🕷️ Crawler Inspector

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Direct Parameter Lookup

Raw Queries and Responses

1. Shard Calculation

Query:

Response:

Calculated Shard: 67 (from laksa165)

2. Crawled Status Check

Query:

curl -X POST \
  'http://laksa067.int.ahrefs:8124/' \
  -H 'Content-Type: text/plain' \
  -H 'X-ClickHouse-Database: crawler3' \
  -H 'Authorization: Basic YXBpOg==' \
  -d 'SELECT getAhrefsURLFromUnparsed(src_unparsed) AS found_url, ifNull(toUnixTimestamp(download_stamp), 0) AS crawl_time, ifNull(toUnixTimestamp(props_url_first_seen), 0) AS first_indexed_time, download_http_code AS http_code, src_unparsed AS src_unparsed, src_root_hash AS src_root_hash, history_drop_reason AS history_drop_reason, meta_title AS meta_title, meta_descriptions AS meta_descriptions, attrs_boilerpipe_text AS attrs_boilerpipe_text, attrs_markdown AS attrs_markdown, attrs_readable_markdown AS attrs_readable_markdown, meta_canonical AS meta_canonical, ml_categories_json AS ml_categories_json, ml_types_json AS ml_types_json, ml_intent_types_json AS ml_intent_types_json, meta_language AS meta_language, attrs_author AS attrs_author, ifNull(toUnixTimestamp(attrs_publish_time), 0) AS attrs_publish_time, ifNull(toUnixTimestamp(attrs_original_publish_time), 0) AS attrs_original_publish_time, ifNull(attrs_is_republished, 0) AS attrs_is_republished, ifNull(attrs_nr_words, 0) AS attrs_nr_words, ifNull(attrs_boilerpipe_nr_words, 0) AS attrs_boilerpipe_nr_words, ifNull(body_ext_links_number, 0) AS body_ext_links_number, ifNull(body_int_links_number, 0) AS body_int_links_number, ifNull(meta_nofollow, 0) AS meta_nofollow, ifNull(meta_noarchive, 0) AS meta_noarchive, ifNull(props_was_rendered, 0) AS props_was_rendered, ifNull(src_redirect, \'\') AS src_redirect, ifNull(download_time_msec, 0) AS download_time_msec, ifNull(download_ttfb_msec, 0) AS download_ttfb_msec, ifNull(download_size, 0) AS download_size FROM crawler3.page_info_local FINAL PREWHERE (src_root_hash, src_unparsed) IN ((getAhrefsRootHashFromUnparsed(getAhrefsUnparsedNoserviceFromURL(\'https://www.therecoveryvillage.com/treatment-program/addiction-medications/antidepressants/\')), getAhrefsUnparsedNoserviceFromURL(\'https://www.therecoveryvillage.com/treatment-program/addiction-medications/antidepressants/\'))) FORMAT JSONEachRow'

Response:

{"found_url":"https:\/\/www.therecoveryvillage.com\/treatment-program\/addiction-medications\/antidepressants\/","crawl_time":1776267951,"first_indexed_time":1563546406,"http_code":200,"src_unparsed":"com,therecoveryvillage!www,\/treatment-program\/addiction-medications\/antidepressants\/ s443","src_root_hash":"8559758477774084267","history_drop_reason":null,"meta_title":"Antidepressants | How Do Antidepressants Work? | Learn More","meta_descriptions":["Antidepressants help alleviate the symptoms of depression. Knowing the different types of antidepressants can help you understand the best treatment options."],"attrs_boilerpipe_text":"Antidepressants help alleviate the symptoms of depression and are one of the three most prescribed medication classes in America.\nAntidepressantsare used in the\nmanagement of depression\nto help alleviate symptoms.Antidepressant drugsare\none of the three\nmost commonly prescribed therapeutic drug classes, and the use of antidepressants in the treatment of various mental health conditions has\nincreased\nsignificantlyin recent years.\nUnderstanding howantidepressant medicationswork and why they may help manage depression or other\nmental health disorders\ncan be beneficial when discussing treatment options with a doctor.\nWhat Are Antidepressants?\nAntidepressant medicationsare used to alleviate symptoms associated with depression, such as fatigue, loss of interest, trouble sleeping, overwhelming feelings of guilt or worthlessness orthoughts of suicide. They work by augmenting different natural chemicals in the brain, also known as neurotransmitters, to influence a person’s mood.\nBackground and History\nThehistory of antidepressantsbegan in the\n1950s\n, with the thought that changing the balance of certain natural chemicals in the brain would cause changes in mood and could produce euphoria or feelings of happiness.\nFree, Confidential Helpline\nReady to take the next step toward recovery?\nOur Recovery Advocates are available around the clock to answer your questions, verify your insurance, and help you find the right level of care — at no cost to you.\nCall Us Now\nAvailable 24 hours a day, 7 days a week\nThe\nfirst two antidepressants\nto show success in the management of depression were iproniazid, a monoamine oxidase inhibitor (MAOI) that was originally developed for the treatment of tuberculosis, and imipramine, a tricyclic antidepressant (TCA). The success of these medications in the management of depression and the subsequent accepted use by prescribers led to the development of other medications in these two drug classes. However, these medications came with\nconsiderable side effects\n, including weight gain, fatigue and the potential of death from overdose.\nThe 1980s and 90s marked a drastic change in the management of depression as groundbreaking developments were made with the introduction of new medications called selective serotonin reuptake inhibitors (\nSSRIs\n), serotonin-norepinephrine reuptake inhibitors (\nSNRIs\n) and atypical antidepressants.\nThese medications had greater clinical success with fewer side effects than the previously used medications, making them much more popular for the management of depression. The first wasProzac (fluoxetine), an SSRI, which was introduced to the American market in 1987, and was received with monumental popularity with annual sales soon topping\n$1 billion\n.\nCurrently, the Centers for Disease Control and Prevention (CDC) report that approximately\n1 in 10 people\naged 12 years and older take an antidepressant, with the use of antidepressants approximately\ndoubling\nbetween 1999 to 2014.\nUse in Treating Mental Illness\nAntidepressants have become widely accepted as effective in the management of depression as well as other mental illnesses, including\nanxiety disorders\n,\ncompulsion disorders\nand other\nmood disorders\n.\nThe American Psychiatric Association recommends the use ofantidepressants for depressionto modify an individual’s brain chemistry, which may be causing the symptoms of depression. These medications have successfully managed depression because they arenot habit-formingand they do not act as stimulants or sedatives.\nAntidepressants for anxietycan help\nalleviate anxiety symptoms\nwhile also reducing the symptoms of depression that commonly accompany anxiety disorders as coexisting conditions.\nHow Do Antidepressants Work?\nThere are three naturally occurring chemicals, also known as neurotransmitters, in the brain that are linked with the regulation of mood and emotions. These\nchemicals are serotonin, norepinephrine and dopamine\n, and they are part of a larger group of chemicals known as monoamines.\nThe theory behind the role of these three neurotransmitters in depression is known as the monoamine hypothesis, first accepted in the 1960s. This theory proposes that people with depression have depleted concentrations of serotonin, norepinephrine and dopamine in the brain, resulting in the symptoms associated with depression.\nThe different types of antidepressants vary in how they affect the concentrations of these brain chemicals. Because of the time that it takes to change the concentrations of these chemicals in the brain,it can take at least\nthree to four weeks or up to four months\nfor a patient to notice a significant difference in their mood when starting or switching an antidepressant medication.\nAlso, everyone’s brain chemistry is slightly different so what works for one person, most likely will not work exactly the same for another person. Therefore, one of the most important factors that affectwhat antidepressants dois the individual makeup and concentrations of serotonin, norepinephrine and dopamine in each person.\nTypes of Antidepressants\nAntidepressants areclassifiedbased on how they work, also known as their mechanism of action. A comprehensiveantidepressant listwould include up to\nnearly 50 different medications\nthat have been used over time in the management of depression, whether it was diagnosed by itself or as a co-occurring disorder with other mental health conditions.\nHowever, the list ofcommon antidepressantsis much smaller and includes:\nProzac(fluoxetine)\nCymbalta(duloxetine)\nPaxil(paroxetine)\nZoloft(sertraline)\nWellbutrin(bupropion)\nLexapro(escitalopram)\nCelexa(citalopram)\nEffexor(venlafaxine)\nRemeron(mirtazapine)\nThesecommon antidepressantscome from a couple of different classes that are defined by their mechanism of action.\nSelective Serotonin Reuptake Inhibitors (SSRIs)\nSelective serotonin reuptake inhibitors\n(SSRIs) are the most commonly prescribed antidepressants as they are typically thefirst-line agentsof choice when initiating treatment for a patient. Essentially,SSRI drugswork by targeting serotonin in the brain to prevent reuptake, resulting in an increase in serotonin in the brain.\nSomeSSRImedications\ninclude\n:\nCelexa (citalopram)\nLexapro (escitalopram)\nLuvox (fluvoxamine)\nProzac (fluoxetine)\nPaxil (paroxetine)\nZoloft (sertraline)\nSerotonin-Norepinephrine Reuptake Inhibitors (SNRIs)\nSerotonin-norepinephrine reuptake inhibitors\n(SNRIs), orSNRI drugs,inhibit the reuptake of the neurotransmitters serotonin and norepinephrine in the brain. How these medications affect the brain is\ndose-dependent\n, meaning that at lower doses, they only affect the reuptake of serotonin, but at higher doses, they affect the reuptake of norepinephrine also.\nSome SNRImedications\ninclude\n:\nEffexor (venlafaxine)\nPristiq (desvenlafaxine)\nCymbalta (duloxetine)\nFetzima (levomilnacipran)\nRelated Topic:\nSSRI vs SNRI\nTricyclic Antidepressants (TCAs)\nTricyclic antidepressants(TCAs) were the\nmost commonly prescribed class\nof antidepressants until the introduction of SSRIs in the 1980s and 1990s. Similar to SNRIs,TCA drugswork mainly by inhibiting the reuptake of serotonin and norepinephrine.\nThe use of TCA drugs is mainly reserved for patients who have been well-controlled on these medications for many years or for patients who do not respond well to SSRIs or SNRIs. The use of TCA drugs has decreased because they tend to cause more side effects and they require more monitoring through laboratory tests because an overdose of a TCA can be deadly.\nSome TCA medications include:\nElavil (amitriptyline)\nTofranil (imipramine)\nNorpramin (desipramine)\nPamelor (nortriptyline)\nAnafranil (clomipramine)\nSilenor (doxepin)\nMonoamine Oxidase Inhibitors (MAOIs)\nMonoamine oxidase inhibitors\n, also known asMAOIs, work by\ninhibiting specific enzymes\nthat are responsible for a class of chemicals called monoamines. For the treatment of depression, the three monoamines of interest are serotonin, dopamine and norepinephrine. By inhibiting the breakdown of these chemicals, also known as neurotransmitters, MAOIs trigger an increase in serotonin, norepinephrine and dopamine.\nThe different MAOIs available prevent the breakdown of different monoamines depending on their specific chemical structure. Because these medications affect more monoamines than just those involved in depression, it is common to see this class of medication used in the treatment of other conditions, such as Parkinson’s Disease.\nTypically, MAOIs are used as a\nlast-line option\nfor the treatment of depression because they have many interactions with other drugs, and an overdose can be deadly.\nSome MAOI medications include:\nNardil (phenelzine)\nParnate (tranylcypromine)\nAtypical Antidepressants\nAtypical antidepressantsis the term used to classify the remaining available antidepressants that have unique mechanisms of action and do not fall under another, more specific, category.\nAtypical antidepressants include:\nWellbutrin (bupropion)\nRemeron (mirtazapine)\nSerzone (nefazodone)\nDesyrel (trazodone)\nViibryd (vilazodone)\nTrintellix (vortioxetine)\nEffectiveness of Antidepressants\nAntidepressant medications are widely accepted as effective and beneficial for the management of depression. The simple answer to the question “Do antidepressants work?” is \nyes\n; however, it can take several weeks for these medications to reach full effectiveness, making it a slow, sometimes frustrating process when choosing or switching antidepressant medications.\nBecause there are so many options available for\ndepression treatment\n, recently there has been increasing debate regarding which options are the best for first-line treatment. A\nrecent review\nevaluating the results of over 500 clinical studies concluded that five antidepressants appear to be more effective, better tolerated and less likely to be changed after eight weeks of treatment than other drugs. These drugs are:\nLexapro (escitalopram)\nPaxil (paroxetine)\nZoloft (sertraline)\nRemeron (mirtazapine)\nAgomelatine (a medication that is not marketed in the United States)\nWhen evaluating themost effective antidepressantmedications, the effectiveness of a certain medication is dependent on the person’s brain chemistry. Although the findings of the above-mentioned study may provide some guidance regarding good first-line options for treatment, a doctor should consider a person’s unique symptoms, medical history, and risk for side effects when\nchoosing the most appropriate option for a patient\n.\nBecause antidepressants generally take several weeks to achieve full effectiveness, it is very important to take the medication on a regular basis, to follow-up with a doctor routinely and to not stop the medication abruptly, which could cause withdrawal reactions.\nSide Effects\nCommon side effects of antidepressants include: \nNausea and vomiting\nWeight gain\nDiarrhea or stomach upset\nSleep disturbances, such as feeling very sleepy or having difficulty falling asleep\nSexual dysfunction\nSome antidepressants can have serious side effects and these side effects should be discussed with your doctor:\nSuicidal thinking\nBirth defects\nHigh blood pressure\nWhen researching antidepressants, there is a lot of controversy regarding thelong-term effects of antidepressants. Some\nresearch\nsuggests that the use of antidepressants may increase the risk for a person dying prematurely. However, many prescribers maintain that the appropriate use of these medications can help patients lead happier and healthier lives.\nAlso, due to the nature of how antidepressant medications work and the neurotransmitters that they affect, it is\npossible for patients to experience a decrease in effectiveness\nover time due to the brain becoming less responsive to the medications, also known as tolerance.\nTypically, the most bothersome side effects for patients areantidepressants’ sexual side effectsand weight gain. Weight gain is a possible side effect with nearly all antidepressants except Wellbutrin (bupropion). Bupropion is commonly considered the\nmedication of choice\nfor patients who would benefit from possibleantidepressant weight loss.\nWhen considering the possible side effects of any medication, including antidepressants, it is important for prescribers and patients to weigh the risks and benefits of taking a certain medication. If the benefits outweigh the risks, then it is a good choice. It is important to be upfront with a doctor regarding expectations for treatment to have the best chance for treatment success.\nRisk of Suicide\nAntidepressants and suicide have become increasing concerns in the health care community. In 2004, the Food and Drug Administration (FDA) required manufacturers to add a boxed warning to all antidepressant medications to highlight the increased risk of suicidal thinking or behavior in children and adolescents during the initiation of treatment. In 2007, this warning was expanded to include young adults up to the age of 24 years old. \nBecause of the potential forantidepressants causing suicidal thoughts, routine follow-up and closing monitoring are very important in helping prevent a tragic outcome. Patients should inform their health care provider immediately if they begin to feel worse or develop new symptoms, especially after changing their medication or dose.\nIf you or someone you know is having\nsuicidal thoughts\n, don’t wait to get help. Call your doctor immediately, go to an emergency room or call the\nNational Suicide Prevention Lifeline\nat\n1-800-273-TALK (8255)\n. If you’d rather not speak to a person, you can reach the Crisis Text Line by texting HOME to 741741 from anywhere in America.\nSerotonin Syndrome\nBecause some antidepressant medications achieve their effectiveness by increasing the amount of serotonin in the brain, they have the risk of causing serotonin syndrome. Serotonin syndrome is a potentially life-threatening condition with\nsymptoms\nlike:\nAgitation\nMuscle tremors\nRacing heartbeat\nVomiting\nDiarrhea\nIncreased sweating\nMuscle rigidity\nSerotonin syndrome\nhas been reported\nwith SSRIs and SNRIs. Serotonin syndrome can occur when SSRIs and SNRIs are taken alone, but the risk of experiencing this condition rises when these drugs are taken with other serotonergic agents, like St. John’s Wort and tricyclic antidepressants and triptans, or other drugs likefentanyl,lithium,\ntram\na\ndol\nand\nampheta\nm\nines\n.\nIf someone believes that they are experiencing serotonin syndrome, they should discontinue their medication immediately and seek medical treatment right away. The risk for serotonin syndrome increases during treatment initiation and dose increases. It is important to discuss the signs and symptoms of serotonin syndrome with a health care provider when taking medications that may increase levels of serotonin in the body.\nPossible Interactions\nAntidepressant interactionsexist with many other medications (prescription and over-the-counter), supplements and food. Specifically, MAOIs are the most notable antidepressant class for having interactions with other medications, supplements and food. However, TCAs, SNRIs and SSRIs carry the risk for serotonin syndrome among other interactions. Because depression commonly occurs with other medical conditions, it is important to discuss the potential for drug interactions with a health care provider.\nOne example of a common combination of medications is antidepressants and antipsychotics.The antidepressants and antipsychotics interactionhappens because SSRIs and some antipsychotics\ncompete in the liver\nfor a limited amount of enzymes that are responsible for the metabolism of the medication. With a decrease in the metabolism of these medications, drug levels in the blood will fluctuate and may lead to decreased effectiveness of the medication or drug levels that are too high.\nAlso, antidepressants can have interactions with certain foods and beverages. One very serious interaction is between\nantidepressants and alcohol\n. Alcohol has multiple ways of interacting with antidepressants, and it can negatively affect depression and can worsen the side effects of certain antidepressants, such as SSRIs. It is important to discuss the possibility of antidepressant interactions when speaking with a health care provider.\nTaking Antidepressants While Pregnant\nMany women of childbearing age will ask their doctors about the possible effects of antidepressants on pregnancy. Taking antidepressants while pregnant is not a concern for some antidepressants. However, some other antidepressant medications might harm an unborn baby if an expectant mother takes them during pregnancy. If someone is considering taking an antidepressant medication and is pregnant, plans to become pregnant or is breastfeeding, it’s best to consult a doctor before taking antidepressants.\nStopping Antidepressants\nThere are many reasons why a patient may consider or be considered by their health care provider for discontinuation of their antidepressant treatment. When discontinuing antidepressants, it is important to\ntaper (gradually decrease the dose) over at least several weeks\nto preventantidepressant withdrawal.\nThe specific recommendations ofhow to taper off antidepressantsis dependent on the specific antidepressant(s) that a patient is taking. It is important to discuss any questions regarding stopping an antidepressant with a health care provider.\nWhat to Do in Case of Overdose\nAntidepressant overdosecan be very serious and must be treated by trained medical professionals.What happens when you overdose on antidepressantsdepends on the type of antidepressant(s) you are taking. Most SSRIs are noted as being\nconsidered generally safe\n, but when taken in excessive dosages, they have a risk for a serious heart arrhythmia called QTc prolongation. Additionally,\nTCAs and MAOIs\ncan be fatal when taken in excess.\nIf you think someone may have taken an overdose of an antidepressant (or any drug), call poison control at 1-800-222-1222 immediately as assistance is available 24 hours a day.\nGet More Information on Antidepressants\nIf you or someone you know needs more information regarding antidepressants, you can gather more information regarding these medications by:\nSpeaking with a mental health professional or therapist\nTalking with a primary care doctor\nVisiting\nMedlinePlus: Antidepressants\nVisiting\nHelpGuide: Antidepressant Medications\nDo you or does someone you love struggle with\ndrug or alcohol addiction and depression\n? The Recovery Village is here to help with comprehensive, compassionate treatment. We have\nseveral facilities\nthat can offer treatment for\ndepression and addiction\n. To speak with a caring representative,\ncall The Recovery Village\ntoday.","attrs_markdown":"Manage Consent\n\nTo provide the best experiences, we use technologies like cookies to store and\/or access device information. Consenting to these technologies will allow us to process data such as browsing behavior or unique IDs on this site. Not consenting or withdrawing consent, may adversely affect certain features and functions.\n\nFunctional\n\nFunctional\n\nAlways active\n\nThe technical storage or access is strictly necessary for the legitimate purpose of enabling the use of a specific service explicitly requested by the subscriber or user, or for the sole purpose of carrying out the transmission of a communication over an electronic communications network.\n\nPreferences\n\nPreferences\n\nThe technical storage or access is necessary for the legitimate purpose of storing preferences that are not requested by the subscriber or user.\n\nStatistics\n\nStatistics\n\nThe technical storage or access that is used exclusively for statistical purposes. The technical storage or access that is used exclusively for anonymous statistical purposes. 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[Tennessee](https:\/\/www.therecoveryvillage.com\/local-rehab-resources\/tennessee\/)\n  - [Texas](https:\/\/www.therecoveryvillage.com\/local-rehab-resources\/texas\/)\n  - [Vermont](https:\/\/www.therecoveryvillage.com\/local-rehab-resources\/vermont\/)\n  - [Utah](https:\/\/www.therecoveryvillage.com\/local-rehab-resources\/utah\/)\n  - [Virginia](https:\/\/www.therecoveryvillage.com\/local-rehab-resources\/virginia\/)\n  - [Washington](https:\/\/www.therecoveryvillage.com\/local-rehab-resources\/washington\/)\n  - [West Virginia](https:\/\/www.therecoveryvillage.com\/local-rehab-resources\/west-virginia\/)\n\n[(352) 771-2700](tel:3527712700)\n\n**We are available** - help is a call away.\n\n[(352) 771-2700](tel:3527712700)\n\n**We are available** - help is a call away.\n\n[Verify Insurance](https:\/\/www.therecoveryvillage.com\/admissions\/insurance\/#s-insurance)\n\n[Find Location](https:\/\/www.therecoveryvillage.com\/locations\/)\n\n[Home](https:\/\/www.therecoveryvillage.com\/) \\> [Drug & Alcohol Treatment Programs Near Me](https:\/\/www.therecoveryvillage.com\/treatment-program\/) \\> [Addiction Medications](https:\/\/www.therecoveryvillage.com\/treatment-program\/addiction-medications\/) \\> Antidepressants\n\n# Antidepressants\nJump To\n\n- [What Are Antidepressants?](https:\/\/www.therecoveryvillage.com\/treatment-program\/addiction-medications\/antidepressants\/#iframe-trv-form-intake)\n- [Background and History](https:\/\/www.therecoveryvillage.com\/treatment-program\/addiction-medications\/antidepressants\/#iframe-trv-form-intake)\n- [Use in Treating Mental Illness](https:\/\/www.therecoveryvillage.com\/treatment-program\/addiction-medications\/antidepressants\/#iframe-trv-form-intake)\n- [How Do Antidepressants Work?](https:\/\/www.therecoveryvillage.com\/treatment-program\/addiction-medications\/antidepressants\/#iframe-trv-form-intake)\n- [Types of Antidepressants](https:\/\/www.therecoveryvillage.com\/treatment-program\/addiction-medications\/antidepressants\/#iframe-trv-form-intake)\n- [Effectiveness of Antidepressants](https:\/\/www.therecoveryvillage.com\/treatment-program\/addiction-medications\/antidepressants\/#iframe-trv-form-intake)\n- [Side Effects](https:\/\/www.therecoveryvillage.com\/treatment-program\/addiction-medications\/antidepressants\/#iframe-trv-form-intake)\n- [Risk of Suicide](https:\/\/www.therecoveryvillage.com\/treatment-program\/addiction-medications\/antidepressants\/#iframe-trv-form-intake)\n- [Serotonin Syndrome](https:\/\/www.therecoveryvillage.com\/treatment-program\/addiction-medications\/antidepressants\/#iframe-trv-form-intake)\n- [Possible Interactions](https:\/\/www.therecoveryvillage.com\/treatment-program\/addiction-medications\/antidepressants\/#iframe-trv-form-intake)\n- [Taking Antidepressants While Pregnant](https:\/\/www.therecoveryvillage.com\/treatment-program\/addiction-medications\/antidepressants\/#iframe-trv-form-intake)\n- [Stopping Antidepressants](https:\/\/www.therecoveryvillage.com\/treatment-program\/addiction-medications\/antidepressants\/#iframe-trv-form-intake)\n- [What to Do in Case of Overdose](https:\/\/www.therecoveryvillage.com\/treatment-program\/addiction-medications\/antidepressants\/#iframe-trv-form-intake)\n- [Get More Information on Antidepressants](https:\/\/www.therecoveryvillage.com\/treatment-program\/addiction-medications\/antidepressants\/#iframe-trv-form-intake)\n- [Find A Center Near You](https:\/\/www.therecoveryvillage.com\/treatment-program\/addiction-medications\/antidepressants\/#elementor-toc__heading-anchor-14)\n- [Reach out now](https:\/\/www.therecoveryvillage.com\/treatment-program\/addiction-medications\/antidepressants\/#elementor-toc__heading-anchor-15)\n\n[(352) 771-2700](tel:3527712700)\n\n**24\/7 Confidential Support**\n\nGet customized treatment near you.\n\n### Antidepressants help alleviate the symptoms of depression and are one of the three most prescribed medication classes in America.\nAntidepressantsare used in the[management of depression](https:\/\/www.therecoveryvillage.com\/mental-health\/depression\/treatment\/)to help alleviate symptoms.Antidepressant drugsare[one of the three](https:\/\/www.cdc.gov\/nchs\/products\/databriefs\/db283.htm)most commonly prescribed therapeutic drug classes, and the use of antidepressants in the treatment of various mental health conditions has[increased](https:\/\/www.apa.org\/monitor\/2017\/11\/numbers)significantlyin recent years.\n\nUnderstanding howantidepressant medicationswork and why they may help manage depression or other[mental health disorders](https:\/\/www.therecoveryvillage.com\/mental-health\/)can be beneficial when discussing treatment options with a doctor.\n\n## What Are Antidepressants?\nAntidepressant medicationsare used to alleviate symptoms associated with depression, such as fatigue, loss of interest, trouble sleeping, overwhelming feelings of guilt or worthlessness orthoughts of suicide. They work by augmenting different natural chemicals in the brain, also known as neurotransmitters, to influence a person’s mood.\n\n## Background and History\nThehistory of antidepressantsbegan in the[1950s](http:\/\/content.time.com\/time\/health\/article\/0,8599,1952143,00.html), with the thought that changing the balance of certain natural chemicals in the brain would cause changes in mood and could produce euphoria or feelings of happiness.\n\nFree, Confidential Helpline\n\nReady to take the next step toward recovery?\n\nOur Recovery Advocates are available around the clock to answer your questions, verify your insurance, and help you find the right level of care — at no cost to you.\n\nCall Us Now\n\n[(352) 771-2700](tel:3527712700)\n\nAvailable 24 hours a day, 7 days a week\n\nThe[first two antidepressants](https:\/\/www.britannica.com\/science\/antidepressant)to show success in the management of depression were iproniazid, a monoamine oxidase inhibitor (MAOI) that was originally developed for the treatment of tuberculosis, and imipramine, a tricyclic antidepressant (TCA). The success of these medications in the management of depression and the subsequent accepted use by prescribers led to the development of other medications in these two drug classes. However, these medications came with[considerable side effects](http:\/\/content.time.com\/time\/health\/article\/0,8599,1952143,00.html), including weight gain, fatigue and the potential of death from overdose.\n\nThe 1980s and 90s marked a drastic change in the management of depression as groundbreaking developments were made with the introduction of new medications called selective serotonin reuptake inhibitors ([SSRIs](https:\/\/www.therecoveryvillage.com\/treatment-program\/addiction-medications\/ssris\/)), serotonin-norepinephrine reuptake inhibitors ([SNRIs](https:\/\/www.therecoveryvillage.com\/treatment-program\/addiction-medications\/snris\/)) and atypical antidepressants.\n\nThese medications had greater clinical success with fewer side effects than the previously used medications, making them much more popular for the management of depression. The first wasProzac (fluoxetine), an SSRI, which was introduced to the American market in 1987, and was received with monumental popularity with annual sales soon topping[\\$1 billion](http:\/\/content.time.com\/time\/health\/article\/0,8599,1952143,00.html).\n\nCurrently, the Centers for Disease Control and Prevention (CDC) report that approximately[1 in 10 people](https:\/\/www.cdc.gov\/nchs\/products\/databriefs\/db283.htm)aged 12 years and older take an antidepressant, with the use of antidepressants approximately[doubling](https:\/\/www.cdc.gov\/nchs\/products\/databriefs\/db283.htm)between 1999 to 2014.\n\n## Use in Treating Mental Illness\nAntidepressants have become widely accepted as effective in the management of depression as well as other mental illnesses, including[anxiety disorders](https:\/\/www.therecoveryvillage.com\/mental-health\/anxiety\/treatment\/),[compulsion disorders](https:\/\/www.therecoveryvillage.com\/mental-health\/impulse-control-disorder\/treatment\/)and other[mood disorders](https:\/\/www.therecoveryvillage.com\/mental-health\/mood-disorders\/treatment\/).\n\nThe American Psychiatric Association recommends the use ofantidepressants for depressionto modify an individual’s brain chemistry, which may be causing the symptoms of depression. These medications have successfully managed depression because they arenot habit-formingand they do not act as stimulants or sedatives.\n\nAntidepressants for anxietycan help[alleviate anxiety symptoms](https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK279594\/)while also reducing the symptoms of depression that commonly accompany anxiety disorders as coexisting conditions.\n\n## How Do Antidepressants Work?\nThere are three naturally occurring chemicals, also known as neurotransmitters, in the brain that are linked with the regulation of mood and emotions. These[chemicals are serotonin, norepinephrine and dopamine](https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC4428540\/), and they are part of a larger group of chemicals known as monoamines.\n\nThe theory behind the role of these three neurotransmitters in depression is known as the monoamine hypothesis, first accepted in the 1960s. This theory proposes that people with depression have depleted concentrations of serotonin, norepinephrine and dopamine in the brain, resulting in the symptoms associated with depression.\n\nThe different types of antidepressants vary in how they affect the concentrations of these brain chemicals. Because of the time that it takes to change the concentrations of these chemicals in the brain,it can take at least[three to four weeks or up to four months](https:\/\/www.psychiatry.org\/patients-families\/depression\/what-is-depression)for a patient to notice a significant difference in their mood when starting or switching an antidepressant medication.\n\nAlso, everyone’s brain chemistry is slightly different so what works for one person, most likely will not work exactly the same for another person. Therefore, one of the most important factors that affectwhat antidepressants dois the individual makeup and concentrations of serotonin, norepinephrine and dopamine in each person.\n\n## Types of Antidepressants\nAntidepressants areclassifiedbased on how they work, also known as their mechanism of action. A comprehensiveantidepressant listwould include up to[nearly 50 different medications](http:\/\/www.amhsjournal.org\/article.asp?issn=2321-4848;year=2018;volume=6;issue=1;spage=81;epage=94;aulast=Fasipe)that have been used over time in the management of depression, whether it was diagnosed by itself or as a co-occurring disorder with other mental health conditions.\n\nHowever, the list ofcommon antidepressantsis much smaller and includes:\n\n- Prozac(fluoxetine)\n- Cymbalta(duloxetine)\n- Paxil(paroxetine)\n- Zoloft(sertraline)\n- Wellbutrin(bupropion)\n- Lexapro(escitalopram)\n- Celexa(citalopram)\n- Effexor(venlafaxine)\n- Remeron(mirtazapine)\n\nThesecommon antidepressantscome from a couple of different classes that are defined by their mechanism of action.\n\n### Selective Serotonin Reuptake Inhibitors (SSRIs)\n[Selective serotonin reuptake inhibitors](https:\/\/www.therecoveryvillage.com\/treatment-program\/addiction-medications\/ssris\/)(SSRIs) are the most commonly prescribed antidepressants as they are typically thefirst-line agentsof choice when initiating treatment for a patient. Essentially,SSRI drugswork by targeting serotonin in the brain to prevent reuptake, resulting in an increase in serotonin in the brain.\n\nSomeSSRImedications[include](http:\/\/www.amhsjournal.org\/article.asp?issn=2321-4848;year=2018;volume=6;issue=1;spage=81;epage=94;aulast=Fasipe):\n\n- Celexa (citalopram)\n- Lexapro (escitalopram)\n- Luvox (fluvoxamine)\n- Prozac (fluoxetine)\n- Paxil (paroxetine)\n- Zoloft (sertraline)\n### Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)\n[Serotonin-norepinephrine reuptake inhibitors](https:\/\/www.therecoveryvillage.com\/treatment-program\/addiction-medications\/snris\/)(SNRIs), orSNRI drugs,inhibit the reuptake of the neurotransmitters serotonin and norepinephrine in the brain. How these medications affect the brain is[dose-dependent](http:\/\/www.amhsjournal.org\/article.asp?issn=2321-4848;year=2018;volume=6;issue=1;spage=81;epage=94;aulast=Fasipe), meaning that at lower doses, they only affect the reuptake of serotonin, but at higher doses, they affect the reuptake of norepinephrine also.\n\nSome SNRImedications[include](http:\/\/www.amhsjournal.org\/article.asp?issn=2321-4848;year=2018;volume=6;issue=1;spage=81;epage=94;aulast=Fasipe):\n\n- Effexor (venlafaxine)\n- Pristiq (desvenlafaxine)\n- Cymbalta (duloxetine)\n- Fetzima (levomilnacipran)\n\n**Related Topic:**[SSRI vs SNRI](https:\/\/www.therecoveryvillage.com\/treatment-program\/addiction-medications\/ssri-vs-snri\/)\n\n### Tricyclic Antidepressants (TCAs)\nTricyclic antidepressants(TCAs) were the[most commonly prescribed class](http:\/\/www.amhsjournal.org\/article.asp?issn=2321-4848;year=2018;volume=6;issue=1;spage=81;epage=94;aulast=Fasipe)of antidepressants until the introduction of SSRIs in the 1980s and 1990s. Similar to SNRIs,TCA drugswork mainly by inhibiting the reuptake of serotonin and norepinephrine.\n\nThe use of TCA drugs is mainly reserved for patients who have been well-controlled on these medications for many years or for patients who do not respond well to SSRIs or SNRIs. The use of TCA drugs has decreased because they tend to cause more side effects and they require more monitoring through laboratory tests because an overdose of a TCA can be deadly.\n\nSome TCA medications include:\n\n- Elavil (amitriptyline)\n- Tofranil (imipramine)\n- Norpramin (desipramine)\n- Pamelor (nortriptyline)\n- Anafranil (clomipramine)\n- Silenor (doxepin)\n### Monoamine Oxidase Inhibitors (MAOIs)\n[Monoamine oxidase inhibitors](https:\/\/www.therecoveryvillage.com\/treatment-program\/addiction-medications\/antidepressants\/maois\/), also known asMAOIs, work by[inhibiting specific enzymes](http:\/\/www.amhsjournal.org\/article.asp?issn=2321-4848;year=2018;volume=6;issue=1;spage=81;epage=94;aulast=Fasipe)that are responsible for a class of chemicals called monoamines. For the treatment of depression, the three monoamines of interest are serotonin, dopamine and norepinephrine. By inhibiting the breakdown of these chemicals, also known as neurotransmitters, MAOIs trigger an increase in serotonin, norepinephrine and dopamine.\n\nThe different MAOIs available prevent the breakdown of different monoamines depending on their specific chemical structure. Because these medications affect more monoamines than just those involved in depression, it is common to see this class of medication used in the treatment of other conditions, such as Parkinson’s Disease.\n\nTypically, MAOIs are used as a[last-line option](http:\/\/www.amhsjournal.org\/article.asp?issn=2321-4848;year=2018;volume=6;issue=1;spage=81;epage=94;aulast=Fasipe)for the treatment of depression because they have many interactions with other drugs, and an overdose can be deadly.\n\nSome MAOI medications include:\n\n- Nardil (phenelzine)\n- Parnate (tranylcypromine)\n### Atypical Antidepressants\nAtypical antidepressantsis the term used to classify the remaining available antidepressants that have unique mechanisms of action and do not fall under another, more specific, category.\n\nAtypical antidepressants include:\n\n- Wellbutrin (bupropion)\n- Remeron (mirtazapine)\n- Serzone (nefazodone)\n- Desyrel (trazodone)\n- Viibryd (vilazodone)\n- Trintellix (vortioxetine)\n## Effectiveness of Antidepressants\nAntidepressant medications are widely accepted as effective and beneficial for the management of depression. The simple answer to the question “Do antidepressants work?” is *yes*; however, it can take several weeks for these medications to reach full effectiveness, making it a slow, sometimes frustrating process when choosing or switching antidepressant medications.\n\nBecause there are so many options available for[depression treatment](https:\/\/www.therecoveryvillage.com\/mental-health\/depression\/treatment\/), recently there has been increasing debate regarding which options are the best for first-line treatment. A[recent review](https:\/\/discover.dc.nihr.ac.uk\/content\/signal-00580\/the-most-effective-antidepressants-for-adults-revealed-in-major-review)evaluating the results of over 500 clinical studies concluded that five antidepressants appear to be more effective, better tolerated and less likely to be changed after eight weeks of treatment than other drugs. These drugs are:\n\n- Lexapro (escitalopram)\n- Paxil (paroxetine)\n- Zoloft (sertraline)\n- Remeron (mirtazapine)\n- Agomelatine (a medication that is not marketed in the United States)\n\nWhen evaluating themost effective antidepressantmedications, the effectiveness of a certain medication is dependent on the person’s brain chemistry. Although the findings of the above-mentioned study may provide some guidance regarding good first-line options for treatment, a doctor should consider a person’s unique symptoms, medical history, and risk for side effects when[choosing the most appropriate option for a patient](https:\/\/psychiatryonline.org\/pb\/assets\/raw\/sitewide\/practice_guidelines\/guidelines\/mdd-guide.pdf).\n\nBecause antidepressants generally take several weeks to achieve full effectiveness, it is very important to take the medication on a regular basis, to follow-up with a doctor routinely and to not stop the medication abruptly, which could cause withdrawal reactions.\n\n## Side Effects\nCommon side effects of antidepressants include:\n\n- Nausea and vomiting\n- Weight gain\n- Diarrhea or stomach upset\n- Sleep disturbances, such as feeling very sleepy or having difficulty falling asleep\n- Sexual dysfunction\n\nSome antidepressants can have serious side effects and these side effects should be discussed with your doctor:\n\n- Suicidal thinking\n- Birth defects\n- High blood pressure\n\nWhen researching antidepressants, there is a lot of controversy regarding thelong-term effects of antidepressants. Some[research](https:\/\/health.usnews.com\/health-news\/patient-advice\/articles\/2015\/06\/11\/what-are-the-long-term-effects-of-taking-antidepressants)suggests that the use of antidepressants may increase the risk for a person dying prematurely. However, many prescribers maintain that the appropriate use of these medications can help patients lead happier and healthier lives.\n\nAlso, due to the nature of how antidepressant medications work and the neurotransmitters that they affect, it is[possible for patients to experience a decrease in effectiveness](https:\/\/www.health.harvard.edu\/mind-and-mood\/what-are-the-real-risks-of-antidepressants)over time due to the brain becoming less responsive to the medications, also known as tolerance.\n\nTypically, the most bothersome side effects for patients areantidepressants’ sexual side effectsand weight gain. Weight gain is a possible side effect with nearly all antidepressants except Wellbutrin (bupropion). Bupropion is commonly considered the[medication of choice](https:\/\/psychiatryonline.org\/pb\/assets\/raw\/sitewide\/practice_guidelines\/guidelines\/mdd-guide.pdf)for patients who would benefit from possibleantidepressant weight loss.\n\nWhen considering the possible side effects of any medication, including antidepressants, it is important for prescribers and patients to weigh the risks and benefits of taking a certain medication. If the benefits outweigh the risks, then it is a good choice. It is important to be upfront with a doctor regarding expectations for treatment to have the best chance for treatment success.\n\n## Risk of Suicide\nAntidepressants and suicide have become increasing concerns in the health care community. In 2004, the Food and Drug Administration (FDA) required manufacturers to add a boxed warning to all antidepressant medications to highlight the increased risk of suicidal thinking or behavior in children and adolescents during the initiation of treatment. In 2007, this warning was expanded to include young adults up to the age of 24 years old.\n\nBecause of the potential forantidepressants causing suicidal thoughts, routine follow-up and closing monitoring are very important in helping prevent a tragic outcome. Patients should inform their health care provider immediately if they begin to feel worse or develop new symptoms, especially after changing their medication or dose.\n\n**If you or someone you know is having**[**suicidal thoughts**](https:\/\/www.therecoveryvillage.com\/mental-health\/suicide-hotlines\/)**, don’t wait to get help. Call your doctor immediately, go to an emergency room or call the[National Suicide Prevention Lifeline](https:\/\/suicidepreventionlifeline.org\/)at[1-800-273-TALK (8255)](tel:1-800-273-8255). If you’d rather not speak to a person, you can reach the Crisis Text Line by texting HOME to 741741 from anywhere in America.**\n\n## Serotonin Syndrome\nBecause some antidepressant medications achieve their effectiveness by increasing the amount of serotonin in the brain, they have the risk of causing serotonin syndrome. Serotonin syndrome is a potentially life-threatening condition with[symptoms](https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC3865832\/)like:\n\n- Agitation\n- Muscle tremors\n- Racing heartbeat\n- Vomiting\n- Diarrhea\n- Increased sweating\n- Muscle rigidity\n\nSerotonin syndrome[has been reported](http:\/\/pi.lilly.com\/us\/prozac.pdf)with SSRIs and SNRIs. Serotonin syndrome can occur when SSRIs and SNRIs are taken alone, but the risk of experiencing this condition rises when these drugs are taken with other serotonergic agents, like St. John’s Wort and tricyclic antidepressants and triptans, or other drugs likefentanyl,lithium,[tram](https:\/\/www.therecoveryvillage.com\/tramadol-addiction\/side-effects\/)a[dol](https:\/\/www.therecoveryvillage.com\/tramadol-addiction\/side-effects\/)and[ampheta](https:\/\/www.therecoveryvillage.com\/amphetamine-addiction\/side-effects\/)m[ines](https:\/\/www.therecoveryvillage.com\/amphetamine-addiction\/side-effects\/).\n\nIf someone believes that they are experiencing serotonin syndrome, they should discontinue their medication immediately and seek medical treatment right away. The risk for serotonin syndrome increases during treatment initiation and dose increases. It is important to discuss the signs and symptoms of serotonin syndrome with a health care provider when taking medications that may increase levels of serotonin in the body.\n\n## Possible Interactions\nAntidepressant interactionsexist with many other medications (prescription and over-the-counter), supplements and food. Specifically, MAOIs are the most notable antidepressant class for having interactions with other medications, supplements and food. However, TCAs, SNRIs and SSRIs carry the risk for serotonin syndrome among other interactions. Because depression commonly occurs with other medical conditions, it is important to discuss the potential for drug interactions with a health care provider.\n\nOne example of a common combination of medications is antidepressants and antipsychotics.The antidepressants and antipsychotics interactionhappens because SSRIs and some antipsychotics[compete in the liver](https:\/\/idp.springer.com\/authorize?response_type=cookie&client_id=springerlink&redirect_uri=http:\/\/link.springer.com\/article\/10.2165\/00002018-199615050-00004)for a limited amount of enzymes that are responsible for the metabolism of the medication. With a decrease in the metabolism of these medications, drug levels in the blood will fluctuate and may lead to decreased effectiveness of the medication or drug levels that are too high.\n\nAlso, antidepressants can have interactions with certain foods and beverages. One very serious interaction is between[antidepressants and alcohol](https:\/\/www.therecoveryvillage.com\/alcohol-abuse\/alcohol-and-ssri\/). Alcohol has multiple ways of interacting with antidepressants, and it can negatively affect depression and can worsen the side effects of certain antidepressants, such as SSRIs. It is important to discuss the possibility of antidepressant interactions when speaking with a health care provider.\n\n## Taking Antidepressants While Pregnant\nMany women of childbearing age will ask their doctors about the possible effects of antidepressants on pregnancy. Taking antidepressants while pregnant is not a concern for some antidepressants. However, some other antidepressant medications might harm an unborn baby if an expectant mother takes them during pregnancy. If someone is considering taking an antidepressant medication and is pregnant, plans to become pregnant or is breastfeeding, it’s best to consult a doctor before taking antidepressants.\n\n## Stopping Antidepressants\nThere are many reasons why a patient may consider or be considered by their health care provider for discontinuation of their antidepressant treatment. When discontinuing antidepressants, it is important to[taper (gradually decrease the dose) over at least several weeks](https:\/\/psychiatryonline.org\/pb\/assets\/raw\/sitewide\/practice_guidelines\/guidelines\/mdd-guide.pdf)to preventantidepressant withdrawal.\n\nThe specific recommendations ofhow to taper off antidepressantsis dependent on the specific antidepressant(s) that a patient is taking. It is important to discuss any questions regarding stopping an antidepressant with a health care provider.\n\n## What to Do in Case of Overdose\nAntidepressant overdosecan be very serious and must be treated by trained medical professionals.What happens when you overdose on antidepressantsdepends on the type of antidepressant(s) you are taking. Most SSRIs are noted as being[considered generally safe](https:\/\/www.poison.org\/articles\/2014-dec\/antidepressants), but when taken in excessive dosages, they have a risk for a serious heart arrhythmia called QTc prolongation. Additionally,[TCAs and MAOIs](https:\/\/www.poison.org\/articles\/2014-dec\/antidepressants)can be fatal when taken in excess.\n\n**If you think someone may have taken an overdose of an antidepressant (or any drug), call poison control at 1-800-222-1222 immediately as assistance is available 24 hours a day.**\n\n## Get More Information on Antidepressants\nIf you or someone you know needs more information regarding antidepressants, you can gather more information regarding these medications by:\n\n- Speaking with a mental health professional or therapist\n- Talking with a primary care doctor\n- Visiting[MedlinePlus: Antidepressants](https:\/\/medlineplus.gov\/antidepressants.html)\n- Visiting[HelpGuide: Antidepressant Medications](https:\/\/www.helpguide.org\/articles\/depression\/antidepressant-medication.htm)\n\n**Do you or does someone you love struggle with**[**drug or alcohol addiction and depression**](https:\/\/www.therecoveryvillage.com\/mental-health\/depression\/substance-abuse\/)**? The Recovery Village is here to help with comprehensive, compassionate treatment. We have**[**several facilities**](https:\/\/www.therecoveryvillage.com\/locations\/)**that can offer treatment for****depression and addiction****. To speak with a caring representative,**[**call The Recovery Village**](https:\/\/www.therecoveryvillage.com\/contact\/)**today.**\n\n## Find A Center Near You\nFind The Recovery Village Drug, Alcohol and Mental Health Rehab nearest you.\n\n[Find Location](https:\/\/www.therecoveryvillage.com\/locations\/)\n\n[View all locations](https:\/\/www.therecoveryvillage.com\/locations\/)\n\n[PrevRead PreviousBuprenorphine](https:\/\/www.therecoveryvillage.com\/treatment-program\/addiction-medications\/buprenorphine\/)\n\n[Read NextAnti-Anxiety MedicationsNext](https:\/\/www.therecoveryvillage.com\/treatment-program\/addiction-medications\/anxiety-medication\/)\n\n### Related Articles\n### [Understanding Your Insurance Coverage in 2026 and Beyond](https:\/\/www.therecoveryvillage.com\/insurance\/understanding-insurance-changes\/)\n### [Before Your Deductible Resets, Invest in Your Recovery](https:\/\/www.therecoveryvillage.com\/before-deductible-reset-rehab-more-affordable\/)\n### [Converting Power of Peers](https:\/\/www.therecoveryvillage.com\/support-system\/converting-power-of-peers\/)\n### [Mental Health and Loneliness](https:\/\/www.therecoveryvillage.com\/mental-health\/mental-health-and-loneliness\/)\n### [The 6 Stages of Mental Health Recovery](https:\/\/www.therecoveryvillage.com\/mental-health\/stages-of-mental-health-recovery\/)\n### [Reset Your Mind: Benefits of Inpatient Mental Health Care](https:\/\/www.therecoveryvillage.com\/mental-health\/benefits-of-inpatient-mental-health-care\/)\n### [How To Let Go of a Toxic Loved One](https:\/\/www.therecoveryvillage.com\/mental-health\/toxic-loved-one\/)\n### [Denying Our Mental Health: Why We Do It and How To Move Past It](https:\/\/www.therecoveryvillage.com\/mental-health\/denial-and-mental-health\/)\n### [How To Find and Choose a Therapist](https:\/\/www.therecoveryvillage.com\/mental-health\/choosing-a-therapist\/)\n### [10 Habits for Proper Mental Health](https:\/\/www.therecoveryvillage.com\/mental-health\/habits-for-mental-health\/)\n\n#### Medical Disclaimer\nThe Recovery Village aims to improve the quality of life for people struggling with substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare providers.\n### Sources\nAmerican Psychiatric Association. “What is Depression.” January 2017. Accessed June 9, 2019.\n\nAmerican Psychiatric Association. “[Treating Major Depressive Disorder: A Quick Reference Guide](https:\/\/psychiatryonline.org\/pb\/assets\/raw\/sitewide\/practice_guidelines\/guidelines\/mdd-guide.pdf \"Treating Major Depressive Disorder: A Quick Reference Guide\").” October 2010. Accessed June 9, 2019.\n\nAmerican Psychological Association. “[By the numbers: Antidepressant use on the rise](https:\/\/www.apa.org\/monitor\/2017\/11\/numbers \"By the numbers: Antidepressant use on the rise\").” November 2017. Accessed June 9, 2019.\n\nThe Centers for Disease Control and Prevention. “[Antidepressant Use Among Persons Aged 12\\[…\\] States, 2011–2014](https:\/\/www.cdc.gov\/nchs\/products\/databriefs\/db283.htm \"Antidepressant Use Among Persons Aged 12 and Over: United States, 2011–2014\").” August 2017. Accessed June 9, 2019.\n\nElli Lilly and Company. “[Prozac Prescribing Information](http:\/\/pi.lilly.com\/us\/prozac.pdf \"Prozac Prescribing Information\").” March 2017. Accessed June 9, 2019.\n\nEncyclopedia Britannica. “[Antidepressant](https:\/\/www.britannica.com\/science\/antidepressant \"Antidepressant\").” June 2019. Accessed June 9, 2019.\n\nFitzpatrick L. “[A Brief History of Antidepressants](http:\/\/content.time.com\/time\/health\/article\/0,8599,1952143,00.html \"A Brief History of Antidepressants\").” TIME Magazine, January 7, 2010. Accessed June 9, 2019.\n\nHarvard Health Publishing. “[What are the real risks of antidepressants?](https:\/\/www.health.harvard.edu\/mind-and-mood\/what-are-the-real-risks-of-antidepressants \"What are the real risks of antidepressants?\")” March 2019. Accessed June 9, 2019\n\nHillhouse, Todd; Porter, Joseph. “[A brief history of the development of an\\[…\\]oamines to glutamate](https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC4428540\/ \"A brief history of the development of antidepressant drugs: From monoamines to glutamate\").” Experimental and Clinical Psychopharmacology, February 2015. Accessed June 9, 2019.\n\nInformedHealth.org. “[Treatment Options for Generalized Anxiety Disorder](https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK279594\/ \"Treatment Options for Generalized Anxiety Disorder\").” February 2018. Accessed June 9, 2019.\n\nMeyer, Michele; Baldessarini, Ross; Goff, Donald; Centorrino, Franca. “[Clinically Significant Interactions of P\\[…\\] Antipsychotic Drugs](https:\/\/idp.springer.com\/authorize?response_type=cookie&client_id=springerlink&redirect_uri=http:\/\/link.springer.com\/article\/10.2165\/00002018-199615050-00004 \"Clinically Significant Interactions of Psychotropic Agents with Antipsychotic Drugs\").” Drug Safety, October 26, 2012. Accessed June 9, 2019.\n\nThe National Institute for Health Research. “[The most effective antidepressants for a\\[…\\]aled in major review](https:\/\/discover.dc.nihr.ac.uk\/content\/signal-00580\/the-most-effective-antidepressants-for-adults-revealed-in-major-review \"The most effective antidepressants for adults revealed in major review\").” April 2018. Accessed June 9, 2019.\n\nOlumuyiwa, John Fasipe. “[Neuropharmacological classification of a\\[…\\]mechanisms of action](http:\/\/www.amhsjournal.org\/article.asp?issn=2321-4848;year=2018;volume=6;issue=1;spage=81;epage=94;aulast=Fasipe \"Neuropharmacological classification of antidepressant agents based on their mechanisms of action\").” Yenepoya University, June 2018. Accessed June 9, 2019.\n\nPoison Control: National Capital Poison Center. “[Antidepressants](https:\/\/www.poison.org\/articles\/2014-dec\/antidepressants \"Antidepressants\").” November 2014. Accessed June 9, 2019.\n\nSchroeder, Michael. “[What Are the Long-Term Effects of Taking Antidepressants?](https:\/\/health.usnews.com\/health-news\/patient-advice\/articles\/2015\/06\/11\/what-are-the-long-term-effects-of-taking-antidepressants \"What Are the Long-Term Effects of Taking Antidepressants?\")” U.S. News, June 11, 2015. Accessed June 9, 2019.\n\nThe U.S. Food and Drug Administration. “Depression: FDA-Approved Medications May Help.” April 2017. Accessed June 9, 2019.\n\nVolpe-Abadie, Jacqueline; Kaye, Aadam; Kaye, Alan David. “[Serotonin Syndrome](https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC3865832\/ \"Serotonin Syndrome\").” The Ochsner Journal, 2013. Accessed June 9, 2019.\n\n## Reach out now\nWe can help answer your questions and talk through any concerns.\n\n[352-771-2700](tel:3527712700)\n\n[![TRV TheRecoveryVillage Logo 2023 white](https:\/\/www.therecoveryvillage.com\/wp-content\/uploads\/2024\/09\/TRV_TheRecoveryVillage_Logo-2023-white.webp)![TRV TheRecoveryVillage Logo 2023 white](https:\/\/www.therecoveryvillage.com\/wp-content\/uploads\/2024\/09\/TRV_TheRecoveryVillage_Logo-2023-white.webp)](https:\/\/www.therecoveryvillage.com\/)\n\n[![TRV TheRecoveryVillage Logo 2023 white](https:\/\/www.therecoveryvillage.com\/wp-content\/uploads\/2024\/09\/TRV_TheRecoveryVillage_Logo-2023-white.webp)![TRV TheRecoveryVillage Logo 2023 white](https:\/\/www.therecoveryvillage.com\/wp-content\/uploads\/2024\/09\/TRV_TheRecoveryVillage_Logo-2023-white.webp)](https:\/\/www.therecoveryvillage.com\/)\n\n#### Medical Disclaimer\nThe Recovery Village aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. 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Recovery Village \\| All Rights Reserved\n\n[![](https:\/\/www.therecoveryvillage.com\/wp-content\/uploads\/2024\/10\/samsha-logo-dark-copy.jpg-removebg-preview.webp)![](https:\/\/www.therecoveryvillage.com\/wp-content\/uploads\/2024\/10\/samsha-logo-dark-copy.jpg-removebg-preview.webp)](https:\/\/www.samhsa.gov\/)\n\n[![Legitscript](https:\/\/static.legitscript.com\/seals\/3204193.png)![Legitscript](https:\/\/static.legitscript.com\/seals\/3204193.png)](https:\/\/www.legitscript.com\/websites\/?checker_keywords=www.therecoveryvillage.com)\n\n[![National Quality](https:\/\/www.therecoveryvillage.com\/wp-content\/uploads\/2024\/08\/goldseal_transparent_gif.webp)![National Quality](https:\/\/www.therecoveryvillage.com\/wp-content\/uploads\/2024\/08\/goldseal_transparent_gif.webp)](https:\/\/www.qualitycheck.org\/quality-report\/?bsnid=545008)\n\n[![National Association](https:\/\/www.therecoveryvillage.com\/wp-content\/uploads\/2024\/10\/National-Association-of-Addiction-Treatment-Providers.webp)![National Association](https:\/\/www.therecoveryvillage.com\/wp-content\/uploads\/2024\/10\/National-Association-of-Addiction-Treatment-Providers.webp)](https:\/\/www.naatp.org\/resources\/addiction-industry-directory\/581\/the-recovery-village-drug-and-alcohol-rehab)\n\nManage consent\n\n![](https:\/\/www.facebook.com\/tr?id=287527848376296&ev=PageView&noscript=1)\n\nYou need to [enable JavaScript](https:\/\/www.openwidget.com\/enable-javascript) to use the communication tool powered by [OpenWidget](https:\/\/www.openwidget.com\/)","attrs_readable_markdown":"### Antidepressants help alleviate the symptoms of depression and are one of the three most prescribed medication classes in America.\nAntidepressantsare used in the[management of depression](https:\/\/www.therecoveryvillage.com\/mental-health\/depression\/treatment\/)to help alleviate symptoms.Antidepressant drugsare[one of the three](https:\/\/www.cdc.gov\/nchs\/products\/databriefs\/db283.htm)most commonly prescribed therapeutic drug classes, and the use of antidepressants in the treatment of various mental health conditions has[increased](https:\/\/www.apa.org\/monitor\/2017\/11\/numbers)significantlyin recent years.\n\nUnderstanding howantidepressant medicationswork and why they may help manage depression or other[mental health disorders](https:\/\/www.therecoveryvillage.com\/mental-health\/)can be beneficial when discussing treatment options with a doctor.\n\n## What Are Antidepressants?\nAntidepressant medicationsare used to alleviate symptoms associated with depression, such as fatigue, loss of interest, trouble sleeping, overwhelming feelings of guilt or worthlessness orthoughts of suicide. They work by augmenting different natural chemicals in the brain, also known as neurotransmitters, to influence a person’s mood.\n\n## Background and History\nThehistory of antidepressantsbegan in the[1950s](http:\/\/content.time.com\/time\/health\/article\/0,8599,1952143,00.html), with the thought that changing the balance of certain natural chemicals in the brain would cause changes in mood and could produce euphoria or feelings of happiness.\n\nFree, Confidential Helpline\n\nReady to take the next step toward recovery?\n\nOur Recovery Advocates are available around the clock to answer your questions, verify your insurance, and help you find the right level of care — at no cost to you.\n\nCall Us Now\n\nAvailable 24 hours a day, 7 days a week\n\nThe[first two antidepressants](https:\/\/www.britannica.com\/science\/antidepressant)to show success in the management of depression were iproniazid, a monoamine oxidase inhibitor (MAOI) that was originally developed for the treatment of tuberculosis, and imipramine, a tricyclic antidepressant (TCA). The success of these medications in the management of depression and the subsequent accepted use by prescribers led to the development of other medications in these two drug classes. However, these medications came with[considerable side effects](http:\/\/content.time.com\/time\/health\/article\/0,8599,1952143,00.html), including weight gain, fatigue and the potential of death from overdose.\n\nThe 1980s and 90s marked a drastic change in the management of depression as groundbreaking developments were made with the introduction of new medications called selective serotonin reuptake inhibitors ([SSRIs](https:\/\/www.therecoveryvillage.com\/treatment-program\/addiction-medications\/ssris\/)), serotonin-norepinephrine reuptake inhibitors ([SNRIs](https:\/\/www.therecoveryvillage.com\/treatment-program\/addiction-medications\/snris\/)) and atypical antidepressants.\n\nThese medications had greater clinical success with fewer side effects than the previously used medications, making them much more popular for the management of depression. The first wasProzac (fluoxetine), an SSRI, which was introduced to the American market in 1987, and was received with monumental popularity with annual sales soon topping[\\$1 billion](http:\/\/content.time.com\/time\/health\/article\/0,8599,1952143,00.html).\n\nCurrently, the Centers for Disease Control and Prevention (CDC) report that approximately[1 in 10 people](https:\/\/www.cdc.gov\/nchs\/products\/databriefs\/db283.htm)aged 12 years and older take an antidepressant, with the use of antidepressants approximately[doubling](https:\/\/www.cdc.gov\/nchs\/products\/databriefs\/db283.htm)between 1999 to 2014.\n\n## Use in Treating Mental Illness\nAntidepressants have become widely accepted as effective in the management of depression as well as other mental illnesses, including[anxiety disorders](https:\/\/www.therecoveryvillage.com\/mental-health\/anxiety\/treatment\/),[compulsion disorders](https:\/\/www.therecoveryvillage.com\/mental-health\/impulse-control-disorder\/treatment\/)and other[mood disorders](https:\/\/www.therecoveryvillage.com\/mental-health\/mood-disorders\/treatment\/).\n\nThe American Psychiatric Association recommends the use ofantidepressants for depressionto modify an individual’s brain chemistry, which may be causing the symptoms of depression. These medications have successfully managed depression because they arenot habit-formingand they do not act as stimulants or sedatives.\n\nAntidepressants for anxietycan help[alleviate anxiety symptoms](https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK279594\/)while also reducing the symptoms of depression that commonly accompany anxiety disorders as coexisting conditions.\n\n## How Do Antidepressants Work?\nThere are three naturally occurring chemicals, also known as neurotransmitters, in the brain that are linked with the regulation of mood and emotions. These[chemicals are serotonin, norepinephrine and dopamine](https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC4428540\/), and they are part of a larger group of chemicals known as monoamines.\n\nThe theory behind the role of these three neurotransmitters in depression is known as the monoamine hypothesis, first accepted in the 1960s. This theory proposes that people with depression have depleted concentrations of serotonin, norepinephrine and dopamine in the brain, resulting in the symptoms associated with depression.\n\nThe different types of antidepressants vary in how they affect the concentrations of these brain chemicals. Because of the time that it takes to change the concentrations of these chemicals in the brain,it can take at least[three to four weeks or up to four months](https:\/\/www.psychiatry.org\/patients-families\/depression\/what-is-depression)for a patient to notice a significant difference in their mood when starting or switching an antidepressant medication.\n\nAlso, everyone’s brain chemistry is slightly different so what works for one person, most likely will not work exactly the same for another person. Therefore, one of the most important factors that affectwhat antidepressants dois the individual makeup and concentrations of serotonin, norepinephrine and dopamine in each person.\n\n## Types of Antidepressants\nAntidepressants areclassifiedbased on how they work, also known as their mechanism of action. A comprehensiveantidepressant listwould include up to[nearly 50 different medications](http:\/\/www.amhsjournal.org\/article.asp?issn=2321-4848;year=2018;volume=6;issue=1;spage=81;epage=94;aulast=Fasipe)that have been used over time in the management of depression, whether it was diagnosed by itself or as a co-occurring disorder with other mental health conditions.\n\nHowever, the list ofcommon antidepressantsis much smaller and includes:\n\n- Prozac(fluoxetine)\n- Cymbalta(duloxetine)\n- Paxil(paroxetine)\n- Zoloft(sertraline)\n- Wellbutrin(bupropion)\n- Lexapro(escitalopram)\n- Celexa(citalopram)\n- Effexor(venlafaxine)\n- Remeron(mirtazapine)\n\nThesecommon antidepressantscome from a couple of different classes that are defined by their mechanism of action.\n\n### Selective Serotonin Reuptake Inhibitors (SSRIs)\n[Selective serotonin reuptake inhibitors](https:\/\/www.therecoveryvillage.com\/treatment-program\/addiction-medications\/ssris\/)(SSRIs) are the most commonly prescribed antidepressants as they are typically thefirst-line agentsof choice when initiating treatment for a patient. Essentially,SSRI drugswork by targeting serotonin in the brain to prevent reuptake, resulting in an increase in serotonin in the brain.\n\nSomeSSRImedications[include](http:\/\/www.amhsjournal.org\/article.asp?issn=2321-4848;year=2018;volume=6;issue=1;spage=81;epage=94;aulast=Fasipe):\n\n- Celexa (citalopram)\n- Lexapro (escitalopram)\n- Luvox (fluvoxamine)\n- Prozac (fluoxetine)\n- Paxil (paroxetine)\n- Zoloft (sertraline)\n### Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)\n[Serotonin-norepinephrine reuptake inhibitors](https:\/\/www.therecoveryvillage.com\/treatment-program\/addiction-medications\/snris\/)(SNRIs), orSNRI drugs,inhibit the reuptake of the neurotransmitters serotonin and norepinephrine in the brain. How these medications affect the brain is[dose-dependent](http:\/\/www.amhsjournal.org\/article.asp?issn=2321-4848;year=2018;volume=6;issue=1;spage=81;epage=94;aulast=Fasipe), meaning that at lower doses, they only affect the reuptake of serotonin, but at higher doses, they affect the reuptake of norepinephrine also.\n\nSome SNRImedications[include](http:\/\/www.amhsjournal.org\/article.asp?issn=2321-4848;year=2018;volume=6;issue=1;spage=81;epage=94;aulast=Fasipe):\n\n- Effexor (venlafaxine)\n- Pristiq (desvenlafaxine)\n- Cymbalta (duloxetine)\n- Fetzima (levomilnacipran)\n\n**Related Topic:**[SSRI vs SNRI](https:\/\/www.therecoveryvillage.com\/treatment-program\/addiction-medications\/ssri-vs-snri\/)\n\n### Tricyclic Antidepressants (TCAs)\nTricyclic antidepressants(TCAs) were the[most commonly prescribed class](http:\/\/www.amhsjournal.org\/article.asp?issn=2321-4848;year=2018;volume=6;issue=1;spage=81;epage=94;aulast=Fasipe)of antidepressants until the introduction of SSRIs in the 1980s and 1990s. Similar to SNRIs,TCA drugswork mainly by inhibiting the reuptake of serotonin and norepinephrine.\n\nThe use of TCA drugs is mainly reserved for patients who have been well-controlled on these medications for many years or for patients who do not respond well to SSRIs or SNRIs. The use of TCA drugs has decreased because they tend to cause more side effects and they require more monitoring through laboratory tests because an overdose of a TCA can be deadly.\n\nSome TCA medications include:\n\n- Elavil (amitriptyline)\n- Tofranil (imipramine)\n- Norpramin (desipramine)\n- Pamelor (nortriptyline)\n- Anafranil (clomipramine)\n- Silenor (doxepin)\n### Monoamine Oxidase Inhibitors (MAOIs)\n[Monoamine oxidase inhibitors](https:\/\/www.therecoveryvillage.com\/treatment-program\/addiction-medications\/antidepressants\/maois\/), also known asMAOIs, work by[inhibiting specific enzymes](http:\/\/www.amhsjournal.org\/article.asp?issn=2321-4848;year=2018;volume=6;issue=1;spage=81;epage=94;aulast=Fasipe)that are responsible for a class of chemicals called monoamines. For the treatment of depression, the three monoamines of interest are serotonin, dopamine and norepinephrine. By inhibiting the breakdown of these chemicals, also known as neurotransmitters, MAOIs trigger an increase in serotonin, norepinephrine and dopamine.\n\nThe different MAOIs available prevent the breakdown of different monoamines depending on their specific chemical structure. Because these medications affect more monoamines than just those involved in depression, it is common to see this class of medication used in the treatment of other conditions, such as Parkinson’s Disease.\n\nTypically, MAOIs are used as a[last-line option](http:\/\/www.amhsjournal.org\/article.asp?issn=2321-4848;year=2018;volume=6;issue=1;spage=81;epage=94;aulast=Fasipe)for the treatment of depression because they have many interactions with other drugs, and an overdose can be deadly.\n\nSome MAOI medications include:\n\n- Nardil (phenelzine)\n- Parnate (tranylcypromine)\n### Atypical Antidepressants\nAtypical antidepressantsis the term used to classify the remaining available antidepressants that have unique mechanisms of action and do not fall under another, more specific, category.\n\nAtypical antidepressants include:\n\n- Wellbutrin (bupropion)\n- Remeron (mirtazapine)\n- Serzone (nefazodone)\n- Desyrel (trazodone)\n- Viibryd (vilazodone)\n- Trintellix (vortioxetine)\n## Effectiveness of Antidepressants\nAntidepressant medications are widely accepted as effective and beneficial for the management of depression. The simple answer to the question “Do antidepressants work?” is *yes*; however, it can take several weeks for these medications to reach full effectiveness, making it a slow, sometimes frustrating process when choosing or switching antidepressant medications.\n\nBecause there are so many options available for[depression treatment](https:\/\/www.therecoveryvillage.com\/mental-health\/depression\/treatment\/), recently there has been increasing debate regarding which options are the best for first-line treatment. A[recent review](https:\/\/discover.dc.nihr.ac.uk\/content\/signal-00580\/the-most-effective-antidepressants-for-adults-revealed-in-major-review)evaluating the results of over 500 clinical studies concluded that five antidepressants appear to be more effective, better tolerated and less likely to be changed after eight weeks of treatment than other drugs. These drugs are:\n\n- Lexapro (escitalopram)\n- Paxil (paroxetine)\n- Zoloft (sertraline)\n- Remeron (mirtazapine)\n- Agomelatine (a medication that is not marketed in the United States)\n\nWhen evaluating themost effective antidepressantmedications, the effectiveness of a certain medication is dependent on the person’s brain chemistry. Although the findings of the above-mentioned study may provide some guidance regarding good first-line options for treatment, a doctor should consider a person’s unique symptoms, medical history, and risk for side effects when[choosing the most appropriate option for a patient](https:\/\/psychiatryonline.org\/pb\/assets\/raw\/sitewide\/practice_guidelines\/guidelines\/mdd-guide.pdf).\n\nBecause antidepressants generally take several weeks to achieve full effectiveness, it is very important to take the medication on a regular basis, to follow-up with a doctor routinely and to not stop the medication abruptly, which could cause withdrawal reactions.\n\n## Side Effects\nCommon side effects of antidepressants include:\n\n- Nausea and vomiting\n- Weight gain\n- Diarrhea or stomach upset\n- Sleep disturbances, such as feeling very sleepy or having difficulty falling asleep\n- Sexual dysfunction\n\nSome antidepressants can have serious side effects and these side effects should be discussed with your doctor:\n\n- Suicidal thinking\n- Birth defects\n- High blood pressure\n\nWhen researching antidepressants, there is a lot of controversy regarding thelong-term effects of antidepressants. Some[research](https:\/\/health.usnews.com\/health-news\/patient-advice\/articles\/2015\/06\/11\/what-are-the-long-term-effects-of-taking-antidepressants)suggests that the use of antidepressants may increase the risk for a person dying prematurely. However, many prescribers maintain that the appropriate use of these medications can help patients lead happier and healthier lives.\n\nAlso, due to the nature of how antidepressant medications work and the neurotransmitters that they affect, it is[possible for patients to experience a decrease in effectiveness](https:\/\/www.health.harvard.edu\/mind-and-mood\/what-are-the-real-risks-of-antidepressants)over time due to the brain becoming less responsive to the medications, also known as tolerance.\n\nTypically, the most bothersome side effects for patients areantidepressants’ sexual side effectsand weight gain. Weight gain is a possible side effect with nearly all antidepressants except Wellbutrin (bupropion). Bupropion is commonly considered the[medication of choice](https:\/\/psychiatryonline.org\/pb\/assets\/raw\/sitewide\/practice_guidelines\/guidelines\/mdd-guide.pdf)for patients who would benefit from possibleantidepressant weight loss.\n\nWhen considering the possible side effects of any medication, including antidepressants, it is important for prescribers and patients to weigh the risks and benefits of taking a certain medication. If the benefits outweigh the risks, then it is a good choice. It is important to be upfront with a doctor regarding expectations for treatment to have the best chance for treatment success.\n\n## Risk of Suicide\nAntidepressants and suicide have become increasing concerns in the health care community. In 2004, the Food and Drug Administration (FDA) required manufacturers to add a boxed warning to all antidepressant medications to highlight the increased risk of suicidal thinking or behavior in children and adolescents during the initiation of treatment. In 2007, this warning was expanded to include young adults up to the age of 24 years old.\n\nBecause of the potential forantidepressants causing suicidal thoughts, routine follow-up and closing monitoring are very important in helping prevent a tragic outcome. Patients should inform their health care provider immediately if they begin to feel worse or develop new symptoms, especially after changing their medication or dose.\n\n**If you or someone you know is having**[**suicidal thoughts**](https:\/\/www.therecoveryvillage.com\/mental-health\/suicide-hotlines\/)**, don’t wait to get help. Call your doctor immediately, go to an emergency room or call the[National Suicide Prevention Lifeline](https:\/\/suicidepreventionlifeline.org\/)at[1-800-273-TALK (8255)](tel:1-800-273-8255). If you’d rather not speak to a person, you can reach the Crisis Text Line by texting HOME to 741741 from anywhere in America.**\n\n## Serotonin Syndrome\nBecause some antidepressant medications achieve their effectiveness by increasing the amount of serotonin in the brain, they have the risk of causing serotonin syndrome. Serotonin syndrome is a potentially life-threatening condition with[symptoms](https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC3865832\/)like:\n\n- Agitation\n- Muscle tremors\n- Racing heartbeat\n- Vomiting\n- Diarrhea\n- Increased sweating\n- Muscle rigidity\n\nSerotonin syndrome[has been reported](http:\/\/pi.lilly.com\/us\/prozac.pdf)with SSRIs and SNRIs. Serotonin syndrome can occur when SSRIs and SNRIs are taken alone, but the risk of experiencing this condition rises when these drugs are taken with other serotonergic agents, like St. John’s Wort and tricyclic antidepressants and triptans, or other drugs likefentanyl,lithium,[tram](https:\/\/www.therecoveryvillage.com\/tramadol-addiction\/side-effects\/)a[dol](https:\/\/www.therecoveryvillage.com\/tramadol-addiction\/side-effects\/)and[ampheta](https:\/\/www.therecoveryvillage.com\/amphetamine-addiction\/side-effects\/)m[ines](https:\/\/www.therecoveryvillage.com\/amphetamine-addiction\/side-effects\/).\n\nIf someone believes that they are experiencing serotonin syndrome, they should discontinue their medication immediately and seek medical treatment right away. The risk for serotonin syndrome increases during treatment initiation and dose increases. It is important to discuss the signs and symptoms of serotonin syndrome with a health care provider when taking medications that may increase levels of serotonin in the body.\n\n## Possible Interactions\nAntidepressant interactionsexist with many other medications (prescription and over-the-counter), supplements and food. Specifically, MAOIs are the most notable antidepressant class for having interactions with other medications, supplements and food. However, TCAs, SNRIs and SSRIs carry the risk for serotonin syndrome among other interactions. Because depression commonly occurs with other medical conditions, it is important to discuss the potential for drug interactions with a health care provider.\n\nOne example of a common combination of medications is antidepressants and antipsychotics.The antidepressants and antipsychotics interactionhappens because SSRIs and some antipsychotics[compete in the liver](https:\/\/idp.springer.com\/authorize?response_type=cookie&client_id=springerlink&redirect_uri=http:\/\/link.springer.com\/article\/10.2165\/00002018-199615050-00004)for a limited amount of enzymes that are responsible for the metabolism of the medication. With a decrease in the metabolism of these medications, drug levels in the blood will fluctuate and may lead to decreased effectiveness of the medication or drug levels that are too high.\n\nAlso, antidepressants can have interactions with certain foods and beverages. One very serious interaction is between[antidepressants and alcohol](https:\/\/www.therecoveryvillage.com\/alcohol-abuse\/alcohol-and-ssri\/). Alcohol has multiple ways of interacting with antidepressants, and it can negatively affect depression and can worsen the side effects of certain antidepressants, such as SSRIs. It is important to discuss the possibility of antidepressant interactions when speaking with a health care provider.\n\n## Taking Antidepressants While Pregnant\nMany women of childbearing age will ask their doctors about the possible effects of antidepressants on pregnancy. Taking antidepressants while pregnant is not a concern for some antidepressants. However, some other antidepressant medications might harm an unborn baby if an expectant mother takes them during pregnancy. If someone is considering taking an antidepressant medication and is pregnant, plans to become pregnant or is breastfeeding, it’s best to consult a doctor before taking antidepressants.\n\n## Stopping Antidepressants\nThere are many reasons why a patient may consider or be considered by their health care provider for discontinuation of their antidepressant treatment. When discontinuing antidepressants, it is important to[taper (gradually decrease the dose) over at least several weeks](https:\/\/psychiatryonline.org\/pb\/assets\/raw\/sitewide\/practice_guidelines\/guidelines\/mdd-guide.pdf)to preventantidepressant withdrawal.\n\nThe specific recommendations ofhow to taper off antidepressantsis dependent on the specific antidepressant(s) that a patient is taking. It is important to discuss any questions regarding stopping an antidepressant with a health care provider.\n\n## What to Do in Case of Overdose\nAntidepressant overdosecan be very serious and must be treated by trained medical professionals.What happens when you overdose on antidepressantsdepends on the type of antidepressant(s) you are taking. Most SSRIs are noted as being[considered generally safe](https:\/\/www.poison.org\/articles\/2014-dec\/antidepressants), but when taken in excessive dosages, they have a risk for a serious heart arrhythmia called QTc prolongation. Additionally,[TCAs and MAOIs](https:\/\/www.poison.org\/articles\/2014-dec\/antidepressants)can be fatal when taken in excess.\n\n**If you think someone may have taken an overdose of an antidepressant (or any drug), call poison control at 1-800-222-1222 immediately as assistance is available 24 hours a day.**\n\n## Get More Information on Antidepressants\nIf you or someone you know needs more information regarding antidepressants, you can gather more information regarding these medications by:\n\n- Speaking with a mental health professional or therapist\n- Talking with a primary care doctor\n- Visiting[MedlinePlus: Antidepressants](https:\/\/medlineplus.gov\/antidepressants.html)\n- Visiting[HelpGuide: Antidepressant Medications](https:\/\/www.helpguide.org\/articles\/depression\/antidepressant-medication.htm)\n\n**Do you or does someone you love struggle with**[**drug or alcohol addiction and depression**](https:\/\/www.therecoveryvillage.com\/mental-health\/depression\/substance-abuse\/)**? The Recovery Village is here to help with comprehensive, compassionate treatment. We have**[**several facilities**](https:\/\/www.therecoveryvillage.com\/locations\/)**that can offer treatment for****depression and addiction****. To speak with a caring representative,**[**call The Recovery Village**](https:\/\/www.therecoveryvillage.com\/contact\/)**today.**","meta_canonical":null,"ml_categories_json":"{\"\/Health\":998,\"\/Health\/Mental_Health\":952,\"\/Health\/Mental_Health\/Depression\":949}","ml_types_json":"{\"\/Article\":988,\"\/Article\/Tutorial_or_Guide\":521}","ml_intent_types_json":"{\"Informational\":998,\"Commercial\":209}","meta_language":"en-us","attrs_author":null,"attrs_publish_time":0,"attrs_original_publish_time":1563546406,"attrs_is_republished":0,"attrs_nr_words":"4367","attrs_boilerpipe_nr_words":"2660","body_ext_links_number":40,"body_int_links_number":194,"meta_nofollow":0,"meta_noarchive":0,"props_was_rendered":1,"src_redirect":"","download_time_msec":81,"download_ttfb_msec":70,"download_size":93771}

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Antidepressants help alleviate the symptoms of depression and are one of the three most prescribed medication classes in America. Antidepressantsare used in the management of depression to help alleviate symptoms.Antidepressant drugsare one of the three most commonly prescribed therapeutic drug classes, and the use of antidepressants in the treatment of various mental health conditions has increased significantlyin recent years. Understanding howantidepressant medicationswork and why they may help manage depression or other mental health disorders can be beneficial when discussing treatment options with a doctor. What Are Antidepressants? Antidepressant medicationsare used to alleviate symptoms associated with depression, such as fatigue, loss of interest, trouble sleeping, overwhelming feelings of guilt or worthlessness orthoughts of suicide. They work by augmenting different natural chemicals in the brain, also known as neurotransmitters, to influence a person’s mood. Background and History Thehistory of antidepressantsbegan in the 1950s , with the thought that changing the balance of certain natural chemicals in the brain would cause changes in mood and could produce euphoria or feelings of happiness. Free, Confidential Helpline Ready to take the next step toward recovery? Our Recovery Advocates are available around the clock to answer your questions, verify your insurance, and help you find the right level of care — at no cost to you. Call Us Now Available 24 hours a day, 7 days a week The first two antidepressants to show success in the management of depression were iproniazid, a monoamine oxidase inhibitor (MAOI) that was originally developed for the treatment of tuberculosis, and imipramine, a tricyclic antidepressant (TCA). The success of these medications in the management of depression and the subsequent accepted use by prescribers led to the development of other medications in these two drug classes. However, these medications came with considerable side effects , including weight gain, fatigue and the potential of death from overdose. The 1980s and 90s marked a drastic change in the management of depression as groundbreaking developments were made with the introduction of new medications called selective serotonin reuptake inhibitors ( SSRIs ), serotonin-norepinephrine reuptake inhibitors ( SNRIs ) and atypical antidepressants. These medications had greater clinical success with fewer side effects than the previously used medications, making them much more popular for the management of depression. The first wasProzac (fluoxetine), an SSRI, which was introduced to the American market in 1987, and was received with monumental popularity with annual sales soon topping $1 billion . Currently, the Centers for Disease Control and Prevention (CDC) report that approximately 1 in 10 people aged 12 years and older take an antidepressant, with the use of antidepressants approximately doubling between 1999 to 2014. Use in Treating Mental Illness Antidepressants have become widely accepted as effective in the management of depression as well as other mental illnesses, including anxiety disorders , compulsion disorders and other mood disorders . The American Psychiatric Association recommends the use ofantidepressants for depressionto modify an individual’s brain chemistry, which may be causing the symptoms of depression. These medications have successfully managed depression because they arenot habit-formingand they do not act as stimulants or sedatives. Antidepressants for anxietycan help alleviate anxiety symptoms while also reducing the symptoms of depression that commonly accompany anxiety disorders as coexisting conditions. How Do Antidepressants Work? There are three naturally occurring chemicals, also known as neurotransmitters, in the brain that are linked with the regulation of mood and emotions. These chemicals are serotonin, norepinephrine and dopamine , and they are part of a larger group of chemicals known as monoamines. The theory behind the role of these three neurotransmitters in depression is known as the monoamine hypothesis, first accepted in the 1960s. This theory proposes that people with depression have depleted concentrations of serotonin, norepinephrine and dopamine in the brain, resulting in the symptoms associated with depression. The different types of antidepressants vary in how they affect the concentrations of these brain chemicals. Because of the time that it takes to change the concentrations of these chemicals in the brain,it can take at least three to four weeks or up to four months for a patient to notice a significant difference in their mood when starting or switching an antidepressant medication. Also, everyone’s brain chemistry is slightly different so what works for one person, most likely will not work exactly the same for another person. Therefore, one of the most important factors that affectwhat antidepressants dois the individual makeup and concentrations of serotonin, norepinephrine and dopamine in each person. Types of Antidepressants Antidepressants areclassifiedbased on how they work, also known as their mechanism of action. A comprehensiveantidepressant listwould include up to nearly 50 different medications that have been used over time in the management of depression, whether it was diagnosed by itself or as a co-occurring disorder with other mental health conditions. However, the list ofcommon antidepressantsis much smaller and includes: Prozac(fluoxetine) Cymbalta(duloxetine) Paxil(paroxetine) Zoloft(sertraline) Wellbutrin(bupropion) Lexapro(escitalopram) Celexa(citalopram) Effexor(venlafaxine) Remeron(mirtazapine) Thesecommon antidepressantscome from a couple of different classes that are defined by their mechanism of action. Selective Serotonin Reuptake Inhibitors (SSRIs) Selective serotonin reuptake inhibitors (SSRIs) are the most commonly prescribed antidepressants as they are typically thefirst-line agentsof choice when initiating treatment for a patient. Essentially,SSRI drugswork by targeting serotonin in the brain to prevent reuptake, resulting in an increase in serotonin in the brain. SomeSSRImedications include : Celexa (citalopram) Lexapro (escitalopram) Luvox (fluvoxamine) Prozac (fluoxetine) Paxil (paroxetine) Zoloft (sertraline) Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs) Serotonin-norepinephrine reuptake inhibitors (SNRIs), orSNRI drugs,inhibit the reuptake of the neurotransmitters serotonin and norepinephrine in the brain. How these medications affect the brain is dose-dependent , meaning that at lower doses, they only affect the reuptake of serotonin, but at higher doses, they affect the reuptake of norepinephrine also. Some SNRImedications include : Effexor (venlafaxine) Pristiq (desvenlafaxine) Cymbalta (duloxetine) Fetzima (levomilnacipran) Related Topic: SSRI vs SNRI Tricyclic Antidepressants (TCAs) Tricyclic antidepressants(TCAs) were the most commonly prescribed class of antidepressants until the introduction of SSRIs in the 1980s and 1990s. Similar to SNRIs,TCA drugswork mainly by inhibiting the reuptake of serotonin and norepinephrine. The use of TCA drugs is mainly reserved for patients who have been well-controlled on these medications for many years or for patients who do not respond well to SSRIs or SNRIs. The use of TCA drugs has decreased because they tend to cause more side effects and they require more monitoring through laboratory tests because an overdose of a TCA can be deadly. Some TCA medications include: Elavil (amitriptyline) Tofranil (imipramine) Norpramin (desipramine) Pamelor (nortriptyline) Anafranil (clomipramine) Silenor (doxepin) Monoamine Oxidase Inhibitors (MAOIs) Monoamine oxidase inhibitors , also known asMAOIs, work by inhibiting specific enzymes that are responsible for a class of chemicals called monoamines. For the treatment of depression, the three monoamines of interest are serotonin, dopamine and norepinephrine. By inhibiting the breakdown of these chemicals, also known as neurotransmitters, MAOIs trigger an increase in serotonin, norepinephrine and dopamine. The different MAOIs available prevent the breakdown of different monoamines depending on their specific chemical structure. Because these medications affect more monoamines than just those involved in depression, it is common to see this class of medication used in the treatment of other conditions, such as Parkinson’s Disease. Typically, MAOIs are used as a last-line option for the treatment of depression because they have many interactions with other drugs, and an overdose can be deadly. Some MAOI medications include: Nardil (phenelzine) Parnate (tranylcypromine) Atypical Antidepressants Atypical antidepressantsis the term used to classify the remaining available antidepressants that have unique mechanisms of action and do not fall under another, more specific, category. Atypical antidepressants include: Wellbutrin (bupropion) Remeron (mirtazapine) Serzone (nefazodone) Desyrel (trazodone) Viibryd (vilazodone) Trintellix (vortioxetine) Effectiveness of Antidepressants Antidepressant medications are widely accepted as effective and beneficial for the management of depression. The simple answer to the question “Do antidepressants work?” is yes ; however, it can take several weeks for these medications to reach full effectiveness, making it a slow, sometimes frustrating process when choosing or switching antidepressant medications. Because there are so many options available for depression treatment , recently there has been increasing debate regarding which options are the best for first-line treatment. A recent review evaluating the results of over 500 clinical studies concluded that five antidepressants appear to be more effective, better tolerated and less likely to be changed after eight weeks of treatment than other drugs. These drugs are: Lexapro (escitalopram) Paxil (paroxetine) Zoloft (sertraline) Remeron (mirtazapine) Agomelatine (a medication that is not marketed in the United States) When evaluating themost effective antidepressantmedications, the effectiveness of a certain medication is dependent on the person’s brain chemistry. Although the findings of the above-mentioned study may provide some guidance regarding good first-line options for treatment, a doctor should consider a person’s unique symptoms, medical history, and risk for side effects when choosing the most appropriate option for a patient . Because antidepressants generally take several weeks to achieve full effectiveness, it is very important to take the medication on a regular basis, to follow-up with a doctor routinely and to not stop the medication abruptly, which could cause withdrawal reactions. Side Effects Common side effects of antidepressants include: Nausea and vomiting Weight gain Diarrhea or stomach upset Sleep disturbances, such as feeling very sleepy or having difficulty falling asleep Sexual dysfunction Some antidepressants can have serious side effects and these side effects should be discussed with your doctor: Suicidal thinking Birth defects High blood pressure When researching antidepressants, there is a lot of controversy regarding thelong-term effects of antidepressants. Some research suggests that the use of antidepressants may increase the risk for a person dying prematurely. However, many prescribers maintain that the appropriate use of these medications can help patients lead happier and healthier lives. Also, due to the nature of how antidepressant medications work and the neurotransmitters that they affect, it is possible for patients to experience a decrease in effectiveness over time due to the brain becoming less responsive to the medications, also known as tolerance. Typically, the most bothersome side effects for patients areantidepressants’ sexual side effectsand weight gain. Weight gain is a possible side effect with nearly all antidepressants except Wellbutrin (bupropion). Bupropion is commonly considered the medication of choice for patients who would benefit from possibleantidepressant weight loss. When considering the possible side effects of any medication, including antidepressants, it is important for prescribers and patients to weigh the risks and benefits of taking a certain medication. If the benefits outweigh the risks, then it is a good choice. It is important to be upfront with a doctor regarding expectations for treatment to have the best chance for treatment success. Risk of Suicide Antidepressants and suicide have become increasing concerns in the health care community. In 2004, the Food and Drug Administration (FDA) required manufacturers to add a boxed warning to all antidepressant medications to highlight the increased risk of suicidal thinking or behavior in children and adolescents during the initiation of treatment. In 2007, this warning was expanded to include young adults up to the age of 24 years old. Because of the potential forantidepressants causing suicidal thoughts, routine follow-up and closing monitoring are very important in helping prevent a tragic outcome. Patients should inform their health care provider immediately if they begin to feel worse or develop new symptoms, especially after changing their medication or dose. If you or someone you know is having suicidal thoughts , don’t wait to get help. Call your doctor immediately, go to an emergency room or call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) . If you’d rather not speak to a person, you can reach the Crisis Text Line by texting HOME to 741741 from anywhere in America. Serotonin Syndrome Because some antidepressant medications achieve their effectiveness by increasing the amount of serotonin in the brain, they have the risk of causing serotonin syndrome. Serotonin syndrome is a potentially life-threatening condition with symptoms like: Agitation Muscle tremors Racing heartbeat Vomiting Diarrhea Increased sweating Muscle rigidity Serotonin syndrome has been reported with SSRIs and SNRIs. Serotonin syndrome can occur when SSRIs and SNRIs are taken alone, but the risk of experiencing this condition rises when these drugs are taken with other serotonergic agents, like St. John’s Wort and tricyclic antidepressants and triptans, or other drugs likefentanyl,lithium, tram a dol and ampheta m ines . If someone believes that they are experiencing serotonin syndrome, they should discontinue their medication immediately and seek medical treatment right away. The risk for serotonin syndrome increases during treatment initiation and dose increases. It is important to discuss the signs and symptoms of serotonin syndrome with a health care provider when taking medications that may increase levels of serotonin in the body. Possible Interactions Antidepressant interactionsexist with many other medications (prescription and over-the-counter), supplements and food. Specifically, MAOIs are the most notable antidepressant class for having interactions with other medications, supplements and food. However, TCAs, SNRIs and SSRIs carry the risk for serotonin syndrome among other interactions. Because depression commonly occurs with other medical conditions, it is important to discuss the potential for drug interactions with a health care provider. One example of a common combination of medications is antidepressants and antipsychotics.The antidepressants and antipsychotics interactionhappens because SSRIs and some antipsychotics compete in the liver for a limited amount of enzymes that are responsible for the metabolism of the medication. With a decrease in the metabolism of these medications, drug levels in the blood will fluctuate and may lead to decreased effectiveness of the medication or drug levels that are too high. Also, antidepressants can have interactions with certain foods and beverages. One very serious interaction is between antidepressants and alcohol . Alcohol has multiple ways of interacting with antidepressants, and it can negatively affect depression and can worsen the side effects of certain antidepressants, such as SSRIs. It is important to discuss the possibility of antidepressant interactions when speaking with a health care provider. Taking Antidepressants While Pregnant Many women of childbearing age will ask their doctors about the possible effects of antidepressants on pregnancy. Taking antidepressants while pregnant is not a concern for some antidepressants. However, some other antidepressant medications might harm an unborn baby if an expectant mother takes them during pregnancy. If someone is considering taking an antidepressant medication and is pregnant, plans to become pregnant or is breastfeeding, it’s best to consult a doctor before taking antidepressants. Stopping Antidepressants There are many reasons why a patient may consider or be considered by their health care provider for discontinuation of their antidepressant treatment. When discontinuing antidepressants, it is important to taper (gradually decrease the dose) over at least several weeks to preventantidepressant withdrawal. The specific recommendations ofhow to taper off antidepressantsis dependent on the specific antidepressant(s) that a patient is taking. It is important to discuss any questions regarding stopping an antidepressant with a health care provider. What to Do in Case of Overdose Antidepressant overdosecan be very serious and must be treated by trained medical professionals.What happens when you overdose on antidepressantsdepends on the type of antidepressant(s) you are taking. Most SSRIs are noted as being considered generally safe , but when taken in excessive dosages, they have a risk for a serious heart arrhythmia called QTc prolongation. Additionally, TCAs and MAOIs can be fatal when taken in excess. If you think someone may have taken an overdose of an antidepressant (or any drug), call poison control at 1-800-222-1222 immediately as assistance is available 24 hours a day. Get More Information on Antidepressants If you or someone you know needs more information regarding antidepressants, you can gather more information regarding these medications by: Speaking with a mental health professional or therapist Talking with a primary care doctor Visiting MedlinePlus: Antidepressants Visiting HelpGuide: Antidepressant Medications Do you or does someone you love struggle with drug or alcohol addiction and depression ? The Recovery Village is here to help with comprehensive, compassionate treatment. We have several facilities that can offer treatment for depression and addiction . To speak with a caring representative, call The Recovery Village today.

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[Verify Insurance](https://www.therecoveryvillage.com/admissions/insurance/#s-insurance) [Find Location](https://www.therecoveryvillage.com/locations/) [Home](https://www.therecoveryvillage.com/) \> [Drug & Alcohol Treatment Programs Near Me](https://www.therecoveryvillage.com/treatment-program/) \> [Addiction Medications](https://www.therecoveryvillage.com/treatment-program/addiction-medications/) \> Antidepressants # Antidepressants Jump To - [What Are Antidepressants?](https://www.therecoveryvillage.com/treatment-program/addiction-medications/antidepressants/#iframe-trv-form-intake) - [Background and History](https://www.therecoveryvillage.com/treatment-program/addiction-medications/antidepressants/#iframe-trv-form-intake) - [Use in Treating Mental Illness](https://www.therecoveryvillage.com/treatment-program/addiction-medications/antidepressants/#iframe-trv-form-intake) - [How Do Antidepressants Work?](https://www.therecoveryvillage.com/treatment-program/addiction-medications/antidepressants/#iframe-trv-form-intake) - [Types of Antidepressants](https://www.therecoveryvillage.com/treatment-program/addiction-medications/antidepressants/#iframe-trv-form-intake) - [Effectiveness of Antidepressants](https://www.therecoveryvillage.com/treatment-program/addiction-medications/antidepressants/#iframe-trv-form-intake) - [Side Effects](https://www.therecoveryvillage.com/treatment-program/addiction-medications/antidepressants/#iframe-trv-form-intake) - [Risk of Suicide](https://www.therecoveryvillage.com/treatment-program/addiction-medications/antidepressants/#iframe-trv-form-intake) - [Serotonin Syndrome](https://www.therecoveryvillage.com/treatment-program/addiction-medications/antidepressants/#iframe-trv-form-intake) - [Possible Interactions](https://www.therecoveryvillage.com/treatment-program/addiction-medications/antidepressants/#iframe-trv-form-intake) - [Taking Antidepressants While Pregnant](https://www.therecoveryvillage.com/treatment-program/addiction-medications/antidepressants/#iframe-trv-form-intake) - [Stopping Antidepressants](https://www.therecoveryvillage.com/treatment-program/addiction-medications/antidepressants/#iframe-trv-form-intake) - [What to Do in Case of Overdose](https://www.therecoveryvillage.com/treatment-program/addiction-medications/antidepressants/#iframe-trv-form-intake) - [Get More Information on Antidepressants](https://www.therecoveryvillage.com/treatment-program/addiction-medications/antidepressants/#iframe-trv-form-intake) - [Find A Center Near You](https://www.therecoveryvillage.com/treatment-program/addiction-medications/antidepressants/#elementor-toc__heading-anchor-14) - [Reach out now](https://www.therecoveryvillage.com/treatment-program/addiction-medications/antidepressants/#elementor-toc__heading-anchor-15) [(352) 771-2700](tel:3527712700) **24/7 Confidential Support** Get customized treatment near you. ### Antidepressants help alleviate the symptoms of depression and are one of the three most prescribed medication classes in America. Antidepressantsare used in the[management of depression](https://www.therecoveryvillage.com/mental-health/depression/treatment/)to help alleviate symptoms.Antidepressant drugsare[one of the three](https://www.cdc.gov/nchs/products/databriefs/db283.htm)most commonly prescribed therapeutic drug classes, and the use of antidepressants in the treatment of various mental health conditions has[increased](https://www.apa.org/monitor/2017/11/numbers)significantlyin recent years. Understanding howantidepressant medicationswork and why they may help manage depression or other[mental health disorders](https://www.therecoveryvillage.com/mental-health/)can be beneficial when discussing treatment options with a doctor. ## What Are Antidepressants? Antidepressant medicationsare used to alleviate symptoms associated with depression, such as fatigue, loss of interest, trouble sleeping, overwhelming feelings of guilt or worthlessness orthoughts of suicide. They work by augmenting different natural chemicals in the brain, also known as neurotransmitters, to influence a person’s mood. ## Background and History Thehistory of antidepressantsbegan in the[1950s](http://content.time.com/time/health/article/0,8599,1952143,00.html), with the thought that changing the balance of certain natural chemicals in the brain would cause changes in mood and could produce euphoria or feelings of happiness. Free, Confidential Helpline Ready to take the next step toward recovery? Our Recovery Advocates are available around the clock to answer your questions, verify your insurance, and help you find the right level of care — at no cost to you. Call Us Now [(352) 771-2700](tel:3527712700) Available 24 hours a day, 7 days a week The[first two antidepressants](https://www.britannica.com/science/antidepressant)to show success in the management of depression were iproniazid, a monoamine oxidase inhibitor (MAOI) that was originally developed for the treatment of tuberculosis, and imipramine, a tricyclic antidepressant (TCA). The success of these medications in the management of depression and the subsequent accepted use by prescribers led to the development of other medications in these two drug classes. However, these medications came with[considerable side effects](http://content.time.com/time/health/article/0,8599,1952143,00.html), including weight gain, fatigue and the potential of death from overdose. The 1980s and 90s marked a drastic change in the management of depression as groundbreaking developments were made with the introduction of new medications called selective serotonin reuptake inhibitors ([SSRIs](https://www.therecoveryvillage.com/treatment-program/addiction-medications/ssris/)), serotonin-norepinephrine reuptake inhibitors ([SNRIs](https://www.therecoveryvillage.com/treatment-program/addiction-medications/snris/)) and atypical antidepressants. These medications had greater clinical success with fewer side effects than the previously used medications, making them much more popular for the management of depression. The first wasProzac (fluoxetine), an SSRI, which was introduced to the American market in 1987, and was received with monumental popularity with annual sales soon topping[\$1 billion](http://content.time.com/time/health/article/0,8599,1952143,00.html). Currently, the Centers for Disease Control and Prevention (CDC) report that approximately[1 in 10 people](https://www.cdc.gov/nchs/products/databriefs/db283.htm)aged 12 years and older take an antidepressant, with the use of antidepressants approximately[doubling](https://www.cdc.gov/nchs/products/databriefs/db283.htm)between 1999 to 2014. ## Use in Treating Mental Illness Antidepressants have become widely accepted as effective in the management of depression as well as other mental illnesses, including[anxiety disorders](https://www.therecoveryvillage.com/mental-health/anxiety/treatment/),[compulsion disorders](https://www.therecoveryvillage.com/mental-health/impulse-control-disorder/treatment/)and other[mood disorders](https://www.therecoveryvillage.com/mental-health/mood-disorders/treatment/). The American Psychiatric Association recommends the use ofantidepressants for depressionto modify an individual’s brain chemistry, which may be causing the symptoms of depression. These medications have successfully managed depression because they arenot habit-formingand they do not act as stimulants or sedatives. Antidepressants for anxietycan help[alleviate anxiety symptoms](https://www.ncbi.nlm.nih.gov/books/NBK279594/)while also reducing the symptoms of depression that commonly accompany anxiety disorders as coexisting conditions. ## How Do Antidepressants Work? There are three naturally occurring chemicals, also known as neurotransmitters, in the brain that are linked with the regulation of mood and emotions. These[chemicals are serotonin, norepinephrine and dopamine](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4428540/), and they are part of a larger group of chemicals known as monoamines. The theory behind the role of these three neurotransmitters in depression is known as the monoamine hypothesis, first accepted in the 1960s. This theory proposes that people with depression have depleted concentrations of serotonin, norepinephrine and dopamine in the brain, resulting in the symptoms associated with depression. The different types of antidepressants vary in how they affect the concentrations of these brain chemicals. Because of the time that it takes to change the concentrations of these chemicals in the brain,it can take at least[three to four weeks or up to four months](https://www.psychiatry.org/patients-families/depression/what-is-depression)for a patient to notice a significant difference in their mood when starting or switching an antidepressant medication. Also, everyone’s brain chemistry is slightly different so what works for one person, most likely will not work exactly the same for another person. Therefore, one of the most important factors that affectwhat antidepressants dois the individual makeup and concentrations of serotonin, norepinephrine and dopamine in each person. ## Types of Antidepressants Antidepressants areclassifiedbased on how they work, also known as their mechanism of action. A comprehensiveantidepressant listwould include up to[nearly 50 different medications](http://www.amhsjournal.org/article.asp?issn=2321-4848;year=2018;volume=6;issue=1;spage=81;epage=94;aulast=Fasipe)that have been used over time in the management of depression, whether it was diagnosed by itself or as a co-occurring disorder with other mental health conditions. However, the list ofcommon antidepressantsis much smaller and includes: - Prozac(fluoxetine) - Cymbalta(duloxetine) - Paxil(paroxetine) - Zoloft(sertraline) - Wellbutrin(bupropion) - Lexapro(escitalopram) - Celexa(citalopram) - Effexor(venlafaxine) - Remeron(mirtazapine) Thesecommon antidepressantscome from a couple of different classes that are defined by their mechanism of action. ### Selective Serotonin Reuptake Inhibitors (SSRIs) [Selective serotonin reuptake inhibitors](https://www.therecoveryvillage.com/treatment-program/addiction-medications/ssris/)(SSRIs) are the most commonly prescribed antidepressants as they are typically thefirst-line agentsof choice when initiating treatment for a patient. Essentially,SSRI drugswork by targeting serotonin in the brain to prevent reuptake, resulting in an increase in serotonin in the brain. SomeSSRImedications[include](http://www.amhsjournal.org/article.asp?issn=2321-4848;year=2018;volume=6;issue=1;spage=81;epage=94;aulast=Fasipe): - Celexa (citalopram) - Lexapro (escitalopram) - Luvox (fluvoxamine) - Prozac (fluoxetine) - Paxil (paroxetine) - Zoloft (sertraline) ### Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs) [Serotonin-norepinephrine reuptake inhibitors](https://www.therecoveryvillage.com/treatment-program/addiction-medications/snris/)(SNRIs), orSNRI drugs,inhibit the reuptake of the neurotransmitters serotonin and norepinephrine in the brain. How these medications affect the brain is[dose-dependent](http://www.amhsjournal.org/article.asp?issn=2321-4848;year=2018;volume=6;issue=1;spage=81;epage=94;aulast=Fasipe), meaning that at lower doses, they only affect the reuptake of serotonin, but at higher doses, they affect the reuptake of norepinephrine also. Some SNRImedications[include](http://www.amhsjournal.org/article.asp?issn=2321-4848;year=2018;volume=6;issue=1;spage=81;epage=94;aulast=Fasipe): - Effexor (venlafaxine) - Pristiq (desvenlafaxine) - Cymbalta (duloxetine) - Fetzima (levomilnacipran) **Related Topic:**[SSRI vs SNRI](https://www.therecoveryvillage.com/treatment-program/addiction-medications/ssri-vs-snri/) ### Tricyclic Antidepressants (TCAs) Tricyclic antidepressants(TCAs) were the[most commonly prescribed class](http://www.amhsjournal.org/article.asp?issn=2321-4848;year=2018;volume=6;issue=1;spage=81;epage=94;aulast=Fasipe)of antidepressants until the introduction of SSRIs in the 1980s and 1990s. Similar to SNRIs,TCA drugswork mainly by inhibiting the reuptake of serotonin and norepinephrine. The use of TCA drugs is mainly reserved for patients who have been well-controlled on these medications for many years or for patients who do not respond well to SSRIs or SNRIs. The use of TCA drugs has decreased because they tend to cause more side effects and they require more monitoring through laboratory tests because an overdose of a TCA can be deadly. Some TCA medications include: - Elavil (amitriptyline) - Tofranil (imipramine) - Norpramin (desipramine) - Pamelor (nortriptyline) - Anafranil (clomipramine) - Silenor (doxepin) ### Monoamine Oxidase Inhibitors (MAOIs) [Monoamine oxidase inhibitors](https://www.therecoveryvillage.com/treatment-program/addiction-medications/antidepressants/maois/), also known asMAOIs, work by[inhibiting specific enzymes](http://www.amhsjournal.org/article.asp?issn=2321-4848;year=2018;volume=6;issue=1;spage=81;epage=94;aulast=Fasipe)that are responsible for a class of chemicals called monoamines. For the treatment of depression, the three monoamines of interest are serotonin, dopamine and norepinephrine. By inhibiting the breakdown of these chemicals, also known as neurotransmitters, MAOIs trigger an increase in serotonin, norepinephrine and dopamine. The different MAOIs available prevent the breakdown of different monoamines depending on their specific chemical structure. Because these medications affect more monoamines than just those involved in depression, it is common to see this class of medication used in the treatment of other conditions, such as Parkinson’s Disease. Typically, MAOIs are used as a[last-line option](http://www.amhsjournal.org/article.asp?issn=2321-4848;year=2018;volume=6;issue=1;spage=81;epage=94;aulast=Fasipe)for the treatment of depression because they have many interactions with other drugs, and an overdose can be deadly. Some MAOI medications include: - Nardil (phenelzine) - Parnate (tranylcypromine) ### Atypical Antidepressants Atypical antidepressantsis the term used to classify the remaining available antidepressants that have unique mechanisms of action and do not fall under another, more specific, category. Atypical antidepressants include: - Wellbutrin (bupropion) - Remeron (mirtazapine) - Serzone (nefazodone) - Desyrel (trazodone) - Viibryd (vilazodone) - Trintellix (vortioxetine) ## Effectiveness of Antidepressants Antidepressant medications are widely accepted as effective and beneficial for the management of depression. The simple answer to the question “Do antidepressants work?” is *yes*; however, it can take several weeks for these medications to reach full effectiveness, making it a slow, sometimes frustrating process when choosing or switching antidepressant medications. Because there are so many options available for[depression treatment](https://www.therecoveryvillage.com/mental-health/depression/treatment/), recently there has been increasing debate regarding which options are the best for first-line treatment. A[recent review](https://discover.dc.nihr.ac.uk/content/signal-00580/the-most-effective-antidepressants-for-adults-revealed-in-major-review)evaluating the results of over 500 clinical studies concluded that five antidepressants appear to be more effective, better tolerated and less likely to be changed after eight weeks of treatment than other drugs. These drugs are: - Lexapro (escitalopram) - Paxil (paroxetine) - Zoloft (sertraline) - Remeron (mirtazapine) - Agomelatine (a medication that is not marketed in the United States) When evaluating themost effective antidepressantmedications, the effectiveness of a certain medication is dependent on the person’s brain chemistry. Although the findings of the above-mentioned study may provide some guidance regarding good first-line options for treatment, a doctor should consider a person’s unique symptoms, medical history, and risk for side effects when[choosing the most appropriate option for a patient](https://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/mdd-guide.pdf). Because antidepressants generally take several weeks to achieve full effectiveness, it is very important to take the medication on a regular basis, to follow-up with a doctor routinely and to not stop the medication abruptly, which could cause withdrawal reactions. ## Side Effects Common side effects of antidepressants include: - Nausea and vomiting - Weight gain - Diarrhea or stomach upset - Sleep disturbances, such as feeling very sleepy or having difficulty falling asleep - Sexual dysfunction Some antidepressants can have serious side effects and these side effects should be discussed with your doctor: - Suicidal thinking - Birth defects - High blood pressure When researching antidepressants, there is a lot of controversy regarding thelong-term effects of antidepressants. Some[research](https://health.usnews.com/health-news/patient-advice/articles/2015/06/11/what-are-the-long-term-effects-of-taking-antidepressants)suggests that the use of antidepressants may increase the risk for a person dying prematurely. However, many prescribers maintain that the appropriate use of these medications can help patients lead happier and healthier lives. Also, due to the nature of how antidepressant medications work and the neurotransmitters that they affect, it is[possible for patients to experience a decrease in effectiveness](https://www.health.harvard.edu/mind-and-mood/what-are-the-real-risks-of-antidepressants)over time due to the brain becoming less responsive to the medications, also known as tolerance. Typically, the most bothersome side effects for patients areantidepressants’ sexual side effectsand weight gain. Weight gain is a possible side effect with nearly all antidepressants except Wellbutrin (bupropion). Bupropion is commonly considered the[medication of choice](https://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/mdd-guide.pdf)for patients who would benefit from possibleantidepressant weight loss. When considering the possible side effects of any medication, including antidepressants, it is important for prescribers and patients to weigh the risks and benefits of taking a certain medication. If the benefits outweigh the risks, then it is a good choice. It is important to be upfront with a doctor regarding expectations for treatment to have the best chance for treatment success. ## Risk of Suicide Antidepressants and suicide have become increasing concerns in the health care community. In 2004, the Food and Drug Administration (FDA) required manufacturers to add a boxed warning to all antidepressant medications to highlight the increased risk of suicidal thinking or behavior in children and adolescents during the initiation of treatment. In 2007, this warning was expanded to include young adults up to the age of 24 years old. Because of the potential forantidepressants causing suicidal thoughts, routine follow-up and closing monitoring are very important in helping prevent a tragic outcome. Patients should inform their health care provider immediately if they begin to feel worse or develop new symptoms, especially after changing their medication or dose. **If you or someone you know is having**[**suicidal thoughts**](https://www.therecoveryvillage.com/mental-health/suicide-hotlines/)**, don’t wait to get help. Call your doctor immediately, go to an emergency room or call the[National Suicide Prevention Lifeline](https://suicidepreventionlifeline.org/)at[1-800-273-TALK (8255)](tel:1-800-273-8255). If you’d rather not speak to a person, you can reach the Crisis Text Line by texting HOME to 741741 from anywhere in America.** ## Serotonin Syndrome Because some antidepressant medications achieve their effectiveness by increasing the amount of serotonin in the brain, they have the risk of causing serotonin syndrome. Serotonin syndrome is a potentially life-threatening condition with[symptoms](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3865832/)like: - Agitation - Muscle tremors - Racing heartbeat - Vomiting - Diarrhea - Increased sweating - Muscle rigidity Serotonin syndrome[has been reported](http://pi.lilly.com/us/prozac.pdf)with SSRIs and SNRIs. Serotonin syndrome can occur when SSRIs and SNRIs are taken alone, but the risk of experiencing this condition rises when these drugs are taken with other serotonergic agents, like St. John’s Wort and tricyclic antidepressants and triptans, or other drugs likefentanyl,lithium,[tram](https://www.therecoveryvillage.com/tramadol-addiction/side-effects/)a[dol](https://www.therecoveryvillage.com/tramadol-addiction/side-effects/)and[ampheta](https://www.therecoveryvillage.com/amphetamine-addiction/side-effects/)m[ines](https://www.therecoveryvillage.com/amphetamine-addiction/side-effects/). If someone believes that they are experiencing serotonin syndrome, they should discontinue their medication immediately and seek medical treatment right away. The risk for serotonin syndrome increases during treatment initiation and dose increases. It is important to discuss the signs and symptoms of serotonin syndrome with a health care provider when taking medications that may increase levels of serotonin in the body. ## Possible Interactions Antidepressant interactionsexist with many other medications (prescription and over-the-counter), supplements and food. Specifically, MAOIs are the most notable antidepressant class for having interactions with other medications, supplements and food. However, TCAs, SNRIs and SSRIs carry the risk for serotonin syndrome among other interactions. Because depression commonly occurs with other medical conditions, it is important to discuss the potential for drug interactions with a health care provider. One example of a common combination of medications is antidepressants and antipsychotics.The antidepressants and antipsychotics interactionhappens because SSRIs and some antipsychotics[compete in the liver](https://idp.springer.com/authorize?response_type=cookie&client_id=springerlink&redirect_uri=http://link.springer.com/article/10.2165/00002018-199615050-00004)for a limited amount of enzymes that are responsible for the metabolism of the medication. With a decrease in the metabolism of these medications, drug levels in the blood will fluctuate and may lead to decreased effectiveness of the medication or drug levels that are too high. Also, antidepressants can have interactions with certain foods and beverages. One very serious interaction is between[antidepressants and alcohol](https://www.therecoveryvillage.com/alcohol-abuse/alcohol-and-ssri/). Alcohol has multiple ways of interacting with antidepressants, and it can negatively affect depression and can worsen the side effects of certain antidepressants, such as SSRIs. It is important to discuss the possibility of antidepressant interactions when speaking with a health care provider. ## Taking Antidepressants While Pregnant Many women of childbearing age will ask their doctors about the possible effects of antidepressants on pregnancy. Taking antidepressants while pregnant is not a concern for some antidepressants. However, some other antidepressant medications might harm an unborn baby if an expectant mother takes them during pregnancy. If someone is considering taking an antidepressant medication and is pregnant, plans to become pregnant or is breastfeeding, it’s best to consult a doctor before taking antidepressants. ## Stopping Antidepressants There are many reasons why a patient may consider or be considered by their health care provider for discontinuation of their antidepressant treatment. When discontinuing antidepressants, it is important to[taper (gradually decrease the dose) over at least several weeks](https://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/mdd-guide.pdf)to preventantidepressant withdrawal. The specific recommendations ofhow to taper off antidepressantsis dependent on the specific antidepressant(s) that a patient is taking. It is important to discuss any questions regarding stopping an antidepressant with a health care provider. ## What to Do in Case of Overdose Antidepressant overdosecan be very serious and must be treated by trained medical professionals.What happens when you overdose on antidepressantsdepends on the type of antidepressant(s) you are taking. Most SSRIs are noted as being[considered generally safe](https://www.poison.org/articles/2014-dec/antidepressants), but when taken in excessive dosages, they have a risk for a serious heart arrhythmia called QTc prolongation. Additionally,[TCAs and MAOIs](https://www.poison.org/articles/2014-dec/antidepressants)can be fatal when taken in excess. **If you think someone may have taken an overdose of an antidepressant (or any drug), call poison control at 1-800-222-1222 immediately as assistance is available 24 hours a day.** ## Get More Information on Antidepressants If you or someone you know needs more information regarding antidepressants, you can gather more information regarding these medications by: - Speaking with a mental health professional or therapist - Talking with a primary care doctor - Visiting[MedlinePlus: Antidepressants](https://medlineplus.gov/antidepressants.html) - Visiting[HelpGuide: Antidepressant Medications](https://www.helpguide.org/articles/depression/antidepressant-medication.htm) **Do you or does someone you love struggle with**[**drug or alcohol addiction and depression**](https://www.therecoveryvillage.com/mental-health/depression/substance-abuse/)**? The Recovery Village is here to help with comprehensive, compassionate treatment. We have**[**several facilities**](https://www.therecoveryvillage.com/locations/)**that can offer treatment for****depression and addiction****. To speak with a caring representative,**[**call The Recovery Village**](https://www.therecoveryvillage.com/contact/)**today.** ## Find A Center Near You Find The Recovery Village Drug, Alcohol and Mental Health Rehab nearest you. [Find Location](https://www.therecoveryvillage.com/locations/) [View all locations](https://www.therecoveryvillage.com/locations/) [PrevRead PreviousBuprenorphine](https://www.therecoveryvillage.com/treatment-program/addiction-medications/buprenorphine/) [Read NextAnti-Anxiety MedicationsNext](https://www.therecoveryvillage.com/treatment-program/addiction-medications/anxiety-medication/) ### Related Articles ### [Understanding Your Insurance Coverage in 2026 and Beyond](https://www.therecoveryvillage.com/insurance/understanding-insurance-changes/) ### [Before Your Deductible Resets, Invest in Your Recovery](https://www.therecoveryvillage.com/before-deductible-reset-rehab-more-affordable/) ### [Converting Power of Peers](https://www.therecoveryvillage.com/support-system/converting-power-of-peers/) ### [Mental Health and Loneliness](https://www.therecoveryvillage.com/mental-health/mental-health-and-loneliness/) ### [The 6 Stages of Mental Health Recovery](https://www.therecoveryvillage.com/mental-health/stages-of-mental-health-recovery/) ### [Reset Your Mind: Benefits of Inpatient Mental Health Care](https://www.therecoveryvillage.com/mental-health/benefits-of-inpatient-mental-health-care/) ### [How To Let Go of a Toxic Loved One](https://www.therecoveryvillage.com/mental-health/toxic-loved-one/) ### [Denying Our Mental Health: Why We Do It and How To Move Past It](https://www.therecoveryvillage.com/mental-health/denial-and-mental-health/) ### [How To Find and Choose a Therapist](https://www.therecoveryvillage.com/mental-health/choosing-a-therapist/) ### [10 Habits for Proper Mental Health](https://www.therecoveryvillage.com/mental-health/habits-for-mental-health/) #### Medical Disclaimer The Recovery Village aims to improve the quality of life for people struggling with substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare providers. ### Sources American Psychiatric Association. “What is Depression.” January 2017. Accessed June 9, 2019. American Psychiatric Association. “[Treating Major Depressive Disorder: A Quick Reference Guide](https://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/mdd-guide.pdf "Treating Major Depressive Disorder: A Quick Reference Guide").” October 2010. Accessed June 9, 2019. American Psychological Association. “[By the numbers: Antidepressant use on the rise](https://www.apa.org/monitor/2017/11/numbers "By the numbers: Antidepressant use on the rise").” November 2017. Accessed June 9, 2019. The Centers for Disease Control and Prevention. “[Antidepressant Use Among Persons Aged 12\[…\] States, 2011–2014](https://www.cdc.gov/nchs/products/databriefs/db283.htm "Antidepressant Use Among Persons Aged 12 and Over: United States, 2011–2014").” August 2017. Accessed June 9, 2019. Elli Lilly and Company. “[Prozac Prescribing Information](http://pi.lilly.com/us/prozac.pdf "Prozac Prescribing Information").” March 2017. Accessed June 9, 2019. Encyclopedia Britannica. “[Antidepressant](https://www.britannica.com/science/antidepressant "Antidepressant").” June 2019. Accessed June 9, 2019. Fitzpatrick L. “[A Brief History of Antidepressants](http://content.time.com/time/health/article/0,8599,1952143,00.html "A Brief History of Antidepressants").” TIME Magazine, January 7, 2010. Accessed June 9, 2019. Harvard Health Publishing. “[What are the real risks of antidepressants?](https://www.health.harvard.edu/mind-and-mood/what-are-the-real-risks-of-antidepressants "What are the real risks of antidepressants?")” March 2019. Accessed June 9, 2019 Hillhouse, Todd; Porter, Joseph. “[A brief history of the development of an\[…\]oamines to glutamate](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4428540/ "A brief history of the development of antidepressant drugs: From monoamines to glutamate").” Experimental and Clinical Psychopharmacology, February 2015. Accessed June 9, 2019. InformedHealth.org. “[Treatment Options for Generalized Anxiety Disorder](https://www.ncbi.nlm.nih.gov/books/NBK279594/ "Treatment Options for Generalized Anxiety Disorder").” February 2018. Accessed June 9, 2019. Meyer, Michele; Baldessarini, Ross; Goff, Donald; Centorrino, Franca. “[Clinically Significant Interactions of P\[…\] Antipsychotic Drugs](https://idp.springer.com/authorize?response_type=cookie&client_id=springerlink&redirect_uri=http://link.springer.com/article/10.2165/00002018-199615050-00004 "Clinically Significant Interactions of Psychotropic Agents with Antipsychotic Drugs").” Drug Safety, October 26, 2012. Accessed June 9, 2019. The National Institute for Health Research. “[The most effective antidepressants for a\[…\]aled in major review](https://discover.dc.nihr.ac.uk/content/signal-00580/the-most-effective-antidepressants-for-adults-revealed-in-major-review "The most effective antidepressants for adults revealed in major review").” April 2018. Accessed June 9, 2019. Olumuyiwa, John Fasipe. “[Neuropharmacological classification of a\[…\]mechanisms of action](http://www.amhsjournal.org/article.asp?issn=2321-4848;year=2018;volume=6;issue=1;spage=81;epage=94;aulast=Fasipe "Neuropharmacological classification of antidepressant agents based on their mechanisms of action").” Yenepoya University, June 2018. Accessed June 9, 2019. Poison Control: National Capital Poison Center. “[Antidepressants](https://www.poison.org/articles/2014-dec/antidepressants "Antidepressants").” November 2014. Accessed June 9, 2019. Schroeder, Michael. “[What Are the Long-Term Effects of Taking Antidepressants?](https://health.usnews.com/health-news/patient-advice/articles/2015/06/11/what-are-the-long-term-effects-of-taking-antidepressants "What Are the Long-Term Effects of Taking Antidepressants?")” U.S. News, June 11, 2015. Accessed June 9, 2019. The U.S. Food and Drug Administration. “Depression: FDA-Approved Medications May Help.” April 2017. Accessed June 9, 2019. Volpe-Abadie, Jacqueline; Kaye, Aadam; Kaye, Alan David. “[Serotonin Syndrome](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3865832/ "Serotonin Syndrome").” The Ochsner Journal, 2013. Accessed June 9, 2019. ## Reach out now We can help answer your questions and talk through any concerns. 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### Antidepressants help alleviate the symptoms of depression and are one of the three most prescribed medication classes in America. Antidepressantsare used in the[management of depression](https://www.therecoveryvillage.com/mental-health/depression/treatment/)to help alleviate symptoms.Antidepressant drugsare[one of the three](https://www.cdc.gov/nchs/products/databriefs/db283.htm)most commonly prescribed therapeutic drug classes, and the use of antidepressants in the treatment of various mental health conditions has[increased](https://www.apa.org/monitor/2017/11/numbers)significantlyin recent years. Understanding howantidepressant medicationswork and why they may help manage depression or other[mental health disorders](https://www.therecoveryvillage.com/mental-health/)can be beneficial when discussing treatment options with a doctor. ## What Are Antidepressants? Antidepressant medicationsare used to alleviate symptoms associated with depression, such as fatigue, loss of interest, trouble sleeping, overwhelming feelings of guilt or worthlessness orthoughts of suicide. They work by augmenting different natural chemicals in the brain, also known as neurotransmitters, to influence a person’s mood. ## Background and History Thehistory of antidepressantsbegan in the[1950s](http://content.time.com/time/health/article/0,8599,1952143,00.html), with the thought that changing the balance of certain natural chemicals in the brain would cause changes in mood and could produce euphoria or feelings of happiness. Free, Confidential Helpline Ready to take the next step toward recovery? Our Recovery Advocates are available around the clock to answer your questions, verify your insurance, and help you find the right level of care — at no cost to you. Call Us Now Available 24 hours a day, 7 days a week The[first two antidepressants](https://www.britannica.com/science/antidepressant)to show success in the management of depression were iproniazid, a monoamine oxidase inhibitor (MAOI) that was originally developed for the treatment of tuberculosis, and imipramine, a tricyclic antidepressant (TCA). The success of these medications in the management of depression and the subsequent accepted use by prescribers led to the development of other medications in these two drug classes. However, these medications came with[considerable side effects](http://content.time.com/time/health/article/0,8599,1952143,00.html), including weight gain, fatigue and the potential of death from overdose. The 1980s and 90s marked a drastic change in the management of depression as groundbreaking developments were made with the introduction of new medications called selective serotonin reuptake inhibitors ([SSRIs](https://www.therecoveryvillage.com/treatment-program/addiction-medications/ssris/)), serotonin-norepinephrine reuptake inhibitors ([SNRIs](https://www.therecoveryvillage.com/treatment-program/addiction-medications/snris/)) and atypical antidepressants. These medications had greater clinical success with fewer side effects than the previously used medications, making them much more popular for the management of depression. The first wasProzac (fluoxetine), an SSRI, which was introduced to the American market in 1987, and was received with monumental popularity with annual sales soon topping[\$1 billion](http://content.time.com/time/health/article/0,8599,1952143,00.html). Currently, the Centers for Disease Control and Prevention (CDC) report that approximately[1 in 10 people](https://www.cdc.gov/nchs/products/databriefs/db283.htm)aged 12 years and older take an antidepressant, with the use of antidepressants approximately[doubling](https://www.cdc.gov/nchs/products/databriefs/db283.htm)between 1999 to 2014. ## Use in Treating Mental Illness Antidepressants have become widely accepted as effective in the management of depression as well as other mental illnesses, including[anxiety disorders](https://www.therecoveryvillage.com/mental-health/anxiety/treatment/),[compulsion disorders](https://www.therecoveryvillage.com/mental-health/impulse-control-disorder/treatment/)and other[mood disorders](https://www.therecoveryvillage.com/mental-health/mood-disorders/treatment/). The American Psychiatric Association recommends the use ofantidepressants for depressionto modify an individual’s brain chemistry, which may be causing the symptoms of depression. These medications have successfully managed depression because they arenot habit-formingand they do not act as stimulants or sedatives. Antidepressants for anxietycan help[alleviate anxiety symptoms](https://www.ncbi.nlm.nih.gov/books/NBK279594/)while also reducing the symptoms of depression that commonly accompany anxiety disorders as coexisting conditions. ## How Do Antidepressants Work? There are three naturally occurring chemicals, also known as neurotransmitters, in the brain that are linked with the regulation of mood and emotions. These[chemicals are serotonin, norepinephrine and dopamine](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4428540/), and they are part of a larger group of chemicals known as monoamines. The theory behind the role of these three neurotransmitters in depression is known as the monoamine hypothesis, first accepted in the 1960s. This theory proposes that people with depression have depleted concentrations of serotonin, norepinephrine and dopamine in the brain, resulting in the symptoms associated with depression. The different types of antidepressants vary in how they affect the concentrations of these brain chemicals. Because of the time that it takes to change the concentrations of these chemicals in the brain,it can take at least[three to four weeks or up to four months](https://www.psychiatry.org/patients-families/depression/what-is-depression)for a patient to notice a significant difference in their mood when starting or switching an antidepressant medication. Also, everyone’s brain chemistry is slightly different so what works for one person, most likely will not work exactly the same for another person. Therefore, one of the most important factors that affectwhat antidepressants dois the individual makeup and concentrations of serotonin, norepinephrine and dopamine in each person. ## Types of Antidepressants Antidepressants areclassifiedbased on how they work, also known as their mechanism of action. A comprehensiveantidepressant listwould include up to[nearly 50 different medications](http://www.amhsjournal.org/article.asp?issn=2321-4848;year=2018;volume=6;issue=1;spage=81;epage=94;aulast=Fasipe)that have been used over time in the management of depression, whether it was diagnosed by itself or as a co-occurring disorder with other mental health conditions. However, the list ofcommon antidepressantsis much smaller and includes: - Prozac(fluoxetine) - Cymbalta(duloxetine) - Paxil(paroxetine) - Zoloft(sertraline) - Wellbutrin(bupropion) - Lexapro(escitalopram) - Celexa(citalopram) - Effexor(venlafaxine) - Remeron(mirtazapine) Thesecommon antidepressantscome from a couple of different classes that are defined by their mechanism of action. ### Selective Serotonin Reuptake Inhibitors (SSRIs) [Selective serotonin reuptake inhibitors](https://www.therecoveryvillage.com/treatment-program/addiction-medications/ssris/)(SSRIs) are the most commonly prescribed antidepressants as they are typically thefirst-line agentsof choice when initiating treatment for a patient. Essentially,SSRI drugswork by targeting serotonin in the brain to prevent reuptake, resulting in an increase in serotonin in the brain. SomeSSRImedications[include](http://www.amhsjournal.org/article.asp?issn=2321-4848;year=2018;volume=6;issue=1;spage=81;epage=94;aulast=Fasipe): - Celexa (citalopram) - Lexapro (escitalopram) - Luvox (fluvoxamine) - Prozac (fluoxetine) - Paxil (paroxetine) - Zoloft (sertraline) ### Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs) [Serotonin-norepinephrine reuptake inhibitors](https://www.therecoveryvillage.com/treatment-program/addiction-medications/snris/)(SNRIs), orSNRI drugs,inhibit the reuptake of the neurotransmitters serotonin and norepinephrine in the brain. How these medications affect the brain is[dose-dependent](http://www.amhsjournal.org/article.asp?issn=2321-4848;year=2018;volume=6;issue=1;spage=81;epage=94;aulast=Fasipe), meaning that at lower doses, they only affect the reuptake of serotonin, but at higher doses, they affect the reuptake of norepinephrine also. Some SNRImedications[include](http://www.amhsjournal.org/article.asp?issn=2321-4848;year=2018;volume=6;issue=1;spage=81;epage=94;aulast=Fasipe): - Effexor (venlafaxine) - Pristiq (desvenlafaxine) - Cymbalta (duloxetine) - Fetzima (levomilnacipran) **Related Topic:**[SSRI vs SNRI](https://www.therecoveryvillage.com/treatment-program/addiction-medications/ssri-vs-snri/) ### Tricyclic Antidepressants (TCAs) Tricyclic antidepressants(TCAs) were the[most commonly prescribed class](http://www.amhsjournal.org/article.asp?issn=2321-4848;year=2018;volume=6;issue=1;spage=81;epage=94;aulast=Fasipe)of antidepressants until the introduction of SSRIs in the 1980s and 1990s. Similar to SNRIs,TCA drugswork mainly by inhibiting the reuptake of serotonin and norepinephrine. The use of TCA drugs is mainly reserved for patients who have been well-controlled on these medications for many years or for patients who do not respond well to SSRIs or SNRIs. The use of TCA drugs has decreased because they tend to cause more side effects and they require more monitoring through laboratory tests because an overdose of a TCA can be deadly. Some TCA medications include: - Elavil (amitriptyline) - Tofranil (imipramine) - Norpramin (desipramine) - Pamelor (nortriptyline) - Anafranil (clomipramine) - Silenor (doxepin) ### Monoamine Oxidase Inhibitors (MAOIs) [Monoamine oxidase inhibitors](https://www.therecoveryvillage.com/treatment-program/addiction-medications/antidepressants/maois/), also known asMAOIs, work by[inhibiting specific enzymes](http://www.amhsjournal.org/article.asp?issn=2321-4848;year=2018;volume=6;issue=1;spage=81;epage=94;aulast=Fasipe)that are responsible for a class of chemicals called monoamines. For the treatment of depression, the three monoamines of interest are serotonin, dopamine and norepinephrine. By inhibiting the breakdown of these chemicals, also known as neurotransmitters, MAOIs trigger an increase in serotonin, norepinephrine and dopamine. The different MAOIs available prevent the breakdown of different monoamines depending on their specific chemical structure. Because these medications affect more monoamines than just those involved in depression, it is common to see this class of medication used in the treatment of other conditions, such as Parkinson’s Disease. Typically, MAOIs are used as a[last-line option](http://www.amhsjournal.org/article.asp?issn=2321-4848;year=2018;volume=6;issue=1;spage=81;epage=94;aulast=Fasipe)for the treatment of depression because they have many interactions with other drugs, and an overdose can be deadly. Some MAOI medications include: - Nardil (phenelzine) - Parnate (tranylcypromine) ### Atypical Antidepressants Atypical antidepressantsis the term used to classify the remaining available antidepressants that have unique mechanisms of action and do not fall under another, more specific, category. Atypical antidepressants include: - Wellbutrin (bupropion) - Remeron (mirtazapine) - Serzone (nefazodone) - Desyrel (trazodone) - Viibryd (vilazodone) - Trintellix (vortioxetine) ## Effectiveness of Antidepressants Antidepressant medications are widely accepted as effective and beneficial for the management of depression. The simple answer to the question “Do antidepressants work?” is *yes*; however, it can take several weeks for these medications to reach full effectiveness, making it a slow, sometimes frustrating process when choosing or switching antidepressant medications. Because there are so many options available for[depression treatment](https://www.therecoveryvillage.com/mental-health/depression/treatment/), recently there has been increasing debate regarding which options are the best for first-line treatment. A[recent review](https://discover.dc.nihr.ac.uk/content/signal-00580/the-most-effective-antidepressants-for-adults-revealed-in-major-review)evaluating the results of over 500 clinical studies concluded that five antidepressants appear to be more effective, better tolerated and less likely to be changed after eight weeks of treatment than other drugs. These drugs are: - Lexapro (escitalopram) - Paxil (paroxetine) - Zoloft (sertraline) - Remeron (mirtazapine) - Agomelatine (a medication that is not marketed in the United States) When evaluating themost effective antidepressantmedications, the effectiveness of a certain medication is dependent on the person’s brain chemistry. Although the findings of the above-mentioned study may provide some guidance regarding good first-line options for treatment, a doctor should consider a person’s unique symptoms, medical history, and risk for side effects when[choosing the most appropriate option for a patient](https://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/mdd-guide.pdf). Because antidepressants generally take several weeks to achieve full effectiveness, it is very important to take the medication on a regular basis, to follow-up with a doctor routinely and to not stop the medication abruptly, which could cause withdrawal reactions. ## Side Effects Common side effects of antidepressants include: - Nausea and vomiting - Weight gain - Diarrhea or stomach upset - Sleep disturbances, such as feeling very sleepy or having difficulty falling asleep - Sexual dysfunction Some antidepressants can have serious side effects and these side effects should be discussed with your doctor: - Suicidal thinking - Birth defects - High blood pressure When researching antidepressants, there is a lot of controversy regarding thelong-term effects of antidepressants. Some[research](https://health.usnews.com/health-news/patient-advice/articles/2015/06/11/what-are-the-long-term-effects-of-taking-antidepressants)suggests that the use of antidepressants may increase the risk for a person dying prematurely. However, many prescribers maintain that the appropriate use of these medications can help patients lead happier and healthier lives. Also, due to the nature of how antidepressant medications work and the neurotransmitters that they affect, it is[possible for patients to experience a decrease in effectiveness](https://www.health.harvard.edu/mind-and-mood/what-are-the-real-risks-of-antidepressants)over time due to the brain becoming less responsive to the medications, also known as tolerance. Typically, the most bothersome side effects for patients areantidepressants’ sexual side effectsand weight gain. Weight gain is a possible side effect with nearly all antidepressants except Wellbutrin (bupropion). Bupropion is commonly considered the[medication of choice](https://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/mdd-guide.pdf)for patients who would benefit from possibleantidepressant weight loss. When considering the possible side effects of any medication, including antidepressants, it is important for prescribers and patients to weigh the risks and benefits of taking a certain medication. If the benefits outweigh the risks, then it is a good choice. It is important to be upfront with a doctor regarding expectations for treatment to have the best chance for treatment success. ## Risk of Suicide Antidepressants and suicide have become increasing concerns in the health care community. In 2004, the Food and Drug Administration (FDA) required manufacturers to add a boxed warning to all antidepressant medications to highlight the increased risk of suicidal thinking or behavior in children and adolescents during the initiation of treatment. In 2007, this warning was expanded to include young adults up to the age of 24 years old. Because of the potential forantidepressants causing suicidal thoughts, routine follow-up and closing monitoring are very important in helping prevent a tragic outcome. Patients should inform their health care provider immediately if they begin to feel worse or develop new symptoms, especially after changing their medication or dose. **If you or someone you know is having**[**suicidal thoughts**](https://www.therecoveryvillage.com/mental-health/suicide-hotlines/)**, don’t wait to get help. Call your doctor immediately, go to an emergency room or call the[National Suicide Prevention Lifeline](https://suicidepreventionlifeline.org/)at[1-800-273-TALK (8255)](tel:1-800-273-8255). If you’d rather not speak to a person, you can reach the Crisis Text Line by texting HOME to 741741 from anywhere in America.** ## Serotonin Syndrome Because some antidepressant medications achieve their effectiveness by increasing the amount of serotonin in the brain, they have the risk of causing serotonin syndrome. Serotonin syndrome is a potentially life-threatening condition with[symptoms](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3865832/)like: - Agitation - Muscle tremors - Racing heartbeat - Vomiting - Diarrhea - Increased sweating - Muscle rigidity Serotonin syndrome[has been reported](http://pi.lilly.com/us/prozac.pdf)with SSRIs and SNRIs. Serotonin syndrome can occur when SSRIs and SNRIs are taken alone, but the risk of experiencing this condition rises when these drugs are taken with other serotonergic agents, like St. John’s Wort and tricyclic antidepressants and triptans, or other drugs likefentanyl,lithium,[tram](https://www.therecoveryvillage.com/tramadol-addiction/side-effects/)a[dol](https://www.therecoveryvillage.com/tramadol-addiction/side-effects/)and[ampheta](https://www.therecoveryvillage.com/amphetamine-addiction/side-effects/)m[ines](https://www.therecoveryvillage.com/amphetamine-addiction/side-effects/). If someone believes that they are experiencing serotonin syndrome, they should discontinue their medication immediately and seek medical treatment right away. The risk for serotonin syndrome increases during treatment initiation and dose increases. It is important to discuss the signs and symptoms of serotonin syndrome with a health care provider when taking medications that may increase levels of serotonin in the body. ## Possible Interactions Antidepressant interactionsexist with many other medications (prescription and over-the-counter), supplements and food. Specifically, MAOIs are the most notable antidepressant class for having interactions with other medications, supplements and food. However, TCAs, SNRIs and SSRIs carry the risk for serotonin syndrome among other interactions. Because depression commonly occurs with other medical conditions, it is important to discuss the potential for drug interactions with a health care provider. One example of a common combination of medications is antidepressants and antipsychotics.The antidepressants and antipsychotics interactionhappens because SSRIs and some antipsychotics[compete in the liver](https://idp.springer.com/authorize?response_type=cookie&client_id=springerlink&redirect_uri=http://link.springer.com/article/10.2165/00002018-199615050-00004)for a limited amount of enzymes that are responsible for the metabolism of the medication. With a decrease in the metabolism of these medications, drug levels in the blood will fluctuate and may lead to decreased effectiveness of the medication or drug levels that are too high. Also, antidepressants can have interactions with certain foods and beverages. One very serious interaction is between[antidepressants and alcohol](https://www.therecoveryvillage.com/alcohol-abuse/alcohol-and-ssri/). Alcohol has multiple ways of interacting with antidepressants, and it can negatively affect depression and can worsen the side effects of certain antidepressants, such as SSRIs. It is important to discuss the possibility of antidepressant interactions when speaking with a health care provider. ## Taking Antidepressants While Pregnant Many women of childbearing age will ask their doctors about the possible effects of antidepressants on pregnancy. Taking antidepressants while pregnant is not a concern for some antidepressants. However, some other antidepressant medications might harm an unborn baby if an expectant mother takes them during pregnancy. If someone is considering taking an antidepressant medication and is pregnant, plans to become pregnant or is breastfeeding, it’s best to consult a doctor before taking antidepressants. ## Stopping Antidepressants There are many reasons why a patient may consider or be considered by their health care provider for discontinuation of their antidepressant treatment. When discontinuing antidepressants, it is important to[taper (gradually decrease the dose) over at least several weeks](https://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/mdd-guide.pdf)to preventantidepressant withdrawal. The specific recommendations ofhow to taper off antidepressantsis dependent on the specific antidepressant(s) that a patient is taking. It is important to discuss any questions regarding stopping an antidepressant with a health care provider. ## What to Do in Case of Overdose Antidepressant overdosecan be very serious and must be treated by trained medical professionals.What happens when you overdose on antidepressantsdepends on the type of antidepressant(s) you are taking. Most SSRIs are noted as being[considered generally safe](https://www.poison.org/articles/2014-dec/antidepressants), but when taken in excessive dosages, they have a risk for a serious heart arrhythmia called QTc prolongation. Additionally,[TCAs and MAOIs](https://www.poison.org/articles/2014-dec/antidepressants)can be fatal when taken in excess. **If you think someone may have taken an overdose of an antidepressant (or any drug), call poison control at 1-800-222-1222 immediately as assistance is available 24 hours a day.** ## Get More Information on Antidepressants If you or someone you know needs more information regarding antidepressants, you can gather more information regarding these medications by: - Speaking with a mental health professional or therapist - Talking with a primary care doctor - Visiting[MedlinePlus: Antidepressants](https://medlineplus.gov/antidepressants.html) - Visiting[HelpGuide: Antidepressant Medications](https://www.helpguide.org/articles/depression/antidepressant-medication.htm) **Do you or does someone you love struggle with**[**drug or alcohol addiction and depression**](https://www.therecoveryvillage.com/mental-health/depression/substance-abuse/)**? The Recovery Village is here to help with comprehensive, compassionate treatment. We have**[**several facilities**](https://www.therecoveryvillage.com/locations/)**that can offer treatment for****depression and addiction****. To speak with a caring representative,**[**call The Recovery Village**](https://www.therecoveryvillage.com/contact/)**today.**

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