(thing) by duffski Wed Nov 07 2001 at 7:38:54
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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