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All About Antidepressants

For people with depression, the right antidepressant treatment can be life-changing. Here’s a closer look at antidepressants, how they work, and how depression and addiction are related.

The Most Common Types of Antidepressants

The most common antidepressants include:

  • Selective Serotonin Reuptake Inhibitors (SSRIs)
    • Citalopram
    • Escitalopram
    • Fluoxetine
  • Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs)
    • Duloxetine
    • Venlafaxine
  • Norepinephrine-Dopamine Reuptake Inhibitors (NDRIs)
    • Bupropion (Wellbutrin, Zyban)
  • Tricyclics
  • Tetracyclics
  • Monoamine Oxidase Inhibitors (MAOIs)

SSRIs are the most common, and they tend to be a first-line choice for treatment. Tricyclics, tetracyclics, and MAOIs are prescribed less often, as they’re older and tend to have more side effects.

How Do Antidepressants Work?

human brain toy

Each antidepressant is unique, but the majority of antidepressants (SSRIs, SNRIs, NDRIs, Tricyclics, and Tetracyclics) are “reuptake inhibitors.” This means they prevent the brain from re-absorbing neurotransmitters like serotonin, norepinephrine, and dopamine. The idea is to correct a suspected deficiency or imbalance, improving symptoms.

Instead of preventing re-absorption, MAOIs target the enzyme that’s responsible for breaking down neurotransmitters. Reducing this enzyme’s activity leaves more serotonin, norepinephrine, and dopamine in the brain.

How Effective Are Antidepressants?

The effectiveness of any antidepressant depends on things like the type, the dosage, the physiology of the person, and how long they’ve been taking it. When the right fit is found, however, antidepressants tend to be very effective.

In 2018, an international group of researchers performed the largest review of antidepressant trials ever done. Their work confirmed that all 21 antidepressants reviewed were more effective than a placebo.¹ Other studies also confirm that antidepressants do work—we just don’t know which medications will work for which person.

Do Antidepressants Work Right Away?

Antidepressants can take a few weeks to take full effect, and it’s not always the right fit on the first try. You may see big improvements with a particular antidepressant, or you may feel nothing. That’s okay! It’s normal to try different options before finding one that works. Make adjustments with your doctor until you find the right treatment. It’s all about persistence and willingness to try.

What Are the Side Effects?

The good news is that most side effects of antidepressants begin to fade after the first two weeks of use.² Commonly reported side effects are mild and include things like anxiety and nausea. Rarely, severe effects like an increase in suicidal thoughts may occur. These should be reported immediately so adjustments can be made.

How Is Depression Related to Addiction?

Depression and addiction often occur together. For many, substance abuse starts out as self-medication for symptoms. The effects are temporary, leading to a cycle of despair and escape. If underlying depression isn’t treated alongside addiction, continued symptoms may lead to relapse.

At our Orange County drug and alcohol rehab, Adelante Recovery offers dual diagnosis treatment for clients struggling with both addiction and depression. To learn more about how we can help, contact us online or call (949) 427-9099.

Sources:

  1. https://www.nhs.uk/news/medication/big-new-study-confirms-antidepressants-work-better-placebo/
  2. https://www.medicalnewstoday.com/articles/248320#side-effects