Most depressed people need antidepressant medications to treat their depression. However, less than 10% of people with depression are treated adequately with medication. Antidepressants can improve or completely relieve the symptoms of depression. Several medication options are available to treat depression, depending on your age and tolerance of the medications.
- Selective serotonin reuptake inhibitors (SSRIs).
- Tricyclic (TCAs) and heterocyclic antidepressants.
- Monoamine oxidase inhibitors (MAOIs).
What to Think About
If you and your doctor decide that you need medication therapy, there are several considerations in choosing the right medication.
- Understand the side effects of the medication.
- Tell your doctor about all medications you are taking for other illnesses so the doctor can determine whether there are drug interactions.
- If you are an older person, you may need less medication, and it may take longer to be effective.
- Your health care professional will need to monitor your progress every two weeks until it can be determined whether a particular medication is working for you.
- It may take several trials of different medications before you and your doctor find the right medication to treat your depression.
- Once you have begun to feel better, you will need to continue taking your medication for a minimum of 16 to 36 weeks to help reduce the likelihood of another depressive episode.
- Some people need to remain on maintenance medication therapy for the remainder of their lives.
When deciding which medication to prescribe, your doctor will consider:
- Your response to medications in previous depressive episodes.
- Whether you have other illnesses that need to be treated, so you are not given a depression medication that will interact poorly with other medicines you may be taking.
- Which symptoms you are experiencing. Some antidepressants work better than others, depending on the person's symptoms.
- Your age and general state of physical health. Older adults and adults who are taking prescription medications usually need to take lower doses of medications for depression.
- How much the side effects of the medication bother you.
Up to 35% of people with depression do not continue taking their medications for depression. It is important to continue taking medications for your depression as prescribed, even after symptoms go away, to prevent recurrence of depression.
Antidepressant medications often need to be taken for as long as 4 to 6 weeks before they start to relieve the symptoms of depression. During this time, you may experience side effects of the medication. Do not stop taking the medication on your own. If your side effects are particularly bothersome, talk with your doctor to see if you should continue the medication or try another. Often, the side effects will go away in time. There are many things you can do to reduce bothersome side effects of medications.
Most antidepressant medications need to be started at low doses and increased gradually, especially in older adults. Medications should also be stopped gradually by decreasing the dose. If antidepressant medications are stopped abruptly, you may suffer negative effects or the symptoms of depression may return.
Sometimes people on antidepressants need to be very careful when changing from a brand name medication to a generic medication (or vice versa), or when changing from one manufacturer of a medication to another. Making these changes may cause changes in the amount of medication their bodies absorb.
Older adults who are depressed and taking medications for other health conditions (not related to depression) need careful monitoring of their medications. Older adults are more likely to develop harmful side effects from taking many different medications (because it can be more difficult for the older person's body to break down all the different medications).
next: Depression and HIV/AIDS