Antidepressants - Overview
Overview
Depression is a condition that affects the way people feel, think, and act. "Ten to 20 percent of adults in the United States experience depression at some point in their lifetime," noted Adrienne Z. Ables and Otis L. Baughman III in an article for the journal American Family Physician.
Sometimes depressive episodes are sparked by an especially upsetting event in life such as the death of a loved one, the breakup of a relationship, a change in jobs, separation from friends or family, or a severe illness. Because depression seems to run in families, scientists are investigating possible biological causes for the condition. The authors of "Depression: Help Is at Hand," a publication of the Royal College of Psychiatrists (RCP), stated that people who have a parent who has become severely depressed "are about eight times more likely to become depressed" themselves. This may be due to an abnormality in the brain involving chemical messengers called neurotransmittersA substance that helps spread nerve impulses from one nerve cell to another..
Depressed people often have a hard time tracing their sadness to a particular cause. Certain medicines and even some physical illnesses such as the flu can bring on depression, so it is extremely important for people to educate themselves about its signs, symptoms, and treatments.
Symptoms of depression include:
- A long-lasting sad mood
- A change in sleep patterns—either sleeping all the time or having difficulty getting enough sleep
- A change in eating habits—some people eat more when they get depressed, others stop eating altogether and begin losing significant amounts of weight
- A loss of interest in activities or hobbies that used to bring pleasure
- Self-destructive thoughts or actions
- Difficulty making decisions
- A loss of confidence
- Increased irritability
- Problems with school or work
- Problems with friends or family members
- A feeling of hopelessness, as if things will never be any better.
Depression occurs in people of all ages, from small children to the elderly. "In contrast to the normal emotional experiences of sadness, loss, or passing mood states, depression is extreme and persistent and can interfere significantly with an individual's ability to function," stated the authors of the "Depression Research" page of the National Institute of Mental Health (NIMH) Web site.
A study sponsored by the World Health Organization and the World Bank is cited in "Depression Research." The study noted that major depression was found "to be the leading cause of disability in the United States and worldwide." Regardless of what triggers their depression, those who suffer from it require medical assistance. This assistance might include psychotherapyThe treatment of emotional problems by a trained therapist using a variety of techniques to improve a patient's outlook on life., medication, or a combination of both. Many depressed people from all age groups have responded well to treatment.
Anxiety, which is often associated with depression, can also be helped by medication. Severe anxiety can result in Panic AttacksUnexpected episodes of severe anxiety that can cause physical symptoms such as shortness of breath, dizziness, sweating, and shaking.. These attacks can make a person feel like he or she is dying. They cause rapid heartbeat, tightness in the chest, shaking, shortness of breath, and dizziness. Antidepressants can help a person focus on dealing with his or her fears before an attack occurs, and the drugs can alleviate the physical symptoms of an attack.
An Accidental Find
Chemists seem to have stumbled upon drugs with antidepressive effects while working on treatments for other medical problems. The very first antidepressants, iproniazid (sold under the brand name Marsilid) and imipramine (sold under the brand name Tofranil), were developed in the 1950s. Since then, great strides have been made in understanding how the human brain works. These strides contributed to the creation of the four main types of antidepressant drugs known as of 2005: 1) tricyclics, 2) monoamine oxidase inhibitors (MAOIs), 3) selective serotonin reuptake inhibitors (SSRIs), and 4) "others," including serotonin and norepinephrine reuptake inhibitors (SNRIs). All of these drugs get their names from the way they act on chemicals called neurotransmitters located in the human brain.
Tricyclics and MAOIs were available years before the SSRIs came on the scene. Richard DeGrandpre, writing in Nation, stated that "SSRIs have not been clinically proven to be more effective" than the older tricyclics. The SSRIs gained a reputation for safety because they are generally less toxic, or harmful to the body, when taken in overdoses. In normal doses, however, both the new and the old classes of antidepressants have been shown to relieve the symptoms of depression in some patients. Because each patient will respond differently to the various antidepressants, physicians may try several different kinds—or even combine one with another—in the search for the most effective treatment for a particular patient.
The Ultimate Problem Solver?
The most popular antidepressants are the SSRIs. Prozac was the first SSRI approved for use in the treatment of depression. It became available in 1987, received extensive coverage in the media, and within a few years became a household name. Some people were under the impression that Prozac was the ultimate problem solver—a sort of "happy pill" that gave everyone who took it a more positive outlook on life. It had no reported side effects and was even thought to help in weight loss. What most people failed to realize, however, is that antidepressants have no psychological effects on people who don't suffer from depression. They only help depressed patients reach a normal level of functioning.
Still, the market for antidepressants grew wildly in the 1990s and early 2000s. According to The Pill Book, seven of the top fifty prescriptions written by U.S. doctors in 2003 were for antidepressants. Associated Press reporter Bruce Smith, as recorded on the ABC News Web site, noted that 32.7 million prescriptions for Zoloft, another SSRI, were written that year. This made Zoloft the most widely prescribed antidepressant in the United States.
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