Medication Management of Depression
The information provided below is not comprehensive, but rather provides a general overview of the most common associated features.
The first-line of pharmacological treatment in depression are selective serotonin reuptake inhibitors (SSRIs).
Examples: sertraline (Zoloft), fluoxetine (Prozac), paroxetine (Paxil), escitalopram (Lexapro), citalopram (Celexa)
The most common side effects that MAY be experienced by individuals are:
Nausea-Taking the medication with food helps and nausea typically subsides after a few weeks.
Sedation- Typically subsides after a few weeks
Increase Anxiety-Medication to combat the anxiety can be initiated with the SSRI (and later discontinued), but the anxiety typically improves within a few weeks (SSRIs are also the first line of treatment for anxiety).
Sexual Dysfunction-The addition of bupropion often eliminates the sexual dysfunction
Weight Gain
Headache
Increase in Suicidal Ideation-All SSRIs have warning about the increase in suicidal ideation (thoughts of suicide) upon the initiation of medication in teenagers. There is not evidence that there is an increase in the completion of suicide. The thought behind this phenomenon is that the first symptoms relieved by SSRIs are motivation and energy. The depression may not be treated for 6-8 weeks. Therefore, an individual may have more motivation and energy to contemplate and plan suicide before their actual depression is relieved. It is important during the initial introduction of an antidepressant to be cognizant of this and have supports.
Important Information Regarding Antidepressants:
*There are other medications outside of SSRIs that are utilized in the treatment of depression
Examples: sertraline (Zoloft), fluoxetine (Prozac), paroxetine (Paxil), escitalopram (Lexapro), citalopram (Celexa)
The most common side effects that MAY be experienced by individuals are:
Nausea-Taking the medication with food helps and nausea typically subsides after a few weeks.
Sedation- Typically subsides after a few weeks
Increase Anxiety-Medication to combat the anxiety can be initiated with the SSRI (and later discontinued), but the anxiety typically improves within a few weeks (SSRIs are also the first line of treatment for anxiety).
Sexual Dysfunction-The addition of bupropion often eliminates the sexual dysfunction
Weight Gain
Headache
Increase in Suicidal Ideation-All SSRIs have warning about the increase in suicidal ideation (thoughts of suicide) upon the initiation of medication in teenagers. There is not evidence that there is an increase in the completion of suicide. The thought behind this phenomenon is that the first symptoms relieved by SSRIs are motivation and energy. The depression may not be treated for 6-8 weeks. Therefore, an individual may have more motivation and energy to contemplate and plan suicide before their actual depression is relieved. It is important during the initial introduction of an antidepressant to be cognizant of this and have supports.
Important Information Regarding Antidepressants:
- The medication takes 6-8 weeks to reach full therapeutic levels, however you may see some improvement in a couple of weeks
- Need to take routinely at the same time every day to provide steady levels of the medication in the system and be effective.
- Do not stop taking SSRIs suddenly as the following symptoms may occur: Anxiety, agitation, dizziness, insomnia, sadness, electric-shock like sensation in extremities or head.
- Serotonin Syndrome can occur when there is too much serotonin. This is a medical emergency. Symptoms include:
- Change in Mental Status (confusion, delirium, agitation)
- Autonomic Instability (elevated heart rate, fluctuating BP, elevated temp)
- GI Sx.
*There are other medications outside of SSRIs that are utilized in the treatment of depression
If you would like to be evaluated for depression or seek pharmacological treatment.