I’ve been prescribed an antidepressant, but how is it helping me?

If you are using medication to help treat your depression, you are most likely on an antidepressant. A common antidepressant is a class of medications called selective serotonin reuptake inhibitors (SSRIs). What exactly are these medications? And how do they help? Dr. Alex Stolyar, Assistant Professor of Psychiatry, Harvard Medical School and Principal Investigator in Psychiatry at Boston Clinical Trials shared an article with us that investigates the specifics of SSRIs.

How do SSRIs work?  

SSRIs treat depression by increasing levels of serotonin in the brain. Serotonin is one of the chemical messengers (neurotransmitters) that carry signals between brain nerve cells (neurons).

SSRIs block the reabsorption (reuptake) of serotonin into neurons. This makes more serotonin available to improve transmission of messages between neurons. SSRIs are called selective because they mainly affect serotonin, not other neurotransmitters.

SSRIs may also be used to treat conditions other than depression, such as anxiety disorders.

What are some common brands of SSRIs?

The Food and Drug Administration (FDA) has approved these SSRIs to treat depression:

  • Citalopram (Celexa)
  • Escitalopram (Lexapro)
  • Fluoxetine (Prozac)
  • Paroxetine (Paxil, Pexeva)
  • Sertraline (Zoloft)

What are some of the side effects of these medications?

All SSRIs are thought to work in a similar way and generally can cause similar side effects, though some people may not experience any. Many side effects may go away after the first few weeks of treatment, while others may lead you and your doctor to try a different drug.

If you can’t tolerate one SSRI, you may be able to tolerate a different one, as SSRIs differ in their potencies at blocking serotonin reuptake and in how quickly the body eliminates (metabolizes) the drug.

Possible side effects of SSRIs may include, among others:

  • Nausea, vomiting or diarrhea
  • Headache
  • Drowsiness
  • Dry mouth
  • Insomnia
  • Nervousness, agitation or restlessness
  • Dizziness
  • Sexual problems, such as reduced sexual desire, difficulty reaching orgasm or inability to maintain an erection (erectile dysfunction)
  • Impact on appetite, leading to weight loss or weight gain

Taking your medication with food may reduce the risk of nausea. Also, as long as your medication doesn’t keep you from sleeping, you can reduce the impact of nausea by taking it at bedtime.

Which antidepressant is best for you depends on a number of issues, such as your symptoms and any other health conditions you may have.  Ask your doctor and pharmacist about the most common possible side effects for your specific SSRI and read the patient medication guide that comes with the prescription.

How do I find the right medication for me?

People may react differently to the same antidepressant. For example, a particular drug may work better — or not as well — for you than for another person. Or you may have more, or fewer, side effects from taking a specific antidepressant than someone else does.

Inherited traits play a role in how antidepressants affect you. If you have a close relative who responded to a particular antidepressant, tell your doctor, because this could be a good drug choice to start.

In some cases, results of special blood tests, where available, may offer clues about how your body may respond to a particular antidepressant. However, other variables can affect your response to medication.

When choosing an antidepressant, your doctor takes into account your symptoms, any health problems, other medications you take and what has worked for you in the past.

Typically, it may take several weeks or longer before an antidepressant is fully effective and for initial side effects to ease up. Your doctor may recommend some dose adjustments or different antidepressants, but with patience, you and your doctor can find a medication that works well for you.

Occasionally increasing the dose of one medication may not be enough. Ask yourself: “Do I feel full of pep? Do I have energy to complete daily tasks at work or at home? Do I look forward to socializing with friends and family and enjoying activities as I did before?”

If the answer is no, you may have a Treatment Resistant Depression and need to discuss it with your doctor.

Boston Clinical Trials is specializing in conducting clinical trials for treatment resistant depression. Sign up here to receive more information about ongoing and upcoming paid depression studies.

Material for this blog was taken from the following article: https://www.mayoclinic.org/diseases-conditions/depression/in-depth/ssris/art-20044825