Antidepressants are one of the the most prescribed drugs in the United States. This is partly because the number of people diagnosed with depression and anxiety has been risingAnd prescriptions have increased significantly among certain age groups during the pandemic.
Despite the prevalence of these drugs, some patients have “significant misconceptions” about how the drugs work, said Dr. Andrew J. Gerber, a psychiatrist and president and medical director of Silver Hill Hospital in New Canaan, Connecticut. .
About 80 percent Antidepressants are prescribed by primary care physicians who have not received extensive training in the management of mental illness.
Dr. Paul Nestadt, associate professor of psychiatry at Johns Hopkins Medical School, said patients tell him, “You know, Doc, I’ve tried everything. But often, he says, “they never get to a good dose, or they’ve only been on it for a week or two.”
Here are some answers to frequently asked questions about antidepressants.
How do antidepressants work?
There is many types of antidepressantsand they all work a little differently.
In general, they initiate a change in the way brain cells — and different regions of the brain — communicate with each other, said Dr. Gerard Sanacora, professor of psychiatry at the Yale School of Medicine.
Clinical trials have shown that antidepressants are generally more efficient with moderate, severe and chronic depression than with mild depression. Even then, the effect is modest compared to placebo.
The largest study of multiple antidepressants – dubbed the STAR*D trial – found that half of the participants improved after using the first or second drug they tried, and almost 70 percent of people were symptom-free after the fourth antidepressant.
Unfortunately, there is no way to know in advance how a person will react to a given medication. So there may be a period of trial and error.
More research is needed to better understand how antidepressants work and how effective they are, especially when taken over several years.
How do you know which one to take?
The most commonly prescribed antidepressants are selective serotonin reuptake inhibitors, or SSRIs, such as Prozac or Zoloft, and serotonin-norepinephrine reuptake inhibitors, or SSRIs, such as Cymbalta and Effexor. These two types tend to have fewer side effects than tricyclic antidepressants such as clomipramine or monoamine oxidase inhibitors like phenelzine.
Generally speaking, SSRIs and SNRIs are equally effective.
But for some people, the differences between these drugs – even those in the same class – don’t seem subtle at all. If a medication isn’t right for you, there are other options. Experts advise working with your doctor to find the best solution.
How long do antidepressants take to work?
A common myth is that antidepressants are “silver bullets,” said Dr. Kao-Ping Chua, a pediatrician and health policy researcher at…
