You Feel More Energetic But Still Feel Blue
If you feel more physical energy after starting an antidepressant, but you still have depression, thats good and bad news, says Gabriela Cora, MD, a psychiatrist in Miami. It means the depression medication is starting to work, but not in the right way.” Increased physical energy combined with depression is a bad combination that can make you act out or increase your risk of;suicide, she explains. So, report these symptoms to your doctor right away, urges Dr. Cora.
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Monoamine Oxidase Inhibitors Side Effects
Monoamine oxidase inhibitors are a class of antidepressant associated with postural hypotension , high blood pressure, fainting, abnormal heart rhythm, dizziness, headache, drowsiness, insomnia, anxiety, constipation, nausea, diarrhea, sexual dysfunction, weight gain or weight loss, and edema. Seizures, rash, blurred vision, and hepatitis are infrequently associated with MAOIs.
What If An Antidepressant Doesnt Work
If you donât notice any change in your mood after a few weeks, talk with your doctor. If the first antidepressant you take doesnât work, itâs likely that another one will. About 60% of people who take antidepressants feel better with the first medicine they take, but others need to try more than one before noticing a change.
A study funded by the National Institute of Mental Health in 2008 found that about 50% of patients who did not feel better after using one medication noticed an improvement when they took a new one or added a second medication to the first treatment. You and your doctor can work together to find the medication thatâs right for you.
âI had to try a couple of different kinds of medications to find the right one for me,â Brennan tells WebMD. âOne medication worked for a little while, and then I started to feel depressed again. So my doctor switched me to another medication, and that one is working great. Itâs just a matter of sticking with it and letting your doctor know how youâre feeling.â
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The Government Of Canada’s Role
Health Canada regulates drugs like antidepressants under the Food and Drugs Act. We review scientific information about the safety and efficacy of drugs before they are allowed to be sold in Canada.
Health Canada also monitors the safety of health products after they have been approved for sale in Canada. Manufacturers must provide Health Canada with reports of serious side effects for the health products they sell in Canada and maintain the most up-to-date information on their health products. Important drug safety information is available in its official Canadian product monograph, available by search of Health Canada’s Drug Product Database.
Your Depression Is Gone
If youve been taking an antidepressant for at least six months and youve achieved remission, its important to slowly taper off your depression medications with the help of your physician. Antidepressants, particularly selective serotonin reuptake inhibitors , can produce physical symptoms of withdrawal if you stop taking them suddenly, he says. So, you need to reduce the dosage of depression medication slowly, usually over a few weeks.
You may experience some depressive symptoms when discontinuing antidepressants, but this does not mean the depression is returning. Unfortunately, some people stay on their antidepressants longer than needed because the symptoms of discontinuing SSRIs can be mistaken for signs of returning depression.
Work with your doctor to distinguish between the two. You may need to go even slower than a few weeks when tapering off your antidepressant to prevent these withdrawal symptoms.
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Is Brand Name Better
Generic Is the Same, Usually
The US Food and Drug Administration says that the safety, strength, and quality of generic drugs are equal to those of brand-name drugs. However, in practical experience, some people notice that they do not experience the same benefits from a generic drug compared to the brand-name version. Results of some studies suggest generic medications may be absorbed and used by the body slightly differently than brand-name drugs. If you notice a generic medicine is not working as well as a brand-name medicine did for you, tell your physician.
Speak Up About Side Effects
Some individuals may experience side effects from antidepressants. Be sure to discuss them with your doctor. Some common side effects may include increased or decreased appetite, difficulty sleeping or sleeping too much, weight gain or weight loss, or difficulties with sexual response. Some people may experience nausea. Your doctor can help you come up with solutions to handle potential side effects. If the medication makes you nauseous, taking it with food may help. If your antidepressant makes you sleepy, try taking it in the evening before bed. In contrast, certain antidepressants are best taken in the morning. Often, side effects from antidepressants are temporary and may go away after a few weeks of being on them. If side effects are severe, your doctor can prescribe a different medication for you. Never stop taking antidepressant medication abruptly. Doing so may cause serious withdrawal symptoms and depression to return.
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Depression: How Effective Are Antidepressants
Like psychotherapy, antidepressants are a key part of treating . They aim to relieve symptoms and prevent depression from coming back.
Opinions vary on how effective antidepressants are in relieving the symptoms of . Some people doubt that they work well, while others consider them to be essential. But, like with many other treatments, these medications may help in some situations and not in others. They are effective in moderate, severe and chronic depression, but probably not in mild cases. They can also have side effects. It is important to discuss the pros and cons of antidepressants with your doctor.
The main aim of treatment with antidepressants is to relieve the symptoms of severe , such as feeling very down and exhausted, and prevent them from coming back. They are meant to make you feel emotionally stable again and help you to follow a normal daily routine. They are also taken to relieve symptoms such as restlessness, anxiety and sleep problems, and to prevent suicidal thoughts.
This information is about using medication to treat the most common form of , known as unipolar depression. The treatment options for manic depression aren’t discussed here.
Side Effects Of Antidepressant Medications
All medications can have side-effects. Some people experience no side-effects. Others may find the side-effects distressing. In most cases, side-effects lessen as treatment continues.
Treatment is usually started at a low dose, to minimize side-effects, and then slowly increased until the ideal dose is found. The ideal dose is one that provides the greatest benefit with minimum side-effects.
If you are experiencing side effects, check the information given to you by your doctor or pharmacist on the specific effects of any drug you have been prescribed. If side-effects are not mild and tolerable, it is best to continue taking your medication as prescribed but let your doctor know as soon as possible. Your doctor may:
- encourage you to wait a little longer for the side-effects to fade
- adjust your dose
- suggest you take the medication at a different time of day
- prescribe other medications to help control side-effects
- change your medication
- stop medication treatment and suggest a different type of treatment approach.
Side-effects vary depending on the type of medication. More information on side-effects is included for each type of types of antidepressant.
You can help to control possible side-effects on your own by:
Do antidepressants increase the risk of suicide?
Before starting treatment, prepare for the possibility of feeling worse before you feel better. Know what supports are available to you and who you can call.
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How Antidepressants Are Thought To Work
Chemicals like serotonin, norepinephrine and dopamine are naturally present in our bodies. They are needed for normal brain function. In people with depression, it is thought that there may be an imbalance of these chemicals in the brain. Antidepressants are believed to work by bringing one or more of these chemicals back into balance.
There are many types of antidepressants on the market. Talk to your health care provider to see if taking antidepressants is the best choice for you, and if so, which one you should take.
Many people see an improvement with the first antidepressant they use. But you may need to try another type, a higher dose or a combination of drugs to find what works best for you. Also, it may take up to a month to notice the full benefit of the drug.
Even once you start to feel better, keep taking the antidepressant as directed by your health care provider. Most people take antidepressants for at least 6 to 12 months, and some for longer. Make sure you talk to your health care provider before you stop using yours.
Questions To Ask Yourself And Your Doctor
- Is my depression adversely affecting my life enough to require drug treatment?
- Is medication the best option for treating my depression?
- Am I willing to tolerate unwanted side effects?
- What non-drug treatments might help my depression?
- Do I have the time and motivation to pursue other treatments such as therapy and self-help?
- What self-help strategies might reduce my depression?
- If I decide to take medication, should I pursue therapy and alternative treatments as well?
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Ssris Are Used In The Treatment Of:
- depression
- bulimia nervosa
- social phobia
MAOIs are used for all types of depression. They have also been used when ‘atypical’ features were present with the depression such as excessive sleeping, over eating and anxiety.
If you are on antidepressants they may have a different brand name but will generally fall under one of the types mentioned above.
The most commonly prescribed drug type for depression is the SSRI, due mainly to their apparent safety in overdose, compared to others.
Reuptake Inhibitors: Ssris Snris And Ndris
Some of the most commonly prescribed antidepressants are called reuptake inhibitors. What’s reuptake? It’s the process in which neurotransmitters are naturally reabsorbed back into nerve cells in the brain after they are released to send messages between nerve cells. A reuptake inhibitor prevents this from happening. Instead of getting reabsorbed, the neurotransmitter stays — at least temporarily — in the gap between the nerves, called the synapse.
What’s the benefit? The basic theory goes like this: keeping levels of the neurotransmitters higher could improve communication between the nerve cells — and that can strengthen circuits in the brain which regulate mood.
Different kinds of reuptake inhibitors target different neurotransmitters. There are three types:
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What Else Should You Know About Ketamine
- A much lower dose of ketamine is given for depression compared with the dose necessary for anesthesia.
- Like opioids, ketamine has addictive properties. Its important to understand this when weighing risks and benefits. If you have a history of substance abuse such as alcohol or drugs its especially important for you and your doctor to consider whether ketamine is a good option for you.
- When IV ketamine works, people usually respond to it within one to three infusions. If a person has no response at all, further infusions are unlikely to help. Instead, its probably best to try other treatments for depression.
- People who experience some relief from depression within one to three ketamine treatments are probably likely to extend these positive effects if the treatment is repeated several more times. The subsequent sessions may help prolong the effects of ketamine, rather than achieving further dramatic relief of symptoms. There are no standard guidelines for this. Many studies offer eight treatments initially . After this, patient and doctor decide whether to taper or stop ketamine treatments or continue treatments at longer intervals.
What You Can Do
Lifestyle choices can affect how well an antidepressant works for you. Itâs important to get enough rest and avoid recreational drugs and alcohol. With some medications, you need to stay away from citrus juices like orange or grapefruit juice.
A good relationship with your doctor is also key, especially when youâre not feeling well or your medication isnât working as you expected. And talk therapy works hand-in-hand with the right medication. It can help you understand your illness and manage stress and your emotions.
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Antidepressants Should Make You Morenot Lesslike Yourself
People are often concerned that taking a psychotropic drug will change who they are, Dr. Cox says.
Medication should not change your personality. That is never the goal, she says. The goal is to feel like yourself but rid of the problematic symptomsto not feel totally overwhelmed with depression or anxiety.
What Are Antidepressants And How Do They Work
Antidepressants are a class of drugs that reduce symptoms of depressive disorders by correcting chemical imbalances of neurotransmitters in the brain. Chemical imbalances may be responsible for changes in mood and behavior.
Neurotransmitters are vital, as they are the communication link between nervecells in the brain. Neurotransmitters reside within vesicles found in nerve cells, which are released by one nerve and taken up by other nerves. Neurotransmitters not taken up by other nerves are taken up by the same nerves that released them. This process is called “reuptake.” The prevalent neurotransmitters in the brain specific to depression are serotonin, dopamine and norepinephrine .
In general, antidepressants work by inhibiting the reuptake of specific neurotransmitters, hence increasing their levels around the nerves within the brain, such as selective serotonin reuptake inhibitors , antidepressants that will affect serotonin levels in the brain.
Some off- label uses of antidepressants include, but are not limited to: fibromyalgia, chronicurticaria , hot flashes, hyperhidrosis , pruritus , premenstrual symptoms,bulimia nervosa, Tourette syndrome, binge eating disorder, etc.
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Selective Serotonin Reuptake Inhibitors
SSRIs are the most widely prescribed type of antidepressants. They’re usually preferred over other antidepressants, as they cause fewer side effects. An overdose is also less likely to be serious.
Fluoxetine is probably the best known SSRI . Other SSRIs include citalopram , paroxetine and sertraline .
If You Feel Better Can You Stop Taking Antidepressants
Once you and your provider have determined it is safe for you to stop taking your medicine altogether, you should continue to be monitored during periodic follow-up appointments to detect any signs of depression returning.
Long-term treatment with antidepressant medicine may be recommended to prevent further episodes of depression in people who have already had two or more episodes of major depression. A history of depression in ones family is another factor that supports long-term treatment.
Last reviewed by a Cleveland Clinic medical professional on 05/24/2019.
References
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How Effectively Do Antidepressants Relieve The Symptoms
There are a lot of different medications for treating . But it’s difficult to predict how well a particular medication will help an individual. So doctors often first suggest taking a drug that they consider to be effective and relatively well tolerated. If it doesn’t help as much as expected, it’s possible to switch to a different medication. Sometimes a number of different drugs have to be tried before you find one that works.
Studies show that the benefit generally depends on the severity of the : The more severe the depression, the greater the benefits will be. In other words, antidepressants are effective against chronic, moderate and severe depression. They don’t help in mild depression.
The various antidepressants have been compared in many studies. Overall, the commonly used tricyclic antidepressants were found to be equally effective. Studies involving adults with moderate or severe have shown the following:
- Without antidepressants: About 20 to 40 out of 100 people who took a placebo noticed an improvement in their symptoms within six to eight weeks.
- With antidepressants: About 40 to 60 out of 100 people who took an antidepressant noticed an improvement in their symptoms within six to eight weeks.
In other words, antidepressants improved symptoms in about an extra 20 out of 100 people.
Antidepressants can also relieve long-term symptoms of chronic depressive disorder and chronic , and help make them go away completely.
How Long Will You Have To Take Antidepressants
Usually, these drugs must be taken regularly for at least 4 to 8 weeks before their full benefit takes effect. You are monitored closely during this time to detect the development of side effects and to determine the effectiveness of treatment.
In order to prevent a relapse of depression, medicines are generally prescribed for 6 to 12 months after a first-time depression. When you and your provider determine that you are better, you should expect to continue the medication for at least 4 to 6 additional months. After this, your provider may gradually taper you off your medicine.
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You Dont Necessarily Have To Stop Taking Your Antidepressant If Youre Pregnant Or Breastfeeding
Some antidepressants, particularly SSRIs, are considered safe to take while pregnant and breastfeeding.;
Women and their doctors must make a risk-benefit calculation, Dr. Cox says. While its best to be on the fewest medications possible during pregnancy, the risk of untreated symptoms of depression and anxiety may be greater than any risk from medication.;
When moderate to severe, untreated symptoms can pose risk of serious harm to the mother and baby, Dr. Cox says. These symptoms deserve to be treated just like any other health condition that arises during a pregnancy.
Signs Your Antidepressant Isnt Working
Finding the right depression treatment can take time. One way to speed the process: Know the signs that a particular drug isn’t working for you.
When you’re taking a new antidepressant, feeling better right away can spell trouble in some cases, according to one expert.
Tero Vesalainen/Thinkstock
For many people, finding the right depression treatment is a trial-and-error process. An antidepressant may work well for one person but not at all for someone else and experts dont yet have ways to predict this.
In other cases, a person may start to feel better on an antidepressant, but the side effects are too bothersome for them to keep taking it.
A review published in February 2018 in the Lancet;assessed previous studies of 21 antidepressant medications and concluded that although these drugs are an effective treatment for depression, some work better than others, and some are better tolerated by the body than others.
One way to improve your chances of finding the depression medication that works best for you is to look for the following signs that your antidepressant isnt working well enough or is no longer working the way it should.
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