Depression affects around 280 million people worldwide. It is one of the most common mental health issues, along with anxiety. Treatment for depression can include therapy, coping skills, support systems, and medication.
Medication for depression is known as antidepressants. There are five groups of antidepressants and dozens of types of antidepressants to choose from. Each depression medication will fit a different need. Antidepressants can have mild to severe side effects, and it can take some trial and error to find the right one for you.
Always consult a doctor or psychiatrist before taking antidepressants. Antidepressants can be dangerous if mixed with other drugs or vitamins. Do not stop or start antidepressants unless under the supervision of a medical professional.
Read about Lifebulb’s psychiatry services here.
What are antidepressants?
Antidepressants are medications to take for depression. They are an effective way to treat depression, but like any treatment, results will vary. In general, researchers find that antidepressants are more effective on moderate to severe depression than mild depression, which is better treated through a combination of talk therapy and coping skills.
One of the primary causes of depression is chemical imbalances in the brain, primarily imbalances in serotonin, dopamine, and norepinephrine. These brain chemicals help regulate mood and are the “feel good” hormones. When they are out of balance, mood disorders such as anxiety and depression can occur. Many things can knock these chemicals off balance and cause depression, including genetics, trauma, and chronic stress.
Types of antidepressants
There are five types of antidepressants. Although all have been researched and proven effective in treating depression, each has a different approach that may be more or less suited to your needs.
- Selective serotonin reuptake inhibitors (SSRIs): Often the first choice for antidepressant medications, SSRIs work by raising the amount of serotonin, a chemical that helps regulate mood. People with depression often have lower levels of serotonin. SSRIs take around 2 weeks to start working, and it can take up to 8 weeks to feel its effects. Common SSRIs include Lexapro, Celexa, Prozac, and Zoloft.
- Serotonin and norepinephrine reuptake inhibitors (SNRIs): This is a good option for people who struggle with fatigue and alertness due to depression. SNRIs work to increase both serotonin and norepinephrine, which is a brain chemical that boosts alertness and focus. Common SNRIs include Pristiq, Cymbalta, and Effexor.
- Atypical antidepressants: These are depression meds that don’t fit into any other category. Some are commonly used to treat comorbid disorders (such as depression and anxiety or depression and insomnia), but it is a case by case basis. Atypical antidepressants include Wellbutrin, Desyrel (good for insomnia and depression), and Spravato (good if other antidepressants have not worked).
- Tricyclic antidepressants (TCAs): These are usually not the first prescribed because they have more severe side effects, however, they can treat depression in people who have severe depression in which other medications are ineffective. Common TCAs include Norpramin and Pamelor.
- Monoamine oxidase inhibitors (MAOIs): MAOIs are not typically recommended because they can have severe side effects and require heavy dietary restrictions. However, they are effective at treating treatment-resistant depression and are often used as a last resort. They work by blocking the protein monoamine oxidase, whose job is to break down serotonin, norepinephrine, and dopamine (all feel good chemicals). By blocking the protein, those brain chemicals are able to build up.
The best type of antidepressant for you will depend on the type of depression you are experiencing, the severity of depression, any other medication you are taking, and your personal brain chemistry. Talk with a psychiatrist to find the right antidepressant for you.
What is the best antidepressant?
Researchers believe there is no single best antidepressant. Most people will start with an SSRI or SNRI, and move up to more severe medications if necessary. The best antidepressant for you will depend on your symptoms, reactions to potential side effects, and severity of depression.
Most common antidepressants
The most common antidepressants are SSRIs or SNRIs that include:
- Zoloft
- Trazadone
- Prozac
- Cymbalta
- Lexapro
These are the medications that a psychiatrist will likely start you on.
Antidepressants that give you energy:
SNRIs are a good option for people who struggle with the fatigue part of depression because they increase norepinephrine, which is a brain chemical that increases alertness and focus.
SNRIs are also a good option for people with comorbid ADHD and depression, and can, in some cases, be a substitute for stimulant medications.
What is the hardest antidepressant to come off of?
If you are taking antidepressants you should never stop taking them without the guidance of a medical doctor or psychiatrist, as the withdrawal symptoms can be dangerous.
All antidepressants will likely have some withdrawal symptoms. SSRIs and SNRIs are more likely to have withdrawal symptoms. The most likely to cause withdrawal symptoms include:
- Desvenlafaxine (Khedezla, Pristiq)
- Fluvoxamine (Luvox)
- Paroxetine (Paxil, Pexeva)
- Venlafaxine (Effexor)
However, any antidepressant could cause withdrawal. Talk with your doctor before stopping antidepressants.
Side effects of antidepressants
It’s important to understand the side effects of your antidepressant before you start taking them. Every medicine will have different side effects, and different side effects may occur if you are taking other medication.
Common side effects in antidepressants include:
- Nausea: Feeling queasy or experiencing an upset stomach, especially during the initial weeks of taking the medication.
- Insomnia or drowsiness: Some people may have difficulty falling asleep while others may feel more tired than usual.
- Weight changes: This can involve either weight loss or weight gain.
- Low libido: Changes in libido, arousal, or sexual performance may occur.
- Dry mouth: Feeling thirsty or having an unusually dry mouth.
- Headaches: Some individuals may experience headaches or migraines as a result of the medication.
- Anxiety or restlessness: In some cases, antidepressants can initially increase feelings of anxiety or cause restlessness.
- Dizziness: Feeling lightheaded or dizzy, especially when standing up quickly.
- Sweating: Experiencing increased sweating, especially at night.
- Gastrointestinal problems: This can include diarrhea or constipation.
If you experience side effects that are interfering with your quality of life, talk with your doctor about switching your antidepressant.
In general, SSRIs and SNRIs are the most well-tolerated with the least amount of side effects. However, every person’s experience with antidepressants is different. It may take some trial and error to find the right one for you.
Other treatments for depression
The best treatment for depression is a combined approach, utilizing antidepressants, coping mechanisms, and therapy. All three have been proven to be effective at treating depression, and most people get the most benefit when they begin combining approaches.
Traditional psychotherapy isn’t the only form of therapy for depression. EMDR, Inter-Family Systems, Acceptance and Commitment Therapy, Strengths-Based, and more are up-and-coming fields of therapy that have proven effective against depression.
If you’ve tried therapy or antidepressants in the past without much luck, talk to a psychiatrist or therapist about your experience. They may be able to help you understand why previous treatment didn’t work and build an effective treatment plan for your needs.
To be matched with an online, affordable therapist today, call Lifebulb. You can also browse our list of depression therapists near you to choose a licensed therapist yourself. We also have psychiatrists in New Jersey and Virginia who can prescribe and manage antidepressants.