Types of medication
There are two main groups of antidepressants, the newer drugs (the dual action preparations and the SSRIs) and the old drugs (TCA and MAO inhibitors).
SSRI
The type of antidepressant that is most widely used is the SSRIs (an abbreviation of Selective Serotonin Reuptake Inhibitors ). These drugs boost the effect of the signalling substance serotonin in the brain, and they are effective in the treatment of mild to moderate depression.
If you need to be treated with SSRIs there are several possibilities. Many recommend Lexapro(escitalopram), Prozac (fluoxetine), Luvox (Fluvoxamine), Zoloft (sertraline) and Seroxat (Paroxetine). With these types of medicine you avoid problems if you need to take another kind of medicine simultaneously.
Dual action preparations
Another type of medicine that is increasingly used is dual action preparations. Dual action preparations boost the effect of the signalling substance serotonin and noradrenaline in the brain.
If you need to be treated with a dual action preparation there are currently two possibilities: Efexor (venlafaxine XR) and Remeron (mirtazapine). .
The side-effects of SSRI and dual action preparations
This is a list of the side-effects of the treatment with SSRIs and dual action preparations. The side-effects can vary though depending on the preparations so ask your doctor about the known side-effect of the preparation that you are getting. They might be
- restlessness
- difficulty in sleeping
- dryness of the mouth
- nausea and vomiting
- headache
- constipation
- tendency to sweat
- sexual problems (lack of desire, delayed/absent ejaculation)
- weight increase
- high blood pressure (rarely a side-effect in high doses of Efexor)
- changes in the body's sodium balance
TCA
TCAs (tricyclic antidepressants) boost the signalling substances serotonin and noradrenaline in the brain and also block different receptors in the brain's nervous system. They therefore have a slightly different effect than the SSRIs and also have a few more side-effects. This group comprises, amongst others, , Anafranil (clomipramine) and Imipramin (imipramine). TCAs are especially used in severe depressions, where the SSRIs are not effective enough.
Side-effects of TCA
The side-effects that can occur in the treatment with TCA can be
- dryness of the mouth
- constipation
- tendency to sweat
- problems focusing your sight at a short distance (especially in the young)
- dysuria (especially in elderly men with an enlarged prostate gland)
- dizziness (especially when getting up from a sitting or lying position)
- weight increase
- mild shaking of the hands
- effects on the heart beat (especially with too high doses)
Very old and frail people, people with a poor oxygen supply to the heart and people with serious disturbances of the heart beat, should avoid TCA treatment.
Reversible MAO inhibitors
A type of preparations that are only used very rarely is the Reversible MAO inhibitors (RIMA).
Aurorix (moclobemide) is the only preparation in this group that is available in Malaysia. However, treatment with Aurorix is not used very much in Malaysia