How do antidepressants work?
Antidepressants help to restore the chemical balance in the brain. Specifically, these medications target neurotransmitters, such as serotonin and norepinephrine, that affect mood. Antidepressants help to improve mood and can help decrease symptoms of anxiety. Sometimes, anxiety can either be the result of depression, or can cause depression. One disorder may cause symptoms of the other disorder to worsen. By helping to lift mood, these medications can help to break the cycle of depression and anxiety. Besides depression and anxiety, antidepressants are also sometimes used to treat premenstrual syndrome (PMS), chronic pain disorders, such as fibromyalgia, and eating disorders.
Are all antidepressants the same?
There are several types of antidepressants:
Selective serotonin reuptake inhibitors (SSRIs)
Examples: Zoloft, Paxil, Prozac
Examples: Elavil, Sinequan, Tofranil, Anafranil
Monoamine Oxidase Inhibitors (MAOIs)
Examples: Marplan, Parnate
Examples: Wellbutrin, Effexor, Desyrel, Remeron
Each of these types of medications works differently.
Today, most antidepressants prescribed are SSRIs. However, all of these medications will work differently and each person reacts to medication differently, so there is no "right" or "wrong" medication. Many times, it is a matter of trial and error to find the right medication and the right dosage for you.
How long do I need to take antidepressants before seeing improvement?
Most of the time, antidepressants begin to work between two and six weeks after a person has begun to take them. Usually, symptoms such as insomnia or loss of appetite begin to improve first.
Improvements in both mood and energy should begin to appear by the time you have been taking the medication for six weeks. If you do not feel any improvement after six weeks, you should speak with your doctor. He or she may want to adjust your dosage.
What should I do if I forget to take a dose?
If you forget to take a dose, you should ignore the dose and take the next dose at the normal time. You should not double up or take two doses close together without first speaking with your doctor.
Can I drink alcohol while taking antidepressants?
In some people, mixing alcohol and antidepressants can cause dangerous interactions or the effect of the alcohol could be intensified. Some people may feel more depressed or cause the medication to not work, bringing back symptoms of depression. Certain types of antidepressants (MAOIs) can cause serious complications when combined with alcohol. It can create a spike in blood pressure and possible stroke. You should speak with your doctor if you intend to drink alcohol while taking these medications.
Since antidepressants are dependent on taking steady amounts over a period of time in order to be effective, you can't just skip a dose in order to drink alcohol. It can be dangerous to start and stop your medication. If you plan to continue drinking alcohol, talk with your doctor before beginning antidepressants.
What other medications can I take while taking antidepressants?
Your doctor should be aware of all other medications you may be taking, including prescription, over-the-counter and supplements. Although most medications are safe to take along with antidepressants, your doctor would be the best person to determine if there may be the possibility of dangerous interactions when combining medications.
Can I just stop taking antidepressants when I feel better?
Normally, you will begin to feel better after several weeks of taking antidepressants. You should continue to take your medication. Stopping may cause your symptoms to return.
Some medications must also be stopped gradually and can cause symptoms of withdrawal if stopped suddenly. Symptoms of withdrawal can include dizziness, restlessness, fatigue, crying spells and extreme mood swings. Always talk with your doctor before stopping these types of medications. Weaning off antidepressants can take several months and should always be supervised by a doctor. Normally, your doctor will have you reduce your dosage slightly every one to two weeks until you are completely off the medication.
What are some of the side effects of antidepressants?
Most people tolerate antidepressants without experiencing too much discomfort from side effects. If they do experience side effects, they are usually mild. Side effects can include problems with sleeping, drowsiness, nausea, and sexual side effects. Often side effects will disappear after taking the medication for a few weeks. If you are experiencing side effects that are interfering with your daily activities, talk with your doctor. He or she may suggest adjusting your dosage or trying a different medication.
"Antidepressants and Alcohol: What is the Concern?", 2009, July 24, Daniel K. Hall-Flavin, M.D., Mayo Clinic
"Antidepressant Medication", 2005, Author Unknown, Aetna, Inc.
"Antidepressant Medications for Depression", 2008, July 7, Staff Writer, HealthPlace.com