 Depression is a feeling of intense sadness that seems out of proportion to life events, is coupled with physical symptoms (changes in sleep or appetite, trouble concentrating, tiredness, and lowered sex drive), or lasts more than two weeks. Prescription antidepressant drugs are very effective. Doctors may prescribe these medicines alone or combined with counseling. Drugs known as selective serotonin re-uptake inhibitors (SSRIs) are prescribed most often. They include fluoxetine (brand name Prozac), sertraline (Zoloft), paroxetine (Paxil), fluvoxamine (Luvox), and citalopram (Celexa). They’re effective and cause few side effects. Venlafaxine (Effexor), buproprion (Wellbutrin), nefazodone (Serzone), and mirtazapine (Remeron), drugs that don’t belong to a particular class, are as effective as the SSRIs, and most people tolerate them well. The tricyclic antidepressants (TCAs), an older class of drugs that includes Nortriptyline (Pamelor) and amitriptyline (Elavil), are effective and inexpensive but may have more side effects than newer antidepressants like the SSRIs. Monoamine oxidase inhibitors (MAOIs) are generally prescribed to treat depression that hasn’t responded to other therapies. They include Phenelzine (Nardil), tranylcypromine (Parnate), and isocarboxazid (Marplan). These drugs are very effective but doctors prescribe them infrequently because they can have serious interactions with certain foods and medicines. Your doctor will prescribe an antidepressant based on your medical history and symptoms. Don’t expect to see improvement in your symptoms right away. It usually takes three to six weeks to feel the full benefit of antidepressant drugs. References:
Conn's Current Therapy 1999. W. B. Saunders Company, 1999.
National Institute of Mental Health, 1999.
The American Psychiatric Press Textbook of Psychopharmacology. American Psychiatric Press, Inc., 1998. This answer prepared 10/15/99.
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