Types of medication
TESS
There are two main groups of antidepressants, the newer drugs (the dual action preparations and the SSRIs) and the old drugs TCA and MAO inhibitors.
SSRIs
The type of antidepressant that is most widely used is the SSRIs (an abbreviation of Selective Serotonin Reuptake Inhibitors). These drugs boost the effect of the neurotransmitter serotonin in the brain, and they are effective in the treatment of mild to moderate depression. If you need to be treated with SSRIs there are several possibilities. Many recommend Lexapro (escitalopram), Prozac (fluoxetine), Seroxar (paroxetine), or Zoloft (sertraline). With this type of medicines, you do not need to worry so much about problems if you need to take another kind of medicine simultaneously.
Dual action preparations
Another type of medicine that is increasingly used is dual action preparations. Dual action preparations boost the effect of the neurotransmitters serotonin and norepinephrine in the brain. If you need to be treated with a dual action preparation there are currently two possibilities: Effexor (venlafaxine), Cymbalta (duloxetine), and Remeron (mirtazapine).
The side-effects of SSRI and dual action preparations
This is a list of the side-effects of SSRIs and dual action preparations. These side-effects can vary depending on the preparations so ask your doctor about the known side-effect of the preparation that you are getting. They might be:
- restlessness
- difficulty in sleeping
- dryness of the mouth
- nausea and vomiting
- headache
- constipation
- tendency to sweat
- sexual problems (lack of desire, delayed or absent ejaculation)
- weight increase
- high blood pressure (a rare side-effect of high doses of Effexor)
- changes in the body's sodium balance
TCAs
TCA (tricyclic antidepressants) boost the neurotransmitters serotonin and norepinephrine in the brain and also block different receptors in the brain's nervous system. They therefore have a slightly different effect than the SSRIs and also have a few more side-effects. This group comprises, among others, Anafranil (clomipramine), Tofranil (imipramine), Trimipramine (Surmontil). TCAs are especially used in severe depression where the SSRIs are not effective enough.
Side-effects of TCAs
The side-effects that can occur with TCAs can be:
- dryness of the mouth
- constipation
- tendency to sweat
- problems focusing one’s vision at a short distance (especially in the young)
- problems with urination (especially in elderly men with an enlarged prostate gland)
- dizziness (especially when getting up from a sitting or lying position)
- weight increase
- mild shaking of the hands
- effects on the heart beat (especially with very high doses)
Very old and frail people, people with a poor oxygen supply to the heart, and people with serious disturbances of the heart beat, should avoid treatment with TCAs.
MAO inhibitors
A type of preparation that is only used very rarely is the MAO inhibitors (monoamine oxidase inhibitors). This group of antidepressants also boost the neurotransmitters serotonin and norepinephrine in the brain. Aurorix (moclobemide) is the only available preparation of this group of medicines in the Philippines.