MEDICINE FOR DEPRESSION

Aims

This leaflet is for anyone who wants to know more about antidepressants. It discusses how they work, why they are prescribed, their effects and side-effects, and alternative treatments. If your questions are not answered in this leaflet, there are some references and sources of further information at the end of this leaflet.

Where there are areas of disagreement, we have given references to other publications which will allow you to look into these issues for yourself. These include the effectiveness of antidepressants, problems when you stop taking them, and how they compare with other treatments. At the time of writing, these references were available free and in full on the Internet.

What are antidepressants?

Antidepressants are drugs that relieve the symptoms of depression. They were first developed in the 1950s and have been used regularly since then. There are almost thirty different kinds of antidepressants available today and there are four main types:

• Tricyclics
• MAOIs (Monoamine oxidase inhibitors)
• SSRIs (Selective Serotonin Reuptake Inhibitors)
• SNRIs (Serotonin and Noradrenaline Reuptake Inhibitors)

How do they work?

We don't know for certain, but we think that antidepressants work by increasing the activity of certain chemicals work in our brains called neurotransmitters. They pass signals from one brain cell to another. The chemicals most involved in depression are thought to be Serotonin and Noradrenaline.

What are antidepressants used for?

• Moderate to severe depressive illness (Not mild depression).
• Severe anxiety and panic attacks
• Obsessive compulsive disorders
• Chronic pain
• Eating disorders
• Post-traumatic stress disorder.

If you are not clear about why an antidepressant has been suggested for you, ask your doctor.

How well do they work?

After 3 months of treatment, the proportions of people with depression who will be much improved are:

50% and 65% if given an antidepressant
compared with
25 - 30% if given an inactive "dummy" pill, or placebo

It may seem surprising that people given placebo tablets improve, but this happens with all tablets that affect how we feel - the effect is similar with painkillers. Antidepressants are helpful but, like many other medicines, some of the benefit is due to the placebo effect.