Antidepressants are a type whose function, broadly speaking, is to cheer up individuals with depression. During depression, some neurotransmitters such as noradrenaline or serotonin that elevate mood and excitement seem to be in short supply; Most antidepressants act by increasing the availability of these neurotransmitters (Myers, 2006).
For example, one of the most famous antidepressants, Fluoxetine, better known as Prozac, operates by partially blocking the reuptake and elimination of serotonin. Because it slows down the synaptic serotonin gap, this drug and its relatives (sertraline and paroxetine) are called Selective Serotonin Reuptake Inhibitors or SSRIs. These second-generation drugs are typically as effective as tricyclics in treating moderate depression and safer for people with glaucoma and overdose (Myers, 2006; Gross, 2005).
Other antidepressants, tricyclic such as imipramine and amitriptyline, appear to operate by blocking the reuptake of dopamine and norepinephrine, but some also block the reuptake of serotonin, others only block serotonin, and a third group has no known effects on any of the three systems. The name of this type of antidepressant is due to the fact that its basic chemical structure includes three carbon rings. They are effective in the treatment of moderate and severe depression and are usually the first option in case of severe depression.
Although tricyclics are as effective as SSRIs, they tend to cause more side effects such as weight gain, dizziness, dry mouth, hypertension or toxic effects on the cardiovascular system; That is why they are sometimes chosen to be administered through a patch, since it prevents it from passing through the intestines and liver and they are also being gradually replaced by modified tricyclics such as lofrepamine and trazedone, which cause fewer side effects (Myers, 2006; Gross , 2005).
A third type of antidepressants, Monoamine oxidase inhibitors (MAOI), like iproniazid, work by inhibiting an enzyme responsible for breaking down neurotransmitters. Iproniazid was originally used to treat tuberculosis in 1952 and was noted to elevate patients’ mood. This is because this drug and other similar drugs (such as phenelzine) inhibit the activity of an enzyme known as Monoamine Oxidase (MAO) and thus increases the activity of neurons that use norepinephrine and serotonin.
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MAOIs are generally less effective than tricyclics for treating severe depression and just as effective for moderate depression. They are rarely prescribed because they can have serious side effects, such as brain hemorrhages, and dangerous interactions with other drugs and some foods (Gross, 2005).
Another side effect of antidepressants is that they can cause sexual dysfunction, although some suggest that regular exercise can help with this problem.
It is important to know that, although antidepressants begin to act on neurotransmitters in just a few hours, the psychological effects can take 4 weeks (Gross, 2005).
Antidepressants are also often used to treat other conditions such as , the and the (although their ). Additionally, it is sometimes used to treat secondary or postpsychotic depression in schizophrenic patients (Lieberman, Stroup, & Perkins, 2010).
When withdrawing the drug, it should be done slowly, otherwise it can cause insomnia, nausea, anxiety and restlessness (Gross, 2005).
There are researchers who studied the effect of the drug and compared it with the placebo effect, finding only a modest effect of antidepressants, although these studies also had methodological criticism (see ). These investigations make us reflect on the effects of our expectations.
The truth is that the knowledge we have about the biochemical roots of the disorder and recovery is still limited (Elliot Valenstein, 1998, cited in Myers, 2006). Many professionals are concerned that, given the ease of finding and purchasing antidepressants, the development of psychotherapies is being blocked (Gross, 2005).
NOTE: If you are taking antidepressants, do not stop or modify them without consulting your doctor.
Sources:
Gross, R. (2005), Psychology, the science of mind and behavior 5th edition. Hodder Arnold Publication
Lieberman, J., Stroup, S., Perkins, D. (2010), Schizophrenia treatiseLEXUS editors: Barcelona
Myers, D. (2006), Psychology 7th edition. Panamericana Medical Editorial:Madrid