Antidepressant medicines

What are antidepressants?

Antidepressants are medicines that treat depression and its symptoms. There are several different types of antidepressants, including:

  • selective serotonin reuptake inhibitors (SSRIs);
  • serotonin and noradrenaline reuptake inhibitors (SNRIs);
  • tricyclic antidepressants (TCAs);
  • monoamine oxidase inhibitors (MAOIs);
  • reversible inhibitors of monoamine oxidase (RIMAs);
  • noradrenaline-serotonin specific antidepressants (NASSAs); and
  • noradrenaline reuptake inhibitors.

Antidepressant medicines are not stimulants or 'uppers', they do not change your personality and they are not addictive. They reduce the symptoms of depression by correcting chemical imbalances in the brain. Each class, or type, of antidepressant works on brain chemistry in a different way.

When antidepressants are used properly, they can be extremely effective in treating depression and helping depressed people feel like themselves again.

Antidepressant medicines are also used in the treatment of anxiety disorders and bulimia nervosa, and sometimes in the treatment of chronic pain.

Do antidepressants work?

Antidepressants are usually used to treat moderate to severe depression. Doctors estimate that 50 to 70 per cent of people who have major depression are helped by initial antidepressant medication.

Talk to your doctor if you have been experiencing a recent loss of pleasure in your usual activities, or have other symptoms of depression such as:

  • restless sleep;
  • waking very early in the morning;
  • loss of appetite; or
  • feelings of hopelessness or guilt.

Are antidepressants suitable for me?

If your doctor believes antidepressants will be likely to help you, he or she will assess your symptoms based on a number of factors, some of which are:

  • how severe your depression is;
  • your past medical history;
  • your current medical problems and medicines being taken;
  • whether any antidepressant medicines have worked for you in the past; and
  • the side effects you might be likely to experience.

It is very important that you follow your doctor’s instructions so that you have the best chance of a full recovery. He or she might tell you that you need to take antidepressants for what appears to be a long time – usually at least 6 to 12 months. You should follow this advice, and do not stop taking the medicine as soon as you begin to feel better. Your symptoms may return if you stop the medicine before your doctor recommends.

What if I don’t want to take antidepressants?

Depression is a serious illness, and without appropriate treatment it can have a serious impact on your health. In severe cases depression can be life-threatening.

Doctors often prescribe psychological treatment in conjunction with antidepressants for the treatment of depression. For people with mild or moderate depression, psychological treatment alone may be appropriate. Your doctor will discuss with you the most appropriate treatment for you based on your symptoms and past history.

How soon will I feel better?

It will probably be one to 2 weeks after starting the medicine before you begin to feel better, so do not be discouraged if things do not improve straight away. It may take 6 weeks or longer for you to feel the full benefit of antidepressant treatment. Also, some of your symptoms might get better sooner than others — if you have sleeplessness, for example, this might go away before your mood improves.

If you think your antidepressant medicine is not working for you, see your doctor. It’s important that you don’t just stop taking your antidepressants, because stopping abruptly can make you feel agitated and unwell. Antidepressants generally need to be stopped slowly by gradually reducing the dose.

If the first antidepressant you are prescribed doesn’t work for you, your doctor may recommend you try a different type. To avoid interactions between the different antidepressants, you may have to wait a couple of days to 2 weeks before starting your new antidepressant, depending on the medicines used. Some people may need to try several different medicines before they find the one that works for them.

Last Reviewed: 19 December 2012
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References

1. Treatment of depression (revised October 2008). In: eTG complete. Melbourne: Therapeutic Guidelines Limited; 2012 Nov. http://online.tg.org.au/complete/ (accessed Dec 2012).
2. SANE Australia. Antidepressant medication (updated 2010). http://www.sane.org/information/factsheets-podcasts/200-antidepressant-medication (accessed Dec 2012).
3. BeyondBlue. Depression: Antidepressant medical treatment (updated 6 July 2010). http://www.beyondblue.org.au/index.aspx?link_id=89.581 (accessed Dec 2012).
4. Drugs.com. Understanding antidepressant medications (updated 9 Jan 2009). http://www.drugs.com/fda-consumer/understanding-antidepressant-medications-73.html (accessed Dec 2012).
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