Depression is an illness caused by a combination of factors: genetic, biochemical, environmental and psychological. Frequently, the neurotransmitters used by brain cells are imbalanced, which in turn affects mood, thought, sleep, appetite and behavior. Anti-depressants, the medications used to treat depressive illness, rebalance these neurotransmitters, though the exact process by which this happens is not fully understood.
SSRIs
SSRI stands for Selective Serotonin Reuptake Inhibitor. SSRIs block the reabsorption of the neurotransmitter serotonin in the brain. The increased amount of serotonin allows neurotransmission to occur more effectively and in turn, improve mood and reduce depressive symptoms. Common brands are Prozac (fluoxetine), Celexa (citalopram), Lexapro (escitalopram), Paxil (Paroxetine) and Zoloft (sertraline).
SNRI
SNRI stands for serotonin and norepinephrine reuptake inhibitor. SNRIs prevent the reabsorption of both serotonin and norepinephrine in the brain. This allows for enhanced neurotransmission and in turn, improves mood and reduces depressive symptoms. Common brands are Effexor (venlafaxine) and Cymbalta (duloxetine).
NDRI
NDRI stands for norepinephrine and dopamine reuptake inhibitors. NDRIs stop the reabsorption of the neurotransmitters norepinephrine and dopamine in the brain. This causes increased effectiveness of the neurotransmitters and elevates mood. NDRIs should not be taken at the same time as any MAOIs or as Zyban. The most common brand of NDRI is Wellbutrin (bupropion).
TCA
TCA stands for tricyclic antidepressants. These medications limit the reabsorption of serotonin, norepinephrine, and to some extent dopamine in the brain. TCAs were among the first antidepressants developed and have many side effects because they block cell receptors beyond those of the SSRIs, SNRIs, and NDRIs. Common TCA brands include Amitriptyline, Amoxapine, Norpramin (Desipramine), Sinequan (Doxepin), Tofranil (Imipramine), Pamelor (Nortripytline), Vivactil (Proptriptyline), and Surmontil (Trimipramine).
MAOI
MAOI stands for monoamine oxidase inhibitor. MAOIs were the first . MAOIs work by increasing the amount of norepinephrine, serotonin, and dopamine in the brain. MAOIs can cause serious side effects, and are usually prescribed after other antidepressant medications have failed. MAOIs have dangerous interactions with specific foods and beverages, especially those containing tyramine. MAOIs also can have dangerous interactions with other antidepressants, tramadol, meperidine, over the counter decongestants, ST. John's wort, and herbal weight loss products. Common brands of MAOIs include Nardil (Phenelzine), Parnate (Tranylcypromine), Marplan (Isocarboxazid), and Emsam (Selegiline).
Warning
Most anti-depressants take at least three to four weeks before therapeutic effects are felt. Even if a patient feels the depression lift, it is necessary to continue to take the medication for the time specified by the doctor. Antidepressants are not habit forming or addictive, but patients may experience withdrawal symptoms after cessation. Patients often reduce their dose incrementally under doctoral supervision, before stopping. Other patients may remain on anti-depressants indefinitely, especially those who have chronic or recurrent depressive episodes. In some people, antidepressants cause an increased risk of suicide. These medications should only be taken under supervision of a physician.
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