What You Should Know Before Taking Antidepressants

Medication can help millions of people who struggle with depression, according to the U.S. Food and Drug Administration.

Depression affects some 350 million people worldwide. It’s a serious illness and a major cause of disability. But its symptoms can be mistaken for other health issues and some people are afraid to seek help, the FDA said.

Not everyone with depression needs medicine, the agency said. But drugs used to treat it — antidepressants — can help ease symptoms, such as:

• Depressed mood,
• Loss of interest in normally enjoyable activities,
• Changes in appetite or weight,
• Trouble sleeping or sleeping too much,
• Loss of energy or fatigue,
• Restlessness,
• Feelings of worthlessness or excessive guilt,
• Problems thinking, focusing or making decisions,
• Thoughts of death or suicide.

Doctors consider these symptoms — as well as a patient’s medical history, behavior and mental status — to diagnose depression and rule out other health issues, including thyroid disease and Parkinson’s disease.

Doctors should also evaluate patients for bipolar disorder, which can cause major mood swings. Giving antidepressants to someone with bipolar disorder could lead to psychosis, according to the FDA.

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Antidepressants help treat depression by changing brain chemicals called neurotransmitters — such as serotonin, norepinephrine and dopamine — that help regulate mood.

• Selective serotonin reuptake inhibitors (SSRIs), including Prozac (fluoxetine), Celexa (citalopram) and Paxil (paroxetine),
• Serotonin norepinephrine reuptake inhibitors (SNRIs), including Effexor (venlafaxine) and Cymbalta (duloxetine),
• Tricyclic antidepressants (TCAs), including Elavil (amitriptyline), Tofranil (imipramine) and Pamelor (nortriptyline),
• Monoamine oxidase inhibitors (MAOIs), including Nardil (phenelzine) and Parnate (tranylcypromine),
• Other antidepressants include Remeron (mirtazapine) and Wellbutrin (buproprion).

“Some evidence shows that the most effective way to treat many patients with depression is through both talk therapy and prescribed antidepressant medication,” Dr. Mitchell Mathis, director of the FDA’s division of psychiatry products, said in an agency news release.

Taking antidepressants may cause complications, including birth defects and high blood pressure. Other possible side effects include:

• Nausea and vomiting,
• Weight gain,
• Diarrhea,
• Sleeping problems,
• Sexual problems.

It’s important for patients to work with their doctor to find the best treatment for them, Mathis said.

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But medication won’t ease depression overnight, the FDA cautioned. Most patients must take their prescribed drugs for several weeks before they fully take effect.

And people who take antidepressants should not stop without talking to their doctor first — even if they feel better. Suddenly discontinuing this medicine could cause depression to return or lead to withdrawal symptoms, such as anxiety and irritability, according to the FDA.

The FDA requested drug makers to put a warning label on these drugs about the increased risk of suicidal thinking or behavior when children, teens and young adults up to age 24 start treatment or their dosage increases.

If you have suicidal thoughts or know someone who does, or you observe suicidal behaviors, seek immediate medical help. Or call the confidential and toll-free National Suicide Prevention Lifeline at 800-273-TALK (8255).