Depression can affect any one of us at any time of our lives and is more than just feeling a bit fed up or down in the dumps. When you cannot just snap out of it and the symptoms of depression persist for more than a couple of weeks, and interfere with your ability to carry out your normal routines on a daily basis, then your health care provider or GP may prescribe some form of medication to help you combat the depression.
There are many different types of anti-depressants available and the earlier ones include Tricyclic antidepressants (TCAs) and Monoamine Oxidase Inhibitors (MAOIs). Newer types include Selective Serotonin Reuptake Inhibitors (SSRIs) and others, which may not fall into one specific category but which all work by impacting on the chemicals in the brain that are responsible for our mood and how we feel.
The following list represents the most commonly prescribed drugs for depression, their brand names and the name of the pharmaceutical company producing them (in brackets), as well as a brief description of how the different types are believed to work.
Tricyclic Antidepressants (TCAs)
Tricyclic antidepressants are so called because of their molecular structure in that they contain three rings of atoms. Although no one understands exactly how they work, it is thought that the beneficial effects are due to their ability to balance the natural neurotransmitter chemicals in the brain. The most common side effects are dry mouth and drowsiness and possibly blurred vision, sweating, and a slight hesitancy when passing urine. The following list represents some of the most commonly prescribed Tricyclic antidepressants:
o Doxepin - Brand names: Adapin (Lotus Biochemical Corporation) and Sinequan (Pfizer Inc)
o Clomipramine - Brand names: Anafranil (Geneva Pharmaceuticals)
o Nortriptylene - Brand Names: Aventyl (Eli & Lilly) and Pamelor (Novartis Pharmaceuticals)
o Imipramine - Brand Names: Tofranil (Novartis Pharmaceuticals)
o Protriptyline - Brand Names: Vivactil (Merck & Co)
o Trimipramine - Brand Names: Surmontil (Wyeth-Ayerst Pharmaceuticals)
Monoamine Oxidase Inhibitors (MAOIs)
This type of medication works by inhibiting the activity of the enzyme monoamine oxidase, which in turn increases the levels of the neurotransmitters serotonin and norepinephrine. They are not prescribed as often as they used to be as the newer type of medication known as SSRIs have become more popular. MAOIs would usually be prescribed when other medications have proved ineffective. MAOIs can interact with foods containing tyramine and raise blood pressure; they can also interact unfavourably with many other drugs and over the counter preparations. Some MAOIs include:
o Isocarboxazid - Brand Name: Marplan (Oxford Pharmaceutical Services)
o Phenelzine - Brand Name: Nardil (Pfizer Inc)
o Tranylcypromine - Brand Name: Parnate (Glaxo Smith Kline)
Selective Serotonin Reuptake Inhibitors (SSRIs)
SSRIs work by selectively inhibiting the reuptake of the neurotransmitter serotonin in the brain so that levels of serotonin are increased. They are generally considered safer than other types. Side effects include nausea, anxiety, sleep disturbances and sexual dysfunction. They can also interact with other drugs. Some of the more commonly prescribed SSRIs include:
o Citalopram - Brand Name: Celexa (Forest Pharmaceuticals)
o Escitalopram - Brand Name: Lexapro (Forest Pharmaceuticals)
o Fluoextine - Brand Name: Prozac (Eli & Lilly)
o Fluvoxamine - Brand Name: Luvox (Solvay Pharmaceuticals)
o Paroxetine - Brand Name: Paxil (Glaxo Smith Kline)
o Setraline - Brand Name: Zoloft (Pfizer Inc)
Some other types of medication
There are other types of medication available for depression which are not included in the previous categories but which all work in various ways to alter the balance of chemicals in the brain to alleviate depression. For example:
o Bupropion - works by inhibiting the reuptake of both norepinephrine and dopamine. Often used to treat the type of depression known as Seasonal Affective Disorder (SAD), as well as ADHD and as part of a stopping smoking programme. Brand Name: Wellbutrin (Glaxo Smith Kline)
o Duloxetine - works by inhibiting the reuptake of both serotonin and noradrenaline (SNRI). Brand Name: Cymbalta (Eli & Lilly)
o Venlafaxine - Also an SNRI. Brand Name: Effexor (Wyeth-Ayerst Pharmaceuticals)
o Maprotiline - Known as a tetracyclic antidepressant because its molecular structure consists of 4 rings in a T shape. Brand Names: Ludiomil (Novartis Pharmaceuticals)
Which type medication is most suitable?
The type of medication prescribed by your GP will depend on many factors including the kind of depression diagnosed, the severity of the symptoms, other medication that you may be taking and of course the potential risk of any side effects.
It is not possible to predict with any degree of accuracy which one will be most effective and it can take a number of weeks for any effects to be noticed. If after six weeks or so there is no improvement, then another medication may be prescribed until you find the most appropriate one for you.
Regardless of the type of depression diagnosed, the right medication can alleviate the symptoms of depression and help you get back to your old self again.