What you should know about antidepressants

Depression is a common disease, found in 10% to 14% of patients who visit a physician’s office. A frequent treatment for depression is to prescribe antidepressants. Between 1995 and 2002, the use of antidepressants doubled in the United States.

How antidepressants work

The most commonly prescribed type of antidepressant is called serotonin reuptake inhibitors, or SSRIs. These work by stopping the brain from reabsorbing serotonin, a chemical in the brain that helps with feelings of well-being and happiness and helps with thinking, memory, sleep, digestion and circulation. When the brain is prevented from reabsorbing this chemical, it leaves more serotonin available in the brain, improving the user’s mood. Some brand-name SSRIs include ZOLOFT^®, Prozac^®, Celexa^® and Lexapro^®.

Other types of antidepressants include serotonin-norepinephrine reuptake inhibitors, or SNRIs, which increase the level of serotonin and norepinephrine created by the brain and block the brain’s ability to reabsorb the chemicals. Benzodiazepines are often prescribed for short-term anxiety management. Tricylic antidepressants and ketamine are other older types of antidepressants.

All these medicines work to elevate the mood of the user. For reasons doctors do not yet know, some patients respond better to one type of antidepressant than another. In fact, some people need to try several antidepressants before they find the one that works best.

Use care with antidepressants

Whether you take an antidepressant for a long time or are just starting, it is crucial to take them as instructed and not change the dosage without consulting your doctor. You might feel better while taking the antidepressant, assume the depression has lifted and stop taking the medication. The depression may return if this happens.

Remember, antidepressants work by altering the chemistry in the brain. They are powerful drugs. When it is time to stop – or change – a doctor will help the patient safely and slowly reduce the dosage. Patients can’t become addicted to antidepressants, but the body needs time to adjust to the changes. Ending medication suddenly can cause withdrawal symptoms.

The most common side effects from antidepressants include:

• Nausea and vomiting
• Weight gain
• Diarrhea
• Sleepiness
• Sexual problems

Contact a doctor immediately if you have thoughts about suicide or dying, worsening depression or anxiety, panic attacks, insomnia, aggressive behavior, mania or other unusual changes in behavior or mood.

Antidepressants are often paired with talk therapy. GEHA medical plan members have access to telebehavioral health services though MDLIVE. Licensed therapists are available by appointment via secure video. You can activate your MDLIVE account online or by calling 888.912.1183.

If you or someone you know is feeling suicidal, call the toll-free, 24-hour hotline of the National Suicide Prevention Lifeline at 800.273.TALK (800.273.8255); TTY: 800.799.4TTY (800.799.4889).

Sources:
“SSRIs and Benzodiazepines for General Anxiety Disorders (GAD).” www.adaa.org Anxiety and Depression Association of America, 18 June, 2020.
“Mental Health Medications.” nimh.nih.gov National Institute of Mental Health, October, 2016.
“Pharmacologic Management of Adult Depression.” www.aafp.org American Academy of Family Physicians, 15 March 2008