by Marcelle Pick, OB/GYN NP
A list of antidepressants and their side effects
Depression includes a wide range of normal negative emotions and often manifests physically in symptoms that won’t respond to treatment, including but not limited to weight gain, chronic pain, and digestion disorders. But clinical depression differs significantly from minor or situational depression or mood disorders, even though the symptoms can be the same. How can you tell which you have? The difference is that in mild depression the symptoms ebb and flow and eventually lift, while in major depression they spiral down into a full-blown mental health crisis. Patients often describe the sense that they are on the edge of, or slipping into, a deep, dark hole. If you’ve been feeling any of the following symptoms consistently for over a month, you should immediately seek medical advice, preferably from a trained psychiatrist, psychologist, or social worker.
- Overwhelming, persistent feelings of grief, anxiety, guilt, or despair
- A sense of numbness or hollowness
- Feelings of hopelessness
- A loss of interest or pleasure in activities that you once enjoyed, including sex
- Decreased energy
- Difficulty concentrating or making decisions
- Disrupted sleep patterns
- Loss of appetite
- Suicidal thoughts or attempts and obsessing about death—these are serious warning signs that need to be addressed immediately
If this sounds like you, please don’t worry. You can get better. Depression is a physical and mental condition that responds very well to treatment, both conventional and integrative. The most important thing is to get some help. You may be asked to take medication as part of your treatment plan. If so, then you’ll want to know what some of these are, so you can help choose what’s best for you. Following is a list of the many antidepressant medications that are used in conventional medicine. The listing is not comprehensive as the medications change rather quickly with new ones coming out all the time but it will let you know the medications used for depression and their biochemical family. Some side effects of antidepressants are listed below, just look for the headings for the various types of antidepressants. Many side effects can occur even with short-term use. Relatively little is known about the long-term effects of most drugs for depression as they were never studied for long term use, or their interactions with other drugs. For a more comprehensive discussion about antidepressants, or if you’re curious about natural alternatives to antidepressants, be sure to read our articles on antidepressants and alternative treatments for depression.
Common Antidepressant Medications
These drugs have been around for a long time and they affect norepinephrine and serotonin. They are as effective as SSRIs in many people, but they do have a much stronger side effect profile. Thus they are usually suggested as a second or third level option of treatment. Some of the common side effects of include dry mouth, constipation, bladder problems, sexual dysfunction, blurred vision, dizziness, drowsiness, and increased heart rate.
Monoamine oxidase inhibitors (MAIO) are really helpful for some people, with major depression, who don’t react to other antidepressants. They can also use to treat panic disorder and bipolar depression. People who take MAOIs have many things to remember as they have to avoid taking decongestants and eating many foods that contain high levels of the monoamine tyramine, including fish, chocolate, and fermented foods (such as alcoholic beverages, cheeses, soy sauce, processed meats, and pickles).There are also many vitamins and nutrients that can interact with MAOIs. So if you are on an MAOI remember to read labels of the interactions. One of the most notably interactions of tyramine with MAOIs is they can bring on a sharp increase in blood pressure that can lead to a stroke.
The side effects of serotonin reuptake inhibitors (SSRI) include sexual dysfunction, nausea, nervousness, insomnia, agitation, and decreased sweating with increased body temperature. These side effects may be enhanced when an SSRI is combined with other medications or herbs that affect serotonin (such as St. John’s Wort and SAM-e). There are many people however, that do very well with these herbs, just remember that we are all different with different reactions. In extreme cases, the combination of medications (for example, an SSRI and an MAOI) may result in a potentially serious or even fatal serotonin syndrome, characterized by fever, confusion, muscle rigidity, and cardiac, liver, or kidney problems.
There are new classes of antidepressants being developed and being made available for use. Classifying them is not always clear, because of their combined biochemical action. One of the new classes is serotonin/norepinephrine reuptake inhibitors (SNRI), such as the tricyclics. This class of drugs affects both norepinephrine and serotonin levels but has a fewer side effect profile.. SNRIs include Effexor (venlafaxine) and Serzone (nefazadone). Cases of life-threatening liver failure have been reported in patients treated with Serzone, and this trade name was actually discontinued in 2003; however, the generic version of Serzone (nefazodone) remains available. Some of this is probably related to a genetic SNP affecting how drugs are detoxified by the liver. Patients should call their doctor if they have the following symptoms of liver dysfunction: yellowing of the skin or whites of the eyes, unusually dark urine, loss of appetite that lasts for several days, nausea, severe lethargy or abdominal pain. In addition, there are other new medications that are not chemically related to the other antidepressants, however, they have similar side effects to SSRIs. These include Remeron (mirtazepine) and Wellbutrin (bupropion). These drugs must not used by anyone who has, or might be at risk for, seizure disorders.