Avoid Depression Relapse: Don't Just Drop Your Meds

Talk to a Doctor Before Making Treatment Decisions

Avoid Depression Relapse: Don't Just Drop Your Meds

By Amy Abbott Published at August 28, 2013 Views 3,927 Comments 1

Antidepressants may be among the most maligned of prescriptions drugs, Yet, for millions of patients with depression they can be a lifesaver.

Awash in mythology — some ridiculous, some frightening — patients may worry that antidepressants will make them gain or lose weight, become catatonic, or lose libido. And those worries might encourage them to make bad decisions about taking their medications.

While the FDA publishes reported side effects in labeling, not every patient taking antidepressants will experience all side effects at one time, and may experience none.

It also might be tempting to assume that because you're not suffering symptoms right now, that you don't need treatment and can stop medications.

The reality is that many individuals with moderate to severe depression need and benefit from antidepressant medications as part of their total treatment. And going "cold turkey" off your meds is dangerous. Before you change your treatment, be sure to discuss with your doctor.

In it for the long haul.

As with any medication, patients must follow the labeling instructions. For example, if the label directs patients to take with food, take with food,

Most physicians report that antidepressants, unlike a drug for heartburn, may take a long time to get to full efficacy. The British Journal of Psychiatry noted that antidepressants may change the balance of emotional processing, but that doesn't happen overnight.

Individuals who suddenly stop taking an antidepressant may have withdrawal symptoms.

The mystery behind drug therapy.

Despite much literature in the clinical and popular press about antidepressants, experts aren't fully sure how or why they work in the human brain. These four categories make up the popular therapies prescribed today.

Selective serotonin re-uptake inhibitorsMayo Clinic reports SSRIs prompt the brain's neurotransmitters or messengers, which communicate between brain cells. By obstructing the re-absorption of serotonin, the brain seems to better send and receive messages, thus improving mood.

Selective Serotonin and norepinephrine reuptake inhibitors — Also used to treat anxiety pain, researchers believe that SSNIs assist with transmission of several neurotransmitters in the brain.

Monoamine oxidase inhibitorsCleveland Clinic reports that MAOIs are still used, but primarily as third or fourth line therapy. Because of dietary guidelines, patients started taking the newer classes of drugs.

Tricylic antidepressantsTCAs also make available the brain chemical serotonin and norepinephrine, improving mood. Because of side effects, they fell out of favor when SSRIs became popular, but are still available and prescribed.

The takeaway

Depression isn't like a virus picked up from a child's daycare center. It is often a lifelong condition that requires good communication with a trusted medical professional.

Your prescriber wants you to succeed on therapy. Keep communication open. For example, prescription drugs can be expensive; thankfully there are many effective generic drugs on the marketplace today. Patients need to work with their prescriber to find the one that works well for them. If price is a concern, let your physician know.

Many pharma companies that sell branded drugs — when there is no generic equivalent — have programs for reduced cost. The National Mental Health Association also works with the Partnership for Prescription Assistance.

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