Bicyclic Antidepressants

I used to believe that the talking cure was dead, too. I used to be a big evangelist for antidepressants. I still believe that they can save your life. But they can't keep you from becoming depressed again, after you've stopped taking them. What they can do is provide a space where you can deal with the things that your depression centres around. Because, like as not, if you've a tendency to depression at one time, you'll still have it later on. You have to learn to cope with that, and all the SSRIs in the world can't do that for you.

I've been taking Prozac for nearly three months now and although I still get some pretty bad anxiety attacks from time to time (rarely), I feel that this substance has saved me.

I've been severely depressed for my whole life, and after I stopped getting the side effects (they lasted about a week), I felt like life was a big sigh of relief. For the first time ever, I was able to function through negativity. Formerly, any time something bad happened to me, I would think it was "the end of the world," and just give up trying. Now I'm able to acknowledge the problem, figure out a bunch of alternatives, and move on. It's a wonderful feeling.

I don't feel as though the Prozac controls me, I feel like it gives me the ability to control myself. It just helps me to follow my instincts without second guessing myself. Anti-depressants may not be the solution for everyone, but I recommend looking into them.

Antidepressants are drugs used to treat depression, the most common psychiatric illness. According to the DSMV-IV (Diagnostic and Statistical Manual of Mental Disorders, fourth edition) at least five of the following symptoms must be present for two weeks or more, and represent a change from previous function. At least one of the symptoms must be depressed mood or loss of interest or pleasure.
  1. depressed mood most of the day, nearly every day, in adolescents and children this can be irritable mood
  2. loss of interest or pleasure in nearly all activities
  3. significant weight loss or gain without dieting
  4. insomnia or hypersomnia
  5. psychomotor agitation or retardation
  6. fatigue or loss of energy
  7. feelings of worthlessness or excessive guilt
  8. diminished ability to think or concentrate, or indecisiveness, or maybe not. I can't make up my mind.
  9. recurrent thoughts of death, recurrent suicidal ideation, a suicide attempt, or a suicide plan
Major depression should not be diagnosed during bereavement, unless the symptoms last longer than two months. The symptoms should also not be induced by drugs, alcohol, or a general medical condition such as hypothyroidism, which can cause symptoms similar to depression.

The cause of depression is not yet known although some individuals seem predisposed to it. As far as treatment with drugs, there are three major classes used : selective serotonin reuptake inhibitors (SSRIs), monoamine oxidase inhibitors (MAOIs), and tricyclic antidepressants (TCAs).

TCAs are usually the first drug used to treat major depression, and have also been effective in treating bipolar disorder, insomnia, ADHD, and panic disorder. Side effects can include, but are not limited to, orthostatic hypotension (low blood pressure upon standing), sedation , sweating, and yawngasm. Yawngasm, a spontaneous orgasm while yawning, is rare side effect of the antidepressant clomipramine. It can be considered a negative or positive effect (depending on time, location, and/or present company).

SSRIs cause a selective block of serotonin reuptake. These drugs produce almost the same effects as TCAs with less crucial side effects -- usually nausea, insomnia, and anorgasmia (oh, horrors!). This is the antidepressant the general public is most familiar with, as it includes the drug Prozac.

MAOIs are reserved for patients who have not responded well to TCAs and SSRIs. This is because MAOIs have more dangerous side effects; such as, hypertensive crisis (if the patient has a diet rich in tyramine), hypotension (in the absence of a tyramine rich diet), anxiety, and increased agitation. Some tyramine rich foods are figs, avocados, smoked or aged meats, almost all cheeses, and most imported beers (to some people, it is food).

Antidepressants, especially when coupled with psychotherapy, can greatly improve the quality of life for those suffering from depression. It is important for anyone taking antidepressants to note that it takes at least two to three weeks for the drugs to take effect, and that SSRIs should never be taken with MAOIs. Depression is not only the most prevalent psychiatric disorder, it is also the most treatable. Aggressive therapy can make a huge difference in the lives of those suffering. If you meet the criteria for major depressive disorder, please make an appointment to see your doctor as soon as possible.

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