Combination Treatment Is Best
Consider Psychotherapy
Results of several studies suggest that a combination of antidepressant medication with psychotherapy is the most effective treatment for depression. Mental illness is serious. It is important to take depression medication as directed and to see a therapist regularly. Mental illness is nothing to be ashamed of. Millions of people suffer from depression, anxiety, and other mental health disorders. People should feel comfortable seeking help for mental health disorders just as they would for other organic medical conditions like heart disease or diabetes. Cognitive behavioral therapy helps monitor and change unwanted thoughts and behaviors. Interpersonal therapy helps patients have better and more effective relationships with others.
What Are Ssri Antidepressants Used For
SSRI antidepressants help to relieve symptoms of depression such as low mood, irritability, feelings of worthlessness, restlessness, anxiety, and difficulty in sleeping.
They are one of the most commonly prescribed antidepressants because they are effective at improving mood with fewer or less severe side effects compared to some other antidepressants.
In addition to depression, SSRIs may also be used to treat a range of other conditions, for example:
Using Selective Serotonin Reuptake Inhibitors
Almost all SSRIs come in tablet or capsule form. Most antidepressants of this class need to be taken either once or twice per day. If youre prescribed an SSRI, follow the dosage instructions provided by your healthcare provider.
It can take several weeks for most SSRIs to start working. If you dont notice any improvements after starting an SSRI, keep in contact with your healthcare provider. Over time, you may need to adjust your dosage or use a different type of medication.
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Better Represents Antidepressant Use Today
Most previous trials of antidepressants have taken place in specialized mental health settings and have not included people with undiagnosed or mild symptoms of depression.
Many of these previous trials were completed decades ago when antidepressants use was more limited, and the purpose of the trials was to gain regulatory approval.
The team suggests that the participants of the new study better represent the people who are receiving antidepressant prescriptions today.
Our findings, write the authors, support the prescription of SSRI antidepressants in a wider group of participants than previously thought, including those with mild to moderate symptoms who do not meet diagnostic criteria for depression or generalized anxiety disorder.
Keep Up With Checkups
Regular follow up visits with your health care professional are essential. Depression and anxiety are serious illnesses and can be associated with suicidal thoughts and other symptoms. It is imperative to go for follow up appointments as instructed. Treatment with selective serotonin reuptake inhibitors , tricyclic antidepressants , monoanmine oxidase inhibitors , and other antidepressants requires monitoring and fine tuning. The goal is to alleviate depression and anxiety without side effects and symptoms returning. You may also need adjustments to treatment if you undergo a major life change such as being diagnosed with a serious illness or losing a job. Women who are pregnant may also need to adjust the type or dose of medication they are taking. Some medications can have negative effects on a developing fetus.
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Doses And Duration Of Treatment
SSRIs are usually taken in tablet form. When they’re prescribed, you’ll start on the lowest possible dose thought necessary to improve your symptoms.
SSRIs usually need to be taken for 2 to 4 weeks before the benefit is felt. You may experience mild side effects early on, but it’s important that you don’t stop taking the medicine. These effects will usually wear off quickly.
If you take an SSRI for 4 to 6 weeks without feeling any benefit, speak to your GP or mental health specialist. They may recommend increasing your dose or trying an alternative antidepressant.
A course of treatment usually continues for at least 6 months after you feel better, although longer courses are sometimes recommended and some people with recurrent problems may be advised to take them indefinitely.
How Soon Will They Start Working
Everybodys experience of medication is different. Most antidepressants take one to two weeks to start working. But you might feel some benefits sooner than this, such as improved sleep.
Speak to your doctor if you dont feel any benefit after taking an antidepressant regularly for two to four weeks, or if you feel worse. Its possible that a different antidepressant might suit you better.
“I was a total mess before I started my antidepressants. After a struggle through the first two weeks, I began to see the light at the end of what had been a very long tunnel.”
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Antidepressants’ Benefits May Not Outweigh Risks
Overall, the benefit provided by paroxetine in the treatment of anxiety is small. As a result, the benefit may not be substantial enough to warrant a recommendation for them to be used as a first-line treatment in clinical practice, given the side effects associated with SSRIs.
One common side effect of SSRIs is treatment-induced sexual dysfunction. Sexual dysfunction is seen as a side effect in approximately 70 percent of patients taking paroxetine, and most other SSRIs produce similar rates.2 Other side effects include drowsiness, insomnia, and long-term weight gain. Rare but more severe risks include increased suicidal thoughts in children and young adults and serotonin syndrome, a life-threatening adverse reaction to the medication. Furthermore, patients are much more likely to disclose negative side effects on a questionnaire rather than tell their doctor about it, which is the traditional method of obtaining side effect data in clinical trials.3 Thus, published findings may underestimate the true level of adverse effects. In addition to side effects while taking antidepressants, there are also withdrawal effects following discontinuation of the medicationthat may trigger a relapse of symptoms.4 These withdrawal effects may help to explain why most people stay on antidepressants for two years or longer.5
Strategy No : Use Benzodiazepines If Needed But Use Them Wisely
Benzodiazepines are effective in treating panic disorder5 they are also used to treat generalized anxiety disorder and social phobia, two common comorbidities of panic disorder. In contrast to antidepressants, benzodiazepines relieve anxiety within hours,7 can prevent panic attacks within a few days to a few weeks,5 and are free of troublesome activating effects.7 Nevertheless, benzodiazepine use in treating panic disorder can be complicated by abuse, physiologic and psychologic dependence, and sedative and neurocognitive side effects.7,8
The following strategies address the problems associated with benzodiazepine use:
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Starting To Take An Antidepressant For The First Time
Selective serotonin reuptake inhibitors And did you get side effects when you first started taking them?And did you have any side effects at all from it?So youve now realised thats its a much more gradual process than what you first thought?Initial side effects of antidepressantsAdjusting to antidepressantsYou could escape from the thoughts?Would you see that as a weakness or as being able to be kind to yourself?
If Depression Isnt A Chemical Imbalance What Is It
Modern thinking suggests that depression is a problem of circuitry, not chemistry. In this view, symptoms of depression result from failure of synapse formation and changes in the activity level of various emotional signaling centers, set in motion by overactivity of the stress response system, often in response to early adverse experience. Mental health conditions such as depression and anxiety can be seen as aversive yet adaptive responses to adversity.
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Other Psychological Treatment Approaches
Other types of psychological treatment focus more on trying to find the possible causes of the anxiety, such as traumatic childhood events. There hasn’t been much good research on the effectiveness of these approaches in people with generalized anxiety disorder. The few studies that have compared them with cognitive behavioral therapy suggest that these psychodynamic therapies aren’t as helpful as cognitive behavioral therapy.
What Is The Clinical Efficacy Of Ssris
According to a six-year meta-analysis, SSRIs were more efficacious than placebos in adults with depression when judged by two criteria: efficacy and acceptability . The efficacy of a given SSRI across thousands of studies varies significantly, ranging anywhere from about one-third as effective to twice as effective as a placebo, but the effect sizes were generally modest. Studies consistently show that antidepressants work best in conjunction with therapies like cognitive-behavioral therapy .
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Data Capture And Interpretation
Although information about the side effect profile of a given drug is available in both the drug manufacturers package insert and the Physicians Desk Reference , this method of obtaining drug information has limitations. Data included in product labeling are derived from the company-sponsored studies that have been reviewed by the U.S. Food and Drug Administration. Uncommon, rare, and unpredictable drug-related adverse effects may not have emerged in clinical trials and may not be included in the PDR until the drug has been available for several years.
One measure of tolerability of any drug is continued patient use. Consequently, discontinuation rates during clinical trials have been used to measure the tolerability of a given drug. Fluvoxamine is associated with the highest discontinuation rates because of adverse events in clinical trials , followed by fluoxetine and sertraline . Discontinuation rates for any drug after release can be continually redefined using product labeling, published clinical trials, postmarketing surveillance, current literature, case reports, and clinical experience.
What Type Of Medication Is Used To Treat Depression And Anxiety
SSRIs , are medications that may be used to treat depression and anxiety disorders. Some examples of SSRIs are: fluoxetine , citalopram , sertraline and escitalopram .
SSRIs work in the brain to help certain natural chemicals , which are used to communicate between brain cells, manage a persons mood.
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Special Benzodiazepine Risk Factors
Anyone who takes benzodiazepines can experience unpleasant or dangerous side effects. But certain individuals are at a higher risk:
People over 65. Older adults are more sensitive to the sedating effects of benzodiazepines. Even small doses can cause confusion, amnesia, loss of balance, and cognitive impairment that looks like dementia. Benzodiazepine use in the elderly is associated with an increased risk of falls, broken hips and legs, and car accidents. Long-term benzodiazepine use also increases the risk of Alzheimers disease and dementia.
People with a history of substance abuse. Because theyre physically addicting and on their own and dangerous when combined with alcohol and other drugs, anyone with a current or former substance abuse problem should use benzodiazepines only with extreme caution.
Pregnant and breastfeeding women. Benzodiazepine use during pregnancy can lead to dependence in the developing baby, with withdrawal following birth. Benzodiazepines are also excreted in breast milk. Therefore, pregnant women need to have a thorough discussion about the risks and benefits of these medications with their prescribing doctor. If medication is necessary, the goal is the smallest effective dose.
The connection between benzodiazepines and accidents
How Effective Are Ssris
Depression is an extraordinarily complex condition involving multiple brain and body functions and basic appetite for life itself. Due to changes in the activity level of various emotional signaling centers, the brain becomes extremely biased toward negative thoughts and feelings and easily overwhelmed by them. The ability to enjoy life vanishes. Motivation flees with it. Physical movement becomes difficult. Sleep is disturbed. It is a notoriously difficult illness to treat. Talk therapy not only provides symptomatic relief but improves brain function as well. Yet it is not always enoughor fast enough.
From the beginning, there have been questions about the effectiveness of SSRIs. A large meta-analysis recently published in The Lancet found that, overall, all SSRIs and SNRIs were more effective than placebo in treating adults with major depression. However, many well-known SSRIs are ineffective for as many as 30 percent of people who try them.
The successful treatment of depression is important. The longer that depression episodes last and the more episodes that occur, the more that depression changes the brain and becomes a chronic condition and a source of psychic pain. Patients who are prescribed an SSRI that doesnt manage their symptoms well often feel discouraged or unwilling to try another option, further complicating their treatment prospects.
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What Can You Do Yourself
Many people with generalized anxiety disorder don’t even think of going to see a doctor. They try to manage their fears on their own, for example using books or information from the internet. Some learn relaxation techniques, such as progressive muscle relaxation, autogenic training or yoga. The effectiveness of these kinds of strategies for managing anxiety disorders on your own is not well studied in scientific studies. Relaxation techniques are often used in psychological treatments, but it isn’t known how effective they are when used alone.
Some people try herbal sedatives like valerian, lavender or passion flower. There hasn’t been much research on these products either. Many people assume that herbal remedies are better tolerated and safer than other kinds of medicine. But they can also have side effects and may influence the effects of other medication.
People who treat an anxiety disorder on their own may only seek professional help after a very long time. If an anxiety disorder is really affecting your everyday life, certain kinds of psychological treatment and medication can help.
Are Ssris Dangerous
In general, SSRIs are safer and less likely to cause side effects than other, older antidepressant medications. However, like all medications, SSRIs still have certain risks.
All antidepressants, including SSRIs, feature an FDA black box warning that notifies users of an increased risk of suicidal thoughts and/or behavior. This elevated risk affects people under the age of twenty-four. It does not appear to affect adults above 24 years of age.
SSRIs may be dangerous if used with other medications, particularly medications that increase serotonin levels. If youre prescribed an SSRI, make sure to check with your healthcare provider for drug interactions before using your medication.
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What You Can Do
If you do feel like an antidepressant is increasing your anxiety, speak with your doctor about it. There are a number of different approaches they can take to counteract this side effect. For instance, they may lower your dose, switch you to a different medication, or prescribe another medication to counteract it.
It is not advised to stop taking your antidepressant without first consulting your doctor. Stopping your medication too quickly can create its own set problems, known as discontinuation syndrome. You also run the risk that your depression may return or become worse.