Antidepressants are among them most commonly prescribed Taking medicine in the United States.This is partly because of the number of people diagnosed with the disease depression and anxiety already risingand The number of prescriptions has increased dramatically Some age groups during the epidemic.
Despite their popularity, some patients have “serious concerns about their effects,” said Dr. Andrew J. Gerber, a psychiatrist and president and medical director of Silver Mountain Hospital in New Canaan, Conn. misunderstanding”.
about 80% Antidepressants are prescribed by primary care physicians, who do not have extensive training in treating mental illness.
Dr. Paul Nestadt, associate professor of psychiatry at the Johns Hopkins University School of Medicine, said patients tell him, “‘You know, doctor, I’ve tried everything.'” But he said, “They Often there is no answer.” Good dose or they only take it for a week or two. “
Here are some answers to frequently asked questions about antidepressants.
How do antidepressants work?
have Many types of antidepressantsand they all work a little differently.
Overall, they change the way brain cells and different areas of the brain communicate with each other, said Dr. Gerald Sanacola, a professor of psychiatry at Yale University School of Medicine.
Clinical trials show that antidepressants often more effective The incidence of moderate, severe, and chronic depression is higher than that of mild depression. Even so, the effect was modest compared with placebo.
Largest study of multiple antidepressants—nicknamed “ Star*D The trial found that half of the participants improved with the first or second drug they tried, and nearly 70 percent saw their symptoms disappear with the fourth antidepressant.
Unfortunately, there’s no way to know ahead of time how an individual will respond to any particular drug, so it may take a period of trial and error.
More research is needed to better understand how antidepressants work and how effective they are, especially when taken for several years.
How do I know which one to choose?
The most commonly used antidepressants are selective serotonin reuptake inhibitors (SSRIs), such as Prozac or Zoloft, and serotonin-norepinephrine reuptake inhibitors (SNRIs), such as Cymbalta and Effexor.Both types of side effects tend to be worse than those of tricyclic antidepressants such as clomipramine or monoamine oxidase inhibitor Such as phenelzine.
In general, SSRIs and SNRIs work similarly.
But for some people, the differences between these drugs—even those in the same class—don’t feel subtle at all. If one drug doesn’t feel right, there are other options. Experts recommend working with your doctor to find the best option.
How long does it take for antidepressants to work?
A common misconception is that antidepressants are a “quick fix,” said Dr. Kao-Ping Chua, a pediatrician and health policy researcher at the University of Michigan Medical School. “They are absolutely not.”
Experts say that in general, it can take one to two months to start seeing positive results. This assumes you are taking the optimal amount.
Initially, clinicians tended to perform exams more frequently so they could monitor patients.
“Determining the correct dosage may take some time,” Dr. Choi said. If adjusting the dose still doesn’t work, “it may be reasonable to switch to another antidepressant,” he says.
If you are experiencing acute or debilitating symptoms of depression, including thoughts of self-harm, call the Suicide and Crisis Lifeline on 988 for immediate help.
Are side effects inevitable?
No.
unlike older AntidepressantsSSRI, and SNRI drugs generally don’t have many short-term side effects, and if they do, they are usually mild.
Some of the most common symptoms that may appear within a few days of starting the medication include decreased libido, headache, dry mouth, and upset stomach. But experts say many people experience no side effects at all.
Dr. Neistat says short-term side effects usually disappear as your body adjusts to the medication—and you should know which side effects are most likely to persist two to three weeks after starting the medication.
Decreased libido may persist, which could be a “deal-breaker,” he said. At that point, your doctor may try other medications to treat the problem or switch to a different antidepressant.
Long-term use can cause other side effects, including weight gain or emotional dulling.
Finally, antidepressants may interact with other medications. For example, combining SSRIs with ibuprofen can increase the risk of gastrointestinal bleeding. Additionally, drinking alcohol while taking antidepressants is generally not recommended.
Is there anything else I should do besides taking my medication?
Yes.
Therapy remains one of the recommended first-choice treatments for depression. Antidepressants won’t make problems go away, but they can make it easier to cope with them, Dr. Chua said.
Experts say lifestyle changes may also help.research shows exercise Can reduce symptoms of depression.and eat one A heart-healthy diet may be beneficial, although more research is needed on how food affects mood. Too much or too little sleep can also affect how we feel, so it’s important to get enough rest.
Are antidepressants used to treat conditions other than depression?
Yes.
They can also treat chronic pain like shingles and migraines, as well as anxiety, social phobia, post-traumatic stress disorder, and obsessive-compulsive disorder.
What about “black box” warnings?
In 2004, the U.S. Food and Drug Administration issued a “black box” warning that the use of certain antidepressants may be linked to suicidal ideation and behavior in teenagers. Three years later, the warning was expanded to include people aged 18 to 24.
The warning is based on the following analysis: drug trials There were no suicides. However, researchers did find a significant risk of suicidal thoughts. Other research SSRIs found to decrease suicide rate and suicidal behavior In young people, this results in some experts Calls for warnings to be reassessed.
How do I know when to stop taking antidepressants?
Psychiatrists usually recommend that you discuss stopping the medication after at least six months of benefit.
study Research shows that “patients who do well on antidepressants are more likely to experience a relapse of depression if they stop taking their antidepressants,” Dr. Tsai said.
But that’s not the case for everyone, he adds, so talk to your healthcare provider about whether to stop taking your medication.
Psychotherapy may help People successfully stop taking antidepressants.But it’s always important Taper off medication Under the supervision of a physician.
In some cases, if the dose is not tapered slowly enough, patients may experience what are commonly known as “brain shocks” (feeling like electric shocks) or Other side effects, such as nausea. Department of Psychiatry, Columbia University Irving Medical Center.
Slow tapering is especially important for antidepressants with short half-lives like Effexor or Paxil, he added. He added that when patients stop taking such drugs, the amount of the drug in their bodies “decreases very quickly.”
Some people with chronic and recurring depression may need to take antidepressants indefinitely, Dr. Hellerstein said.
It’s generally considered safe, he said, adding that the risk is much greater for people who don’t get treatment.
If you are having suicidal thoughts, please contact the 988 Suicide and Crisis Lifeline by calling or texting 988 or visit TalkingOfSuicide.com/resources Get a list of other resources.go here Get resources outside the United States.
