 Depression is a feeling of intense sadness and loss of interest in things that normally bring pleasure. Most people experience these feelings some time in their lives and the feelings usually go away without treatment. But if your sadness seems out of proportion to life events, you have physical symptoms (changes in sleep or appetite, trouble concentrating, tiredness, or less interest in sex), or the feelings last more than two weeks, you may be suffering from a more severe form of depression called clinical depression. If it becomes severe, suicide can be a risk.Don't try to go it alone with these feelings: It's important to see a doctor so you can be treated. Prescription antidepressant drugs are very effective. Your doctor may also recommend counseling. Several classes of prescription antidepressants are available. Your doctor will consider your medical history and symptoms when deciding which drug to prescribe. Drugs known as selective serotonin reuptake inhibitors (SSRIs) are most commonly prescribed. They include fluoxetine (brand name Prozac), sertraline (>Zoloft), paroxetine (>Paxil), escitalopram (Lexapro), duloxetine (Cymbalta), and citalopram (>Celexa). Generic fluvoxamine and nefazodone are still available, but their brands have been discontinued by their manufacturers due to possible safety concerns. SSRIs are effective and cause few side effects. Venlafaxine (>Effexor), bupropion (>Wellbutrin), and mirtazapine (>Remeron), are drugs that don't belong to a particular class, but 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 drugs such as 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). Although these drugs are very effective, doctors don't prescribe them frequently because they can have serious interactions with certain foods and medications. Don't expect to see improvement in your symptoms right away. It usually takes three to six weeks to feel the full benefit of an antidepressant. Be sure to ask your doctor or pharmacist about any possible side effects of your medication, and take it as prescribed. There is a possible increased risk of suicide in children taking antidepressants. Be sure to talk with your doctor about the benefits and risks of taking these medications. Sources:
Conn's Current Therapy 1999. W. B. Saunders Company, 1998.
National Institute of Mental Health, 1999.
The American Psychiatric Press Textbook of Psychopharmacology. American Psychiatric Press, Inc., 1998.
Medline Plus. Medline, 2006.
Drug Facts and Comparisons. Facts & Comparisons, 2006.
This answer prepared 1/29/2001.
This information updated 2/7/2007.
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