ANTI-DEPRESSANT MEDICATIONS This information is not intended to be a substitute for medical advice. It s purpose is solely informative. If your client or yourself are taking antidepressants, do not change your dosage without consulting the prescribing doctor! According to the chemical imbalance theory, low levels of the brain chemical serotonin lead to depression and depression medication works by bringing serotonin levels back to normal. The Following are a list of the most common Anti-Depressant medications. They are split into two categories, 1) The more common and newer drugs are selective serotonin reuptake inhibitors (SSRIs), and 2) the older and less used tricyclic antidepressants or MAOIs (monoamine oxidase inhibitors). STOPPING MEDICATIONS Once you re clients starts taking antidepressants, stopping can be dangerous if done wrong. Many people have withdrawal symptoms if medication is removed too quickly. If your client decides to stop taking antidepressants, it s essential to do so under the supervision of a psychiatrist or the prescribing Doctor. In order to avoid antidepressant withdrawal symptoms, never stop your medication cold turkey. Instead, gradually taper your dose, allowing for at least 1-2 weeks between each dosage reduction. This tapering process may take up to several months, and should be monitored under a doctor's supervision. If they stop abruptly, they may experience a number of unpleasant withdrawal symptoms such as crying spells, extreme restlessness, dizziness, fatigue, and aches and pains. These withdrawal symptoms are known as antidepressant discontinuation syndrome. Antidepressant discontinuation syndrome is especially common when you stop taking Paxil or Zoloft. However, all medications for depression can cause withdrawal symptoms. Depression and anxiety are also common symptoms when withdrawing from antidepressants. When depression is a withdrawal symptom, it s often worse than the original depression that led to drug treatment in the first place. Unfortunately, many people mistake this withdrawal symptom for a return of their depressive illness and resume medication, creating a vicious circle.
SELECTIVE SEROTONIN REUPTAKE INHIBITORS (SSRI s) The SSRIs act the chemical in the brain serotonin. Serotonin helps regulate mood, but it also plays a role in digestion, pain, sleep, mental clarity, and other bodily functions. As a result, the SSRI antidepressants cause a wide range of side effects. Common side effects include sexual problems, drowsiness, sleep difficulties, and nausea. While some side effects go away after the first few weeks of drug treatment, others persist and may even get worse. In adults over the age of 65, SSRIs pose an additional concern. Studies show that SSRI medications may increase the risk for falls, fractures, and bone loss in older adults. The SSRIs can also cause serious withdrawal symptoms if you stop taking them abruptly. Antidepressant medicines may increase suicidal thoughts or actions in some children, teenagers, and young adults within the first few months of treatment. Individuals being treated with SSRI s should be watched for any change in symptoms or any new symptoms that appear suddenly especially agitation, anxiety, hostility, panic, restlessness, extreme hyperactivity, and suicidal thinking or behavior and report them to the doctor immediately. Be especially observant at the beginning of treatment or whenever there is a change in dose. Fluoxetine (Prozac) Prozac belongs to a class of drugs called selective serotonin reuptake inhibitors (SSRIs). It is used in adults for the treatment of major depressive disorder, panic disorder, obsessive-compulsive disorder, and bulimia. In children and adolescents, Prozac is used to treat major depression and obsessive-compulsive disorder. Side effects may include: abnormal dreams, abnormal ejaculation, abnormal vision, anxiety, chest pain, chills, confusion, diarrhoea, diminished sex drive, dizziness, dry mouth, flu-like symptoms, flushing, gas, headache, hives, impotence, impaired thinking, insomnia, itching, loss of appetite, nausea, nervousness, rash, seizures, sex-drive changes, sinusitis, sleepiness, sore throat, sweating, tremors, upset stomach, vomiting, weakness, yawning
Fluvoxamine maleate (Luvox) Luvox is used to treat obsessive-compulsive disorder. Side effects may include: abnormal ejaculation, agitation, anxiety, diarrhoea, difficulty falling or staying asleep, dizziness, dry mouth, headache, indigestion, nausea, nervousness, sleepiness, sweating, tremor, vomiting, weakness, weight loss Sertraline (Zoloft) Zoloft is an antidepressant medication known as a selective serotonin reuptake inhibitor (SSRI). It is used to treat major depression, obsessive-compulsive disorder, panic disorder, post-traumatic stress disorder, premenstrual dysphoric disorder, and social anxiety disorder. Side effects may include: stomach pain, agitation, anxiety, changes in vision, constipation, decreased sexual drive, diarrhoea, dizziness, dry mouth, fatigue, inability to sleep, increased sweating, loss of appetite/upset stomach, nausea, ejaculation problems, shakiness, tiredness. Paroxetine (Paxil) Paxil is used to treat depression, obsessive compulsive disorder, panic disorder, social anxiety disorder, generalized anxiety disorder, and post-traumatic stress disorder. Side effects may include: abnormal ejaculation, abnormal orgasm, constipation, decreased appetite, decreased sex drive, diarrhoea, dizziness, drowsiness, dry mouth, gas, impotence, male and female genital disorders, nausea, nervousness, sleeplessness, sweating, tremor, weakness, vertigo Escitalopram (Lexapro) Lexapro is used to treat major depression in adults and adolescents 12 to 17 years old. Lexapro is also used to treat generalized anxiety disorder in adults. Side effects may include: decreased sex drive and inability to have an orgasm, difficulty falling or staying asleep, ejaculation problems, fatigue, increased sweating, nausea, sleepiness Citalopram (Celexa) Celexa is a medication for the treatment of depression that persists nearly every day for at least two weeks and interferes with everyday living. Side effects may include: abdominal pain, agitation, anxiety, diarrhea, drowsiness, dry mouth, ejaculation disorders, fatigue, impotence, indigestion, insomnia, loss of appetite, nausea, painful menstruation, respiratory tract infection, sinus or nasal inflammation, sweating, tremor, vomiting
MONOAMINE OXIDASE INHIBITORS (MAOIs) (TRICYCLICs) Tricyclic antidepressants and MAOIs (monoamine oxidase inhibitors) are older classes of antidepressants. Their side effects are more severe than those of the newer antidepressants, so they are only prescribed as a last resort after other treatments and medications have failed. Bupropion (Wellbutrin, Alpenzin, Zyban) Bupropion is used to treat seasonal affective disorder (SAD; episodes of depression that occur in the fall and winter each year). Bupropion (Zyban) is used to help people stop smoking. Side effects may include: drowsiness, excitement, dry mouth, dizziness, headache, nausea, vomiting, uncontrollable shaking of a part of the body, weight loss, constipation, excessive sweating Some side effects can be serious. If your client experiences any of the following symptoms call their doctor immediately: Seizures, confusion, hallucinating (seeing things or hearing voices that do not exist), irrational fears, fever, rash or blisters, itching, hives, swelling of the (face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs), difficulty breathing or swallowing, chest pain, muscle or joint pain, (rapid, pounding, or irregular heartbeat). Venlafaxine (Effexor) Effexor is prescribed for the treatment of depression that interferes with daily functioning. Side effects may include: abnormal ejaculation/orgasm, anxiety, blurred vision, constipation, dizziness, dry mouth, impotence, insomnia, nausea, nervousness, sleepiness, sweating, tremor, vomiting, weakness, weight loss Duloxetine (Cymbalta) Cymbalta is used to treat major depression and diabetic neuropathy, a painful nerve disorder associated with diabetes that affects the hands, legs, and feet. Cymbalta is also used to treat generalized anxiety disorder and fibromyalgia.
Side effects may include: appetite changes, constipation, diarrhoea, dizziness, dry mouth, fatigue, headache, insomnia, nausea, sexual difficulties, sleepiness, sweating, tremor, urinary difficulties, vomiting, weakness Mirtazapine (Remeron) Remeron is a tetracyclic antidepressant used for the treatment of major depressive disorder. Side effects may include: abnormal dreams, abnormal thinking, constipation, dizziness, drowsiness, dry mouth, flu symptoms, increased appetite, weakness, weight gain, decreased ability to fight infection (fever, chill, sore throat), mental or mood changes, mouth sores, thoughts or hurting yourself, tremors, worsening of depression Trazodone (Desyrel) Desyrel is prescribed for the treatment of general depression. Side effects may include: Abdominal or stomach disorder, aches or pains in muscles and bones, anger or hostility, blurred vision, brief loss of consciousness, confusion, constipation, decreased appetite, diarrhoea, dizziness or lightheadedness, drowsiness, dry mouth, excitement, fainting, fast or fluttery heartbeat, fatigue, fluid retention and swelling, headache, inability to fall or stay asleep, low blood pressure, nasal or sinus congestion, nausea, nervousness, nightmares or vivid dreams, tremors, uncoordinated movements, vomiting, weight gain or loss Nerfazodone (Serzone) Serzone is prescribed for the treatment of general depression. Side effects may include: nausea, drowsiness, weakness or tiredness, nightmares, dry mouth, skin more sensitive to sunlight than usual, changes in appetite or weight, constipation, difficulty urinating, frequent urination, blurred vision, changes in sex drive or ability, excessive sweating, Some side effects can be serious. If your client experiences any of the following symptoms call their doctor immediately: muscle spasms (jaw, neck, and back), slow or difficult speech, shuffling walk, uncontrollable shaking of a part of the body, fever, difficulty breathing or swallowing, rash, irregular heartbeat, seizures, painful erections of the penis lasting more than 4 hours.