According to a 2004 Rand Corporation report, depression results in more absenteeism than almost any other physical disorder and costs employers more than US$51 billion per year in absenteeism and lost productivity.
While it may be easy to recite the various brand names and generalize their benefits enough to know they put us (or are supposed to put us) in a better mood, for lack of a better term, the drugs themselves can all be categorized individually, each working in a slightly different way.
The following is a list and very brief description, by category, of depression and anxiety medications currently prescribed by physicians.
Selective Serotonin Reuptake Inhibitors (SSRIs)
SSRIs, which are fairly new to the arsenal of depression and anxiety medications, have gained immense popularity among prescribing psychiatrists within the past 10 years. They are usually prescribed during the early stages of depression, if a person has sought help and behavioral and/or psychotherapy has not proven effective enough. With appropriate dosage, SSRIs can "catch" depression before it becomes severe. Although they do not work for 20% to 40% of people who try them, their ability to work for people with minor (and even major) depressive illnesses makes them attractive enough to prescribing psychiatrists to try them first before moving on to more serious depression and anxiety medications and methods, if need be. SSRIs work on serotonin, one of the brain's three neurotransmitters.
MAOIs are the type of depression and anxiety medications that work for people who are mildly depressed, develop mild depression over a long period of time, are overly sensitive to their environment, or who are easily able to emerge from periods of depression. People who demonstrate an excess of a particular activity (ie, overeating, oversleeping, emotional overreaction) as compensation with stress can benefit from MAOIs, which work on the three neurotransmitters (called monoamines) found in the brain: norepinephrine, serotonin, and dopamine. These are usually only prescribed when a person hasn't responded to any of the other types of depression and anxiety medications.
A strict diet must be followed if taking an MAOI, because in conjunction with certain foods, the body can react with elevated blood pressure, headaches, fluctuating blood sugar (for people with diabetes), and in more severe cases, brain hemorrhage. Because of these risks, MAOIs were taken off the American market for a while, but were reintroduced for patients who haven't had luck with any other depression and anxiety medications.
MAOIs Brand name (chemical name)
Nardil (phenelzine), Parnate (tranylcypromine)
Tricyclic Antidepressants (TCAs)
Tricyclics have been available longer than any other depression and anxiety medications. In 1958, the first tricyclic, imipramine (Tofranil), was released to help combat major depression, and physicians saw a 70% positive response within their patients. Previously the only treatments for severely depressed patients were amphetamines and electroshock therapy. TCAs increase the brain's supply of serotonin and norepinephrine, two of the brain's three neurotransmitters, but it also affects some of the brain's other nerve impulses as well, and this allows for more side effects.
Severely depressed and/or hospitalized patients see the most benefit from taking TCAs because of its sedative effect. In the past, patients were usually prescribed tricyclics before anything else, but with the movement of psychiatrists (and patients!) toward heading off depression before it becomes severe and/or chronic, TCAs are now usually only prescribed if the other types of depression and anxiety medications don't work.
Non-specified or "Other" depression and anxiety medications
Because their chemical make-ups do not fit into any of the other categories, the following list of depression and anxiety medications can only be termed as "other." Wellbutrin, Desyrel, Remeron, and Effexor are prescribed most. Each of the four drugs affects at least one of the brain's three neurotransmitters (norepinephrine, serotonin, dopamine), and as a result, each has its own particular set of side effects. As a result, psychiatrists are much more likely to prescribe one of the other types of depression and anxiety medications (SSRIs, MAOIs, TCAs) before switching to one of these. In some instances, a patient's regimen is augmented by combining an SSRI or TCA with an"other" depression and anxiety medications, but because of an MAOI's particular chemical make-up and dietary requirements, it is prescribed alone.
Brand names (chemical names) of Non-specified depression and anxiety medications
In August of 2004, the FDA approved the investigational drug Cymbaltaâ„¢ (duloxetine HCl), which demonstrated rapid relief of anxiety symptoms associated with depression that was sustained for the length of the study period, according to new data published in the journal Depression and Anxiety. In clinical studies, researchers attribute the medication's effect on a broad spectrum of depression symptoms, which include emotional and painful physical symptoms as well as anxiety, to its dual reuptake inhibition of both serotonin and norepinephrine.
Learn more about treating depression at http://www.e-mentalhealth.com
Charles E. Donovan
Out of the Black Hole: The Patient's Guide to Vagus Nerve Stimulation and Depression