The first antidepressants were discovered by chance during the 1950s at the Munsterlingen asylum in Switzerland when scientists were exploring medications to treat schizophrenia. The first antidepressant, called imipramine, was first given to patients in 1955 and was referred to as a “miracle cure” for depression. Imipramine was sold under the name of Tofranil, which was then followed by multiple competing drug companies to synthesize different tricyclic medications, or antidepressants. Prozac, introduced in 1987, Zoloft, introduced in 1991, and Paxil, introduced in 1992, were new alternatives to Tofranil, since many patients had experienced side effects include sluggishness, weight gain, and occasional overdose from the intake of imipramine. Prozac, Zoloft, and Paxil differ from Tofranil in that they are selective serotonin reuptake inhibitors (SSRIs), which specifically targets serotonin, the chemical compound in the brain that facilitates signals between nerve cells. The APA reported statistics from November 2017 that an average of 12.7% of the U.S. population over age 12 took an antidepressant medication in the last month, and an article published by TIME Magazine indicates that as many as 1 in 10 Americans is on some form on antidepressant medication.
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One of the most commonly prescribed antidepressant medications are reuptake inhibitors. There are three general groups of reuptake inhibitors: SSRIs, SNRIs, and NDRIs. SSRIs, mentioned in the previous paragraph, affect the serotonin transporter which eventually alters serotonin levels in the brain. SNRIs, or serotonin and norepinephrine reuptake inhibitors, block the reuptake of serotonin and norepinephrine. Some generic examples of SNRIs include: Cymbalta, Effexor, and Khedezla. Finally, NDRIs, or norepinephrine and dopamine reuptake inhibitors affect the reuptake of norepinephrine and dopamine. The generic for NDRIs is Wellbutrin. Other types of antidepressants include tetracyclics, which instead of preventing reuptake of certain chemicals, prevent neurotransmitters from binding with specific nerve receptors, which allow norepinephrine and serotonin levels to rise and build up between nerve cells. Generics for NDRIs include Asendin, Ludiomil, and Remeron. In addition, serotonin antagonist and reuptake inhibitors (SARIs) prevent the reuptake of serotonin and prevent serotonin from binding to undesired receptors. Serzone and trazodone are examples of SARIs. Additional types of antidepressants include tricyclic antidepressants (TCAs), monoamine oxidase inhibitors (MAOIs), and nutraceuticals.
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The effectiveness of antidepressants is highly subjective. According to NPS MedicineWise, about 50% of people on antidepressants report that their depression symptoms have halved. The website also claims that antidepressants are more effective in those with moderate to severe depression, rather than mild depression. Often cognitive behavior therapy (CBT) is a recommended effective treatment for those with mild depression.
In addition to their effectiveness being subjective, antidepressants’ side effects are also highly subjective. Often, those who have just started taking antidepressants experience insomnia, nausea, and dizziness within the first few weeks, and gradually these symptoms go away. Weight gain and loss are also symptoms that may be caused by taking antidepressants. Antidepressants can also have negative sexual side effects such as decreased libido, delayed ejaculation, erectile dysfunction, or delayed ability to reach orgasm.
As someone who has been on and off antidepressants for more than 5 years, I think it’s important to be aware of how antidepressants work, what types there are, and what their side effects may be before trying them. For me personally, antidepressants have noticeably helped my depression and anxiety over the past 5 years. Lucky for me, the first antidepressant I tried (sertraline, also known as Zoloft) worked for me, and I have been on it ever since I started it. There were few times in the past 5 years in which I tried lowering my dosage and stopping taking sertraline, but I found that I wasn’t ready to be off of the medication yet, given my headspace. Currently I am taking 200 mg of sertraline, and I have found that this dosage is what works best for myself.
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I recommend to anyone who is considering taking antidepressants or even is currently taking antidepressants to educate yourself on what they are and their possible side effects. More importantly, get a formal diagnosis by a psychiatrist to see if taking antidepressants would be a good thing to try. It is reasonable to be hesitant about taking antidepressants, especially with their known side effects. Despite some of these side effects, I continue to take antidepressant medication because it helps reduce my anxiety and depression, as well as improve my overall mood. I also try not to rely too heavily on my antidepressant medication by exercising, being with friends, and doing things I enjoy to help combat my depression. It is a choice that should be entirely up to you, and this choice should be facilitated with accurate and extensive information. Lastly, there’s nothing wrong with being on antidepressants or being prescribed antidepressants. Oftentimes, antidepressants and depression in general can be stigmatized, despite there being millions of adults on antidepressants. Anything that has been scientifically proven to be a healthy and positive way to combat depression and anxiety is not a thing of shame when tried.