These drugs help with depression
There are a number of different drugs that can help with depression. Depending on the individual findings, concomitant diseases and side effects, different drugs can be considered for therapy. The market for the various groups of active ingredients known as antidepressants, i.e. drugs that help with depression, is very large.
All antidepressant drugs work on the basis of the theory that depression is caused by a lack of certain signal substances in the brain. These antidepressants intervene in the signaling system in the brain and are supposed to raise the blood levels of the signaling substances serotonin and norepinephrine. Some drugs are intended to affect only one of the transmitter systems, while other drugs work in different places. It should be noted that the desired effect of the medication usually only occurs after about 2-4 weeks, whereby side effects can occur after a few hours or days. The attending physician can best discuss which medication makes sense in an individual case in a familiar conversation with the patient.
Citalopram is the most widely prescribed antidepressant in Germany. It belongs to the group of so-called selective serotonin reuptake inhibitors (SSRIs) and is therefore one of the drugs of first choice in the treatment of depression. Citalopram and other substances in this group of active ingredients work by ensuring that the released serotonin remains at the site of action for longer, and thus cause an increase in the active serotonin level in the brain.
The increase in serotonin is intended to counteract depression, which is presumably due to a low serotonin level. In addition to an improvement in mood, the general drive is also increased and anxiety is reduced. A dependence on the drug is not known when taking it.
Read more on this topic at: Citalopram
Sertraline belongs to a newer group of antidepressants, the serotonin reuptake inhibitors (SSRI). As the name suggests, they selectively inhibit the reuptake of serotonin from the synaptic cleft. In comparison to the rather unspecific acting tricyclic antidepressants (for example amitriptyline), side effects are less common. However, the spectrum of side effects is also very broad: insomnia or drowsiness, difficulty concentrating, nervousness, restlessness, dizziness, headache, gastrointestinal complaints such as diarrhea, nausea and vomiting, trembling of the hands (tremor), increased sweating, blurred vision and sexual dysfunction. Side effects in the cardiovascular area, however, are very rare. In addition to treating depression, sertraline is also used in the treatment of obsessive-compulsive disorder and panic disorder. The group of SSRIs, which includes sertraline, is now considered the first choice for the treatment of depression. However, the most commonly prescribed active ingredient from this group is citalopram and not sertraline.
Also read our topic: Zoloft®
Escitalopram belongs to the group of SSRIs. It has a very similar chemical structure to citalopram. The mode of action is the same: there is an inhibition of the uptake of serotonin in the synaptic cleft of the nerve cells. This counteracts the serotonin deficiency present in depression; more serotonin is available in the tissue fluid of the brain. The side effect profile is similar to that of the other active substances from the SSRI group. The most common symptoms are nausea, vomiting, diarrhea, insomnia, dizziness and increased sweating. A decrease in appetite also occurs. Both citalopram and escitalopram can lead to changes in the ECG (QT time prolongation) which can lead to cardiac arrhythmias. As antidepressants that can be taken during pregnancy and breastfeeding, citalopram and sertraline from the group of SSRIs are more suitable, as there are sufficient studies on these active substances. So far, however, there is no evidence that escitalopram has a teratogenic effect. If escitalopram was taken for antidepressant therapy before pregnancy, it can be considered whether the therapy should be continued. In particular to avoid the risk of psychological crises that can arise from a change in medication.
Also read: Cipralex®
Fluoxetine also belongs to the group of SSRIs. It is used to treat depression, obsessive-compulsive disorder, anxiety disorders, and occasionally bulimia (commonly known as eating-vomiting addiction). The side effects are similar to those of setralin. According to the current status, fluoxetine should rather not be taken during pregnancy and breastfeeding, as there is evidence of an increased risk of heart malformations in the unborn child if fluoxetine is taken in the first trimester.
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Amitriptyline is an antidepressant from the group of tricyclic antidepressants. This group is one of the older antidepressant drugs. So it has been in use for a relatively long time. Amitriptyline has been on the market since the early 1960s and has been the most prescribed antidepressant in the world for many years. The group of tricyclic antidepressants works through a relatively unselective re-uptake of certain messenger substances in the nerve cells in the brain. In depression, there is a lack of messenger substances such as norepinephrine and serotonin. By taking amitriptyline, these are increasingly made available again. In addition to its use in depression, amitriptyline is also used for the preventive treatment of certain types of headache such as tension headache and migraine and for chronic neuropathic (nerve-related) pain. Some studies in recent years have shown that another group of antidepressants, the SSRI, is better tolerated. Therefore, in recent years the SSRIs have slowly begun to replace the tricyclic antidepressants such as amitriptyline in their sovereign status in the treatment of depression. This has in particular to do with the spectrum of side effects of tricyclic antidepressants. Due to the relatively unspecific reuptake inhibition of various messenger substances in the brain, the rate of side effects is higher with amitriptyline than with the newer antidepressants. Typical side effects include headache, hand tremors (tremor), Dizziness and drowsiness. Weight gain is also described relatively often. Furthermore, increased sweating, visual disturbances (accommodation disorders, i.e. difficulties in focusing at short distances), nausea and dry mouth can occur. Palpitations and palpitations are also relatively common. An overdose can lead to dangerous cardiac arrhythmias. Other - less common - side effects include difficulty concentrating, tiredness or insomnia, manic states, tingling sensations (paresthesia) and states of confusion. Amitriptyline is one of the few antidepressants that, according to current studies, can also be taken explicitly during pregnancy and breastfeeding.
Further information on this topic can be found at: Amitriptyline and side effects of amitriptyline
Doxepin is an antidepressant from the group of tricyclic antidepressants (like amitriptyline too). It has a relatively strong dampening effect and is therefore often used in patients who tend to be very restless and sleep disorders during their depression. It can also be used for anxiety disorders. It should be taken in the evening so that the dampening effect can have a positive effect on night sleep. The possible side effects are similar to those of amitriptyline. The most common symptoms are dry mouth, trouble focusing the near vision, problems urinating and defecating, and racing heart. Doxepin is not considered the antidepressant of choice during pregnancy and breastfeeding.A readjustment to Doxepin should therefore not take place during pregnancy. However, if a patient was treated with antidepressant doxepin before the onset of pregnancy, consideration should be given to continuing the therapy in order to prevent the depressive symptoms from recurring. So far there is no evidence of teratogenic effects of Doxepin, but other active ingredients have been better studied for use during pregnancy.
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Opipramol is a tricyclic antidepressant. Although it belongs to this group, the mode of action is different. It is not yet known for sure how exactly opipramol works. An inhibition of the re-uptake of messenger substances like all other representatives of this group they do, however, does not seem to do so. Opipramol is used to treat depression, restlessness and anxiety, and sometimes also to treat problems falling asleep. If it is used for insomnia, it should be taken in the evening. Opipramol has a mood-enhancing and calming effect. The side effects include tiredness (sometimes also a desired effect in the treatment of sleep disorders), dizziness, nausea and sexual dysfunction. The side effects usually become more pronounced in the first few weeks of use and then decrease significantly. There are some studies available on the use of opipramol during pregnancy and breastfeeding; a teratogenic effect has not yet been proven. Nonetheless, a different antidepressant should be used for treatment during pregnancy.
Further information on this topic can be found at: Insidon®
Venlafaxine belongs to the group of selective serotonin and noradrenaline reuptake inhibitors (SSNRIs). Depressive symptoms are thus reduced by an increased supply of the messenger substances serotonin and noradrenaline in the synaptic gap. In addition to depression, venlafaxine is also used to treat anxiety disorders. When you start taking venlafaxine, gastrointestinal side effects (nausea, vomiting, loss of appetite, constipation) often occur. Dizziness, restlessness, nervousness and visual disturbances are also relatively common. Use during pregnancy and breastfeeding is recommended if venlafaxine was used before pregnancy. A readjustment during pregnancy should take place on a different, more tried and tested antidepressant.
Like venlafaxine, duloxetine belongs to the SSNRI group. It is used to treat depression, anxiety disorders, polyneuropathy in diabetes and urinary incontinence. The possible side effects are similar to those of venlafaxine. The side effects occur especially during the first few days of use and then gradually decrease. As with venlafaxine, it can be used during pregnancy and breastfeeding if therapy has already been taken. Otherwise another antidepressant should be used for which more relevant studies are available.
Mirtazapine, together with mianserin, belongs to the small group of tetracyclic antidepressants. Mirtazapine intervenes in the resumption of serotonin and norepinephrine and probably also leads to an increased release of dopamine. The most common side effects of mirtazapine are fatigue and weight gain. In patients who suffer from pronounced sleep disorders as part of a depression, the dampening effect can be used to improve night sleep. Mirtazapine is sometimes also used in low doses in patients who do not suffer from depression but who suffer from severe sleep disorders. However, this is an off-label use, so the drug is not officially approved for this indication. Also with mirtazapine during pregnancy there is no evidence of a teratogenic effect. If antidepressant treatment with mirtazapine already exists before pregnancy, this can therefore be continued under certain circumstances. To start a new antidepressant therapy during pregnancy, better researched antidepressants (e.g. citalopram, sertraline, amitriptyline) are available.
Read more on the topic: Mirtazapine
List of drugs for depression
SSRI (selective serotonin reuptake inhibitors)
SNRI (selective norepinephrine reuptake inhibitors)
SSNRI (selective serotonin and noradrenaline reuptake inhibitors)
Medications that are used for depression should only be taken if a doctor has diagnosed depression diagnosed and a specific drug recommended and prescribed has been. In addition to treating depression, some antidepressants are used for treating pain or anxiety disorders as well as treating stress-related ones Incontinence applied. In order to be able to control the effect of the medication and, if necessary, to switch to another, as well as to monitor potential side effects, the use of antidepressants should take place under regular medical supervision.
Antidepressant drugs should not be taken if the attending physician has them not recommended or prescribed Has. Switching to another medication or discontinuing medication should always in agreement done with the attending physician.
Prescription requirement and prescription-free
All drugs called so-called Antidepressants are commercially available, require a prescription and must be prescribed by a doctor. By prescribing the medication, the doctor can ensure that the recommended medication is the right one for the affected person and correctly assess any side effects and interactions that may occur.
Preparations that can be obtained without a prescription are usually based on ingredients from the St. John's wort plant. However, the effect of these preparations is very controversial, since long-term studies have shown that there is no significant effect compared to placebo. When taking St. John's wort and its components, it is also important that you do not do this without consulting a doctor, as there are side effects and interactions with other drugs.
Read more about this: St. John's wort oil - the natural medicinal plant par excellence
Like most drugs, antidepressants have side effects. These can vary depending on the drug taken and from patient to patient. Depending on how the drug intervenes in the metabolism of the signal substances, different undesirable effects arise. Some of these effects are nausea, vomiting, diarrhea, dry mouth, fatigue, headache, weight gain, reduction in sex drive ("loss of libido"), anxiety and an increased tendency to bleed.
Which of the side effects often occur with the respective medication can be found in the package insert on the one hand, and the attending doctor or pharmacist can tell on the other. It must be noted that the side effects of the medication always occur in front the antidepressant effects occur. It can take up to 4 weeks for the desired effect to occur, while the side effects appear after a few hours or days. It is also true, however, that most of the side effects occur at the beginning of the intake, but decrease significantly in the course of treatment.
When taking several medications, it should always be checked whether they can cause interactions with one another. So, some drugs can do the Breakdown of other drugs accelerate or reduce and thus endanger the success of the treatment. Depending on the active ingredient group, drugs for depression have different interactions with other drugs. In order to ensure that there is no risk of interactions with the medication taken, the attending physician should be informed about any medication that is taken regularly.
Especially taking it at the same time several antidepressants can lead to interactions that have an undesirable effect. You should also take drugs that belong to the substance group of the so-called Neuroleptics count or against Seizures are used, a precise examination of the interaction takes place. The same applies to drugs that increase the tendency to bleed ("blood thinner').
A rather unusual, but far-reaching side effect is taking an antidepressant that belongs to the group of active substances called monoamine oxidase inhibitors (MAOIs) counts in connection with the consumption of red wine or cheese. Here the substance Tyramine, which occurs in relatively high quantities in these foods, are no longer adequately degraded. A rapid threat then threatens Increase in blood pressure with possibly life-threatening consequences. When taking MAO inhibitors, foods with a high tyramine content should therefore be avoided.
Compatibility with alcohol
Many patients have concerns about the tolerance of the drugs they take with alcohol. Consumption of alcohol during therapy with medication for depression is fundamental not advised. Depending on the group of active ingredients, the risk of interaction with alcohol varies.
So it can be especially when taking so-called tricyclic Antidepressants, MAOIs such as Alpha adrenoreceptor antagonists the effects of the medication or alcohol become significantly more pronounced. There are some threats numbing Effects of the drugs or one Intoxication effect even when consuming the smallest amounts of alcohol.
The attending doctor should be asked to clarify any interactions with alcohol.
You can find more about citalopram at: Citalopram and alcohol - are they compatible?
Antiepressants without weight gain
A relatively common side effect of taking drugs for depression is one unwanted weight gain during therapy. Not all drugs used for depression have this side effect. The extent of weight gain also differs significantly from active substance group to active substance group. The most widely prescribed group of active ingredients selective serotonin reuptake inhibitors (SSRIs) as well as the group of selective serotonin and norepinephrine reuptake inhibitors (SNRI) for example only have one moderate Weight gain, which often normalizes after a certain period of therapy.
Some people lose weight when taking this medication through one appetite reducing Effect even on weight. Due to an increase in appetite, there is an increase in weight when taken tricyclic Antidepressants common. Drugs of the group of MAOIs have no known impact on weight.
Sleep disorders from antidepressants
sleep disorders are a common symptom of depression. At the same time, sleep disorders can only be caused by the medication taken against depression. Depending on the active ingredient group, some antidepressants can help treat sleep disorders. Especially tricyclic Antidepressants can make sleep easier improve.
However, since these have a number of other disadvantages, a selective serotonin reuptake inhibitor (SSRI) is more likely to be used nowadays additionally another drug administered to treat the sleep disorders.
Sleep disorders caused by the medication taken usually subside as the therapy progresses.
Use in pregnancy
Depression accumulates during the pregnancy and in many cases must be treated with medication. The selection of drugs for depression in pregnant women should be done carefully, as most antidepressants are affected by the placenta and the umbilical cord can get into the child's circulation.
However, pregnancy is by no means a contraindication for the drug treatment of depression. Even large-scale studies have so far not been able to demonstrate any harmful effects of the common antidepressants on mother or child. However, as the data on some drugs are insufficient, the use of some substances is not recommended. If you become pregnant while you are taking antidepressant medication, the attending physician should be informed about this so that he or she may have a Change of medication or Dose adjustment can make.
Use during breastfeeding
All drugs for depression are also in the Breast milk verifiable. However, none of these drugs are contraindicated during breastfeeding. Since there is insufficient data on the use of some medications during pregnancy and breastfeeding, the use of some medications is not recommended. The attending physician can assess whether the drugs used are harmless or whether the drug should be changed.
Use in children
In addition to adults, children also repeatedly suffer from depression, which must be treated with medication. Some drugs for depression are not for use on individuals under 18 years approved and therefore cannot be used on children. The effects of the most commonly prescribed group of active substances in adults selective serotonin reuptake inhibitors has long been discussed in children. Some preparations in this group of substances are now for children from 8 Years authorized.
MAOIs are only approved for people aged 18 and over. Tricyclic According to some studies, drugs against depression have significantly more side effects in children than in adults. Also are Poisoning with drugs of this group of active substances more often in children than in adults.
Herbal medicines for depression
In addition to the classic drugs that are used in depression, there are also herbal preparations that are said to have a positive effect. The most frequently used remedy of this kind in Germany is Johannis herbs. The funds contain up to nine potentially effective substances in different compositions. Large-scale studies have so far been possible Not show that St. John's wort has a significantly demonstrable influence on depression.
However, as some drastic interactions can occur when taking these preparations, a doctor should always be consulted before taking them. It must be noted that St. John's wort preparations For Children under 12 not admitted are.
Can you treat depression without medication?
Whether depression can be treated without medication largely depends on the severity of the depression. While mild depression can in many cases be managed without antidepressant therapy, moderate and severe depression must be treated with medication in the vast majority of cases. In most cases, this should be accompanied by psychotherapeutic treatment. In theory, depression does not last forever, even without drug therapy. The normal duration of an episode is several months if left untreated. With adequate drug therapy, the duration of an episode can be significantly reduced. In view of the high level of psychological distress that most people with depression have, the use of drug therapy is recommended for moderate and severe depressive episodes. In principle, however, a specialized doctor (psychiatrist) or psychologist should always be contacted in the presence of depression in order to be able to develop a common strategy for possible treatment of the disease.
Omega 3 against depression
There are some studies suggesting that omega-3 fatty acids may have beneficial effects in treating depression. The exact mechanism of action is still unclear.However, it has been shown that there are fewer omega-3 fatty acids in the cells of patients with depression. Studies have also shown that patients who eat very little omega-3 fatty acids are more likely to suffer from depression. So far, however, there are no studies that have examined, for example, the effect of omega-3 fatty acids in comparison with antidepressants so that clear statements in this area are not yet possible. There is also evidence that not all omega-3 fatty acids do not have the same antidepressant effects. Initial studies showed a positive effect for the fatty acid eicosapentaenoic acid (EPA), but not for docosahexaenoic acid (DHA). Omega-3 fatty acids are found in oils such as rapeseed oil and fish oil. But not only oils contain the healthy components; fish, for example, is also rich in EPA and DHA. The fish with the highest levels of omega-3 fatty acids are sardines, herring, salmon, mackerel, tuna, trout, cod and haddock. There are also numerous capsule preparations available without a prescription, for example in the drugstore, which contain different variants of omega-3 fatty acids.
Vitamin D for depression
Some studies have shown that people with depression have lower levels of vitamin D in their blood than people who are not depressed. Some studies have also provided indications that supplementation (replacement therapy) with vitamin D leads to an improvement in symptoms in depressed patients.
Due to the study design of the studies available so far, however, no reliable conclusions can be drawn from this, so that there is no scientific recommendation for the intake of vitamin D for depression. As with omega-3 fatty acids, there have been no studies to date that compare the effects of vitamin D and antidepressants. One point that supports the hypothesis that a vitamin D deficiency can have a depressive effect is that vitamin D is mainly formed in the body through exposure to sunlight.
A lack of sunlight therefore leads to a lack of vitamin D. As a counterpart to this, there are so-called seasonal depressions, which mainly occur when there is a lack of daylight in the dark winter months. The fact is that there are no clear recommendations for vitamin D therapy for depressed people.
However, there seems to be a trend towards a positive effect. In this respect, it can be justified to advise a depressed patient to take vitamin D supplements. According to current studies, however, taking vitamin D alone is not sufficient to treat depression. Medicinal antidepressant and / or psychotherapeutic therapy is also required.
Read more on the topic: What role do vitamins play in depression?