| 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.
SSRI
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 signalling
substance 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 Cipramil or Akarin (citalopram),
Cipralex (escitalopram) or Zoloft
(sertraline). With these types of
medicine you avoid 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 signalling substance
serotonin and noradrenaline in the
brain.
If you need to be treated with a dual
action preparation there are currently
two possibilities: Efexor (venlafaxine)
and Mirtazapin. Amongst other names
Mirtazapin is sold under the names
of Remeron and Mirtazapin. The
side-effects of SSRI and dual action
preparations
This is a list of the side-effects
of the treatment with SSRIs and dual
action preparations. The side-effects
can vary though 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/absent
ejaculation)
- weight increase
- high blood pressure
(rarely a side-effect in high
doses of Efexor)
- changes in the
body's sodium balance
TCA
TCA
(tricyclic antidepressants) boost
the signalling substances serotonin
and noradrenaline 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,
amongst others, Noritren (nortriptyline),
Anafranil (clomipramine) and Imipramin
(imipramine). TCA is especially used
in severe depressions, where the SSRIs
are not effective enough. Side-effects
of TCA
The side-effects that can occur in
the treatment with TCA can be
- dryness of the
mouth
- constipation
- tendency to
sweat
- problems focusing
your sight at a short distance
(especially in the young)
- dysuria (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 too
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 TCA
treatment. MAO
inhibitors
A type of preparations that are only
used very rarely is the MAO inhibitors
(monoaminoxidase inhibitors).
Marplan
(isocarboxazid) is an older preparation,
which should only be used after advice
has been sought from a psychiatry
specialist, as very serious side-effects
can occur during the treatment. On
the other hand, Marplan is often very
effective where other forms of treatment
aren't.
Aurorix (moclobemide) doesn't have
the serious side-effects that you
see in the treatment with Marplan.
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