Types of medication

Anti-depressants fall into the following main categories:

• Selective serotonin-reuptake inhibitors (SSRI's)
• Noradrenergic reuptake inhibitor (NRI's)
• Dual-Action antidepressants or Serotonin-noradrenergic reuptake inhibitors (SNRI's)
• Tricyclic antidepressants (TCA's)
• Monoamine oxidase inhibitors (MAOI's)
• Tetracyclic antidepressants
  

SSRI
This is the most commonly prescribed type of antidepressant (Selective Serotonin Reuptake Inhibitors ).
SSRI’s boost the effect of the neurotransmitter ‘serotonin’ in the brain. There are many different brands of SSRI’s within this class, their effect on different people seems to be individual. Your doctor will choose a medication best suited to your needs.
Sometimes it is necessary to try a couple of different preparations before finding the one that works best for you.

Dual action preparations
Dual action preparations boost the effect of the neurotransmitters serotonin and noradrenaline in the brain.

The side-effects of SSRI and dual action preparations
This is a list of some of the side-effects that may occur during treatment with SSRIs and dual action preparations. The side-effects can vary depending on which medication is used, the dose etc. Please ask your doctor for specific information about the side-effects of the particular medication you are on.

• restlessness
• difficulty in sleeping
• dryness of the mouth
• nausea and vomiting
• headache
• constipation
• increased sweating
• sexual problems (reduced libido, delayed/absent ejaculation)
• weight changes
• yawning

TCA

This is the ‘older’ type of antidepressant,
TCAs (tricyclic antidepressants) boost the neurotransmitter serotonin and noradrenaline in the brain and also block different receptors in the central nervous system.

Side-effects of TCA’s
The side-effects that can occur in the treatment with TCA’s include:

• dryness of the mouth
• constipation
• increased sweating
• visual disturbances
• urinary retention (difficulty passing urine)
• dizziness (especially when getting up from a sitting or lying position)
• weight increase
• mild shaking of the hands

MAO inhibitors

Monoamine oxidase inhibitors (MAOIs) are the oldest type of antidepressant. MAOIs relieve depression by preventing the enzyme monoamine oxidase from breaking down the neurotransmitters norepinephrine, serotonin and dopamine in the brain.

These drugs are used much less frequently now, because they can have dangerous side-effects. However they are still effective and are used in some cases.

With some MAOI’s, it is very important to avoid certain foods that contain high levels of tyramine, such as many cheeses, wines, and pickles, as well as medications such as decongestants. The interaction of tyramine with MAOIs can bring on a hypertensive crisis, (a sharp increase in blood pressure) that can lead to a stroke.

If you are prescribed a MAOI, your doctor will provide you with a list of prohibited foods.
Note that some forms of MAOI do not require food restrictions.

Serotonin Syndrome

Serotonin Syndrome is a rare but sometimes fatal syndrome which occurs when levels of serotonin in the brain are excessively high.  This can be a result of an interaction between different medications. Always inform your doctor if you are taking any over the counter medications or prescription medications while you are on an antidepressant.

Signs and Symptoms of Serotonin Syndrome;

• Confusion
• Restlessness
• Hallucinations
• Extreme Agitation
• Fluctuations in Blood Pressure
• Increase in Heart Rate
• Nausea and Vomiting
• Fever
• Seizures
• Coma