DepressiveDisordersTwo

Depressive Disorders

What Treatments Are Avaliable For Depression?

In most cases, if depression is severe enough to prevent proper functioning it can be treated with anti-depressant medication. These will work by raising the levels of certain neurotransmitters in the brain and thus relieving some of the symptoms of depression. They can also help by giving a person more control over their emotions and thoughts, which can help significantly when overcoming depression. These medications however, are not cures for depression. They can simply take 'the edge' off one's mood and make depressed moments shorter and less frequent. Anti-depressant's do not work for everyone, and sometimes it can take several attempts trying different kinds to find one that suits you best. There are different types of anti-depressants, which work in different ways. Here is a list of them. The ones that I have underlined are ones that I have taken.

Selective Serotonin Reuptake Inhibitors - (SSRIs)

These are medications that increase the amount of the neurochemical serotonin in the brain. The levels of this chemical are low during depression. SSRIs are usually well tolerated and the side effects are mild, this means that they are often first line treatment for depression. Examples of SSRIs include:

Fluoxetine (prozac)
Paroxetine (paxil)
Sertraline (zoloft)
Citalopram (celexa)
Fluvoxamine (luvox)

Dual Action Anti-depressants

Some antidepressants which are similar to SSRIs also increase the amount the norepinephrine in the brain. They seem to be very good in treating more severe and chronic cases of depression and the side effects are usually very mild, even less so than the SSRIs. Examples of SNRIs include:

Venlafaxine (effexor)
Mirtazapine (remeron)

Mirtazapine also increases histamine levels, causing drowsiness. It is taken at night time and is often given to people who have trouble falling asleep.

Atypical Anti-depressants

Atypical anti-depressants work in a variety of ways. They are not SSRIs and TCAs but they act in a similar way to them. Examples of these include:

Nefazodone (serzone)
Trazodone (desyrel)
Venlafaxine (effexor)
Bupropion (wellbutrin)

Monoamine Oxidase Inhibitors - (MAOIs)

These are the oldest type of anti-depressants. They are generally only prescribed after other treatment options have failed because of their potentially serious drug and food interactions. If a person taking MAOIs eats cheese, wine, chocolate and nuts or takes over the counter cough and cold medicines their blood pressure can become dangerously high. Examples of MAOIs include:

Phenelzine (nardil)
Tranylcypromine (parnate)

Trycyclic Anti-depressants (TCAs)

TCAs work mainly by increasing the levels of norepinephrine in the brain. They are safe and generally well tolerated if properly prescribed and administered. However if taken in overdose they can cause life threatening heart-rhythm disturbances, so are perhaps not safe for suicidal people or those administering their own medication. Examples of TCA's include:

Amitriptyline (elavil)
Protriptyline (vivactil)
Desipramine (norpramin)
Nortriptyline (aventyl, pamelor)
Trimipramine (surmontil)
Perphenazine (triavil)

Mood Stabilizers And Anti-convulsants

These are medications which are used to treat bipolar depression. Examples include:

Lithium (eskalith, lithobid)
Valproate (depakene, depakote)
Carbamazapine (epitol, tegretol)
Neurontin (gabapentin)
Lamictal (lamotrigine

Anti-psychotics

Anti-psychotics are sometimes used to treat bipolar depression, usually in combination with other anti-depressants and/or mood stabilizers. They are also sometimes used in depression which is so severe that it becomes psychotic. Examples of anti-psychotics include:

Ziprasidone (geodon)
Risperidone (risperdal)
Quetiapine (seroquel)

Electroconvulsive Therapy (ECT)

ECT is useful for patients who cannot take or who are not responding to anti-depressants, who are severely depressed, or at a high risk of suicide. It can also be used for people who are on anti-depressants but they are not getting sufficient relief from their symptoms. It is not used very often and is quite a controversial subject.

During ECT the patient is anaesthetized and an electrical current is passed through the brain to cause a controlled seizure which typically lasts for 20 to 90 seconds. The patient is awake in 5 to 10 minutes. ECT is highly effective and relieves depression within 1 to 2 weeks after beginning treatment. Most patients undergo 6 to 10 treatments. Some receive maintenance ECT while other return to anti-depressant medication. The most common side effect of ECT is short term memory loss, which generally resolves quickly.

Therapy

It is a mistake to rely solely on medication when treating depression, as it almost never works. Most patients will benefit hugely from the combination of therapy and medication, while some people will only need therapy to resolve their depression.

There are several different types of therapy, and because everyone is different, they will work differently on each person. Cognitive therapy helps a person to examine his or her thought processes, allowing him or her to uncover erroneous ideas, assumptions, and so forth. Behavioural therapies can help a person to understand his of her actions, so that he or she can correct behaviours which result from, or contribute to, depression.

Councelling

If depression results from painful past experiences resolving them though councelling, will help significantly.