Buspirone® is used in the treatment of anxiety disorders and for short-term relief of the symptoms of anxiety.

Paxil® is used to treat depression, panic attacks, obsessive compulsive disorders (OCD), social anxiety disorder (social phobia), and generalized anxiety disorder.

Lexapro® is prescribed for major depression.

Celexa® is used to treat major depression.

Generic Prozac® (Fluoxetine) is used to treat depression, bulimia, obsessive compulsive disorders (OCD), and severe symptoms of premenstrual syndrome (premenstrual dysphoric disorder-PMDD).

BuSpar® is used in the treatment of anxiety disorders and for short-term relief of the symptoms of anxiety.

Zoloft® is prescribed for major depressive disorder. Zoloft® can also be used for the type of depression called premenstrual dysphoric disorder (PMDD). In addition, Zoloft® is used in the treatment of obsessive-compulsive disorder. It is also prescribed for the treatment of panic disorder and for posttraumatic stress.

Antidepressants

Antidepressant drugs are not happy pills, and they are not a panacea. They are prescription-only drugs that come with risks as well as benefits, and should only ever be taken under a doctor’s supervision. They are, however, one treatment option. Taking medication is not a sign of personal weakness — and there is good evidence that they do help.

Whether medication is the best treatment option depends on how severe the person's depression is, their history of illness, their age (psychological treatments are usually the first choice for children and adolescents), and their personal preferences. Most people do best with a combination of medication and therapy.

For adults with severe depression, says Dr Petros Markou, there is strong evidence that antidepressants are more effective than any other treatment. If depression is mild or moderate, psychotherapy alone may be sufficient, though even in this case, short-term drug treatment or herbal therapy can help people get to the point where they can engage in therapy and get some exercise (which is also thought to help improve mood).

"How do I get better? Well certainly for me in recent years it has been through drug therapy - mainly in the beginning, because I think it’s very hard to get into all that positive thinking and raise your self esteem and all those things that you’re supposed to do, if the mood is so low you can’t even think at all. So to take anti-depressants, and most of them are very good, they do help me to shift the mood and then work on other therapies, and work with other people that know how I feel, and all of those things that will, I know, in the end make me feel better and put that Black Dog at bay." Leonie Manns, Life Matters 4 May 2000

Which antidepressant?

There are several different kinds of antidepressant drugs, which work in different ways. The most famous are the Prozac family of drugs, or the selective serotonin reuptake inhibitors (SSRIs). Older drugs include the tricyclic antidepressants and the monamine oxidase inhibitors (MAOIs); the newest are the serotonin and noradrenaline reuptake inhibitors (SNRIs). A popular herbal antidepressant is St John's Wort, or Hypericum (see alternative treatments). Many of the older antidepressants are cheaper and just as effective as the newer ones. SSRIs have become popular partly because they are safer when taken in overdose. It is hard to predict which particular medication will work best, and have the fewest side effects, for any individual. In choosing which to try first, a doctor might try and match the patient's particular symptoms with the side-effect profile of the drug — for example, if sleeping too much is a problem, you wouldn't choose one with drowsiness as a side-effect. That being said, the side effects as measured on a group of people in a clinical trial won't necessarily match the individual's reaction. "It just gives you an idea of the probability of different side effects," says pscyhiatrist Dr Petros Markou. "Beyond that, finding the right drug for the individual is a process of trial and error." Antidepressants usually take a while to start working — at least a couple of weeks. A two-week break is necessary between finishing one drug and starting another (see risks). Some kinds of antidepressants should not be stopped suddenly — instead, the dose should be reduced gradually, to minimise side effects like dizziness.

Drug facts

Selective serotonin reuptake inhibitors (SSRIs) eg Prozac (fluoxetine), Cipramil (citalopram), Aropax (paroxetine), Zoloft (sertraline) Work by slowing down reabsorption of the neurotransmitter serotonin in the gaps between the nerve cells Side effects* nausea, agitation, insomnia, drowsiness, tremor, dry mouth, diarrhoea, dizziness, headache, anxiety, weight gain or loss, loss of libido, rash

Serotonin and noradrenaline reuptake inhibitors (SNRIs) Only Efexor (venlafaxine) Works by slowing down the reuptake of both serotonin and noradrenaline, but more selectively than other drugs Side effects* nausea, vomiting, anorexia, headache, rash, anxiety, dizziness, fatigue, high blood pressure, tremor

Tricyclic antidepressants eg Tofranil (imipramine), Pertofran (desipramine), Deptran (doxepin) Work by slowing down reuptake of serotonin and noradrenaline, but also have other effects on the nervous system Side effects* drowsiness, dry mouth, blurred vision, constipation, weight gain, low blood pressure after getting up, urinary problems, impotence, loss of libido, tremor, dizziness, agitation, insomnia

Reversible monamine oxidase inhibitors Only Aurorix, Arima (moclobemide) Work by blocking the action of monoamine oxidase enzymes, but not permanently Side effects* nausea, dry mouth, constipation, diarrhoea, anxiety, restlessness, insomnia, dizziness, headache

Monamine oxidase inhibitors (MAOIs) eg Nardil (phenelzine), Parnate (tranylcypromine) Work by increasing concentrations of adrenaline, noradrenaline, dopamine and serotonin but in a roundabout way - by blocking the action of the enzymes (monoamine oxidase A and B) that break them down Side effects* low blood pressure after getting up, sleep disturbances, drowsiness, fatigue, weakness, tremors, twitching, constipation, dry mouth, weight gain, impotence, loss of libido. Dietary restrictions Matured cheeses, yeast extracts such as Vegemite and Promite, beer, chianti wine, and herrings have to be avoided, and bananas, avocadoes, other wines, and spirits must be limited. MAOIs are not usually given as a first-try treatment.

What are the risks?

As well as the side effects that may come with particular drugs (see box above), some people have been reported to have an extreme reaction to antidepressants, including suicidal tendencies. Studies have shown that there is a greater risk of suicide in the first few days after starting treatment with antidepressants compared to a person who has been on antidepressants for a few months. This is probably because there is a lag period before the antidepressant starts to take effect and during this time, a person is more likely to suicide because of their depression.

Someone on antidepressants should be monitored carefully by their doctor, and friends and family can also help watch out for warning signs, especially in the first days and weeks of treatment. It's thought that adolescents may be particularly at risk of suicide when on antidepressants, so they are not recommend for use with young people.

Another risk of antidepressants is serotonin syndrome, a drug reaction resulting from the over-stimulation of serotonin receptors. This can occur when an antidepressant is taken either with another antidepressant, with certain recreational and other drugs (see below), or more rarely, even when one antidepressant is taken alone. Symptoms include hyperactivity, mental confusion, agitation, shivering, sweating, fever, lack of coordination, seizure, and diarrhoea.

To minimise the risk of serotonin syndrome, there must be a 'washout' period of at least two weeks when switching from one antidepressant drug to another.

Drugs that may induce serotonin syndrome when taken with antidepressants (not a complete list)

ecstasy (MDMA) cocaine lithium

St John's wort (Hypericum) - herbal antidepressant diethylproprion - an amphetamine dextromethorphan - found in many cough suppressants Buspar (buspirone) - for anxiety Selgene, Eldepryl (selegiline) - for Parkinson's Disease anti-epileptics - Tegretol, Carbium, Teril (carbamazepine) analgesics - pethidine, Fortral (pentazocine), Tramal (tramadol), fentanyl anti-migraine drugs - Naramig (naratriptan), Imigran (sumatriptan), Zomig (zolmitriptan) appetite suppressants - phentermine and fenfluramine tryptophan - an amino acid

People with bipolar disorder (manic depression) are often prescribed antidepressants during a depressive episode ('down' cycle), but care must be taken as this can sometimes induce mania (an 'up' cycle). Other drugs are also used for manic depression, such as lithium and anti-epileptic drugs (which also work as mood stabilisers).

Keywords: Antidepressant Medications, List Antidepressants, Tricyclic Antidepressants, Antidepressant Drugs, New Antidepressants, Natural Antidepressants, Side Effects, Antidepressants Pregnancy

An antidepressant is a medication designed to treat or alleviate the symptoms of clinical depression. Some antidepressants, notably the tricyclics, are commonly used off-label in the treatment of neuropathic pain, whether or not the patient is depressed. Smaller doses are generally used for this purpose, and they often take effect more quickly. Many antidepressants also are used for the treatment of anxiety disorders, and tricyclic antidepressants are used in the treatment of chronic pain disorders such as chronic functional abdominal pain (CFAP), myofascial pain syndrome, and post-herpetic neuralgia.