By Barret Procyshyn, Pharmacist at the Dauphin Clinic Pharmacy
Anti-depressants are a very common class of medications seen in the pharmacy. People of all ages can be diagnosed with depression and everyone from young teenagers to the elderly are prescribed antidepressants. Depression has been an illness treated for many years. However; we now better diagnose the disease in more recent times. While there is not much evidence newer anti-depressants are more effective than the “old ones”, new medications do have less side effects and are much better tolerated.
Antidepressants are good medications and they do work well for most people; helping them feel like their “old self” again. However; it is very important to be realistic about the medication’s effectiveness and about how you are likely to feel during the first few weeks of using the medication. If you can better understand both the positive and negative effects of the medication, you will be more likely to have success with the treatment. While on an antidepressant, take note of any side effects and whether or not they improve. It is a good idea to keep some type of journal for your health care providers.
As mentioned, newer antidepressants now have fewer side effects than older generation treatment options. However, side effects can and still do occur. The good news is side effects usually arise around the start of treatment and diminish in a few days or weeks. Although the side effects may be bothersome most are not dangerous. The most common side effects are nausea, vomiting, diarrhea, trouble sleeping, headaches or jittery feelings.
To reduce side effects, antidepressants are often started at low doses and are slowly increased over time. Your pharmacist can also recommend other strategies to reduce side effects. For example you may want to take smaller, but more frequent doses to reduce nausea or vomiting. If you are finding the antidepressant is making it hard to fall asleep, taking it in the morning may be an effective solution.
Occasionally long term effects from antidepressants do occur. Certain antidepressants may cause these long term effects, while others do not, so do not be surprised if your doctor tries switching to a different antidepressant at some point. Weight gain sometimes does occur when antidepressants are used. This may be due to increased appetite or regaining weight lost due to the depression. Exercise and a well-balanced diet are very effective. Exercise may also help with the treatment of depression so it is something to strongly consider.
As mentioned, insomnia is usually a short term problem but it can be prolonged. Consistent sleeping times, eliminating caffeine consumption later in the day and avoiding alcohol are all good sleep practices. Short term sleep aid medication can be used as a last resort.
A more serious long term effect of antidepressants can be emotional numbness. This is when you feel emotionally detached from events and people you would normally care about. This lack of feeling may result in switching to a slightly different antidepressant or lowering the current dose. No matter the circumstance never stop an anti-depressant without consulting a health professional first. These medications need to be stopped slowly with a decreasing dose.
While antidepressants are effective, they are a very slow acting medication. While Tylenol may help a headache in a matter of minutes or an antibiotic clears an infection in a few days antidepressants can take weeks to start working. Some patients may think their new medication is not working, however; it just has not been given enough time. This misunderstanding can sometimes cause treatment failure. While some patients may feel the benefits in the first week, most benefits begin to appear in two to four weeks. Usually your doctor will make adjustments to doses within four weeks if no response is seen. If a dose increase or multiple increases are not effective, the medication can be switched or another medication is sometimes added. Patience is the key to success. It can take up to eight weeks for some patients to feel the full benefit.
Treating depression successfully will result in improved energy, better sleep and hopefully better overall functioning. You will hopefully see improvements in your social life and in work performance. Life can start looking up again and you will start enjoying things you might have lost interest in.
The information in this article is intended as a helpful guide only. It is not intended to be used as a substitute for professional advice. If you have any questions about your medications and what is right for you see your doctor, pharmacist or other health care professional.
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As always if you have any questions or concerns about these or other products, ask your pharmacist.