Antidepressants: Should I Take Them?

White antidepressant pills in round plastic compartments

My Depression Is Not Getting Better

Deciding to take antidepressants is a big decision. It means that you have reached the point in your life where you’re considering the help of a psychotropic medication to alleviate your symptoms. For some, this may be an embarrassing decision to make: the stigma of taking an antidepressant remains locked in their minds.

The stigma of taking antidepressants is not what it once used to be. About 10% of Americans take an antidepressant. But your decision to take one should not be influenced by how many people you know that take them. Even if you do decide to be prescribed to an antidepressant, it does not mean that you have to tell people about it.

It’s no one’s business whether you take psychiatric medications or not. And you should not be ashamed of it if you are! Many people are slowly coming out and revealing their mental struggles with their friends and family. Celebrities are also opening up about their life struggles, mental illnesses and addictions which they have battled throughout their careers.

First things first: have you given yourself a fair shot at getting over your depression naturally? This involves:

  • Talking it out with someone who you trust
  • Exercising and eating healthy on a consistent basis
  • Adopting a good sleep hygiene
  • Getting involved in extracurricular activities
  • Seeing a psychologist or psychiatrist for psychotherapy

If you have tried all of the above and still find yourself trapped in a depressive state of mind, then it’s probably time for you to be prescribed to an antidepressant. There are several classes available:

  • Selective serotonin reuptake inhibitors (SSRIs – currently the most widely used and recommended for major depression)
  • Selective norepinephrine reuptake inhibitors (SNRIs – almost as widely used as the SSRIs)
  • Norepinephrine dopamine reuptake inhibitor (Bupropion: effective for increasing energy in major depression and smoking cessation)
  • Tricyclic antidepressants (TCAs – very effective antidepressants but not as widely used anymore due to potential cardiac side effects)
  • Tetracyclic antidepressants (Mirtazapine: effective for depression with weight loss and insomnia)
  • Monoamine oxidase inhibitors (MAOIs – very effective antidepressants but not as widely used anymore due to interactions with tyramine-rich foods)

As with any medication, antidepressants do have side effects which have to be taken into consideration prior to being prescribed to one. However, not everyone is prone to experiencing the side effects. But on a positive note, they do work very well for depression and anxiety! However, it also takes about 4-6 weeks to see a difference in your mood.

And if you’re considering going on an antidepressant, don’t think that you can now stop the healthy lifestyle and psychotherapy which you were previously doing. Most people experience remission when they combine psychotherapy + antidepressants. And living a healthy lifestyle should always be a given!

If you have given yourself an honest effort at trying to defeat your depression, but still haven’t been able to do so, then it’s probably time to start considering an antidepressant.

Are you Ready? (This is Defeating Stigma Mindfully)

Antidepressants: The Power Of SSRIs

Depressed African American female crying beside bed

Serotonin Rescue

Anxiety and depression are very common mental disorders that can become very debilitating if not properly treated. A common question that many people have is which treatment is best? There is no right or wrong answer; I believe therapy is individualized based on personality and the severity of the illness.

Selective serotonin reuptake inhibitors are a class of antidepressants that are very efficacious at relieving anxious and depressive symptoms. The name says it all: they work by inhibiting the reuptake pump on presynaptic neurons, resulting in more serotonin available in the synaptic cleft.

Let’s break the neuroscience down: you have two neurons (brain cells) lined back to back with some space in between them. That space is called the “synaptic cleft.” Your thoughts are created by these neurons releasing neurotransmitters (brain chemicals) into the synaptic cleft; these neurotransmitters migrate to the next neuron to bind to the receptors, and the process repeats itself. There are millions of these connections in our brain!

The first neuron is called the “presynaptic neuron” because it is “pre or before” the synaptic space and the neuron that follows is called the “postsynaptic neuron”, because it is “post or after” the synaptic space.

The presynaptic neuron, in our case, releases serotonin into the synaptic cleft so it can bind to the postsynaptic neuron. In people with anxiety and depression, it is believed that there is not enough serotonin released, resulting in the uncomfortable symptoms experienced.

On the presynaptic neuron there are pumps that recycle serotonin back into the cell when it is no longer needed. SSRIs block these pumps, allowing the serotonin to float around and increase in quantity; this results in the alleviation of anxious and depressive symptoms.

It takes about 4-6 weeks to start feeling the SSRIs having an effect on your anxiety or depression; they start working immediately in your brain, but the effects take 4-6 weeks to become noticeable. That is why it is very important to take the medication everyday, otherwise, their efficacy goes down. Always talk to you doctor about how to properly take an SSRI!

No one deserves to suffer from the horrific symptoms of anxiety and depression! Your life is worth living and with the proper education and treatment, you can once again take back control of your life!

Are you Ready? (This is Defeating Stigma Mindfully)

Serotonin Syndrome

Dilated pupil secondary to serotonin syndrome

When Serotonin Attacks

Serotonin syndrome can be deadly if not treated in a timely manner. This is a syndrome that occurs when two serotonergic (promoting the release of serotonin in the brain) drugs or medications are combined. Onset is usually within a day of when the extra serotonin is made available in the brain. Common drugs and medications include:

  • Selective Serotonin Reuptake Inhibitors (SSRIs – antidepressant)
  • Serotonin Norepinephrine Reuptake Inhibitors (SNRIs – antidepressant)
  • Monoamine Oxidase Inhibitors (MAOIs – antidepressant)
  • Tricyclic Antidepressants
  • Amphetamines (stimulants)
  • Tramadol (opioid pain medication)
  • Dextromethorphan (cough suppressant)
  • Buspirone (antidepressant)
  • St. John’s Wort (herb with antidepressant properties)
  • Ecstasy or MDMA
  • Cocaine

The symptoms include:

  • High body temperature
  • Agitation
  • Myoclonus
  • Increased reflexes
  • Tremors
  • Sweating
  • Dilated pupils
  • Diarrhea

Complications include:

  • Seizures
  • Muscle breakdown
  • Death

Treatment involves stopping the medications, benzodiazepines for agitation or a serotonin antagonist such as Cyproheptadine. When body temperature is extremely elevated, active cooling measures are needed. With appropriate treatment, the risk of death is < 1%. It is important that everyone is educated on medical conditions that can be caused by psychiatric medications.

Are you Ready? (This is Defeating Stigma Mindfully)