psychotic or paranoid symptoms that usually accompany clinical depression. However, they can cause serious side effects, especially if used at high dosages, wich include tardive dyskinesia, restlessness, blurred vision, muscle spasms or weight gain.

Tranquillizers and sedatives, typically the benzodiazepines, are usually prescribed to ease anxiety and to promote sleep. Because of the high risk of dependency, these drugs are intended only for short-term or occasional use. Tranquillizers are often used not for their primary functions, but to decrease side effects. Quetiapine fumarate (Seroquel) is designed primarily to treat bipolar disorder and schizophrenia, but frequently causes somnolence because of its affinity for histamine (H1 and H2) receptors, exploiting the same side effects as diphenhydramine (Benadryl).

Psychostimulants may be added to an antidepressant regimen if the patient suffers from hypersomnia, anhedonia and/or excessive eating as well as low motivation. These symptoms are common in atypical depression, and can be resolved by adding low to moderate doses of methylphenidate (Ritalin) or amphetamine (Adderall) because these chemicals can enhance motivation and social behavior, and also to suppress appetite and sleep. They can also restore sex drive. Stimulants are known to trigger manic episodes in people suffering from bipolar disorder. Close supervision is urged of those with substance abuse disorders.

If you are about to buy Antidepressants, we recommend you to order it in Canadian pharmacy. You’ll get qualitative medication and you will save money…