Should you take antidepressants for anxiety and depression? Everyone feels a little anxious or sad from time to time. But if your emotions feel debilitating or prevent you from functioning in your day to day life, that might mean that you need to see a psychiatrist or psychiatric nurse practitioner. One treatment option is medication, specifically, antidepressants.
What Symptoms Do Antidepressants Treat?
Antidepressants are psychiatric medications. In addition to psychotherapy, they can be a key component in treating depression, anxiety, and other mental health conditions. These drugs are some of the most commonly prescribed medications around. Their aim is to relieve symptoms of anxiety and depression and prevent them from coming back. Some of the symptoms that antidepressants target include:
- Feeling down and depressed
- Persistent worrying or anxiety
- Suicidal thoughts
- Hopelessness or a sense of “everything being pointless”
- Sense of worthlessness
- Persistent fatigue or exhaustion
- Restlessness
- Sleep problems
- Significant change in appetite
- Difficulty concentrating
- Loss of interest in activities you used to enjoy
How Do Antidepressants Work?
Most antidepressants work by boosting certain neurotransmitters in the brain, such as dopamine, serotonin, and norepinephrine. Neurotransmitters are chemical messengers in the brain. They regulate mood, cognition, and other mental processes.
Here’s a brief overview of the neurotransmitters targeted by antidepressants:
- Serotonin: This brain chemical helps regulate mood, appetite, sleep, and pain perception.
- Norepinephrine: This neurotransmitter is involved in your body’s stress response. It also plays a role in alertness and mood regulation.
- Dopamine: You might have heard of dopamine as the “feel good neurochemical.” It is associated with motivation, reward, and pleasure.
We don’t currently know exactly why changing the levels of these chemicals eases symptoms of anxiety and depression. It’s also true that it can take a bit of trial and error to figure out which antidepressant will work for each person. This can be frustrating, especially because most people have to take an antidepressant for 3-4 weeks before seeing results.
Here is a brief explanation of the four most common classes of antidepressants for anxiety and depression and how they work.
SSRIs
Selective serotonin reuptake inhibitors (SSRIs) are the most commonly prescribed antidepressants for anxiety and depression. They target the neurotransmitter serotonin. As shared previously, neurotransmitters are little chemical messengers in your brain that help with certain mental processes like regulating mood and cognition. When your brain needs to perform one of these processes, it releases one of these neurotransmitters through synaptic vesicles of neurons. After that, the synaptic vesicles reabsorb the neurotransmitters in a process called “reuptake.”
SSRIs prevent the reuptake of serotonin in order to make it more available for regulating emotions, improving your cognitions, and assisting with other mental processes. They are called “selective” because they only target serotonin.
Some examples of SSRI antidepressants include Prozac (fluoxetine), Zoloft (sertraline), Lexapro (escitalopram), Celexa (citalopram), and Paxil (paroxetine).
SNRIs
Serotonin-norepinephrine reuptake inhibitors (SNRIs) are a class of antidepressants that treat depression, anxiety disorders, and other mental health conditions. Similarly to SSRIs, they work by preventing the synaptic vesicles in your brain from reabsorbing serotonin and norepinephrine. This leaves more of these chemicals available for regulating mood, sleep, and your body’s stress response. They can also help improve chronic pain.
Some examples of SNRI antidepressants include Pristiq (desvenlafaxine), Cymbalta (duloxetine), Fetzima (levomilnacipran), Savella (milnacipran), and Effexor (venlafaxine).
Atypical Antidepressants
These medications also treat depression and anxiety by affecting neurotransmitters, but they work a bit differently than other types of antidepressants. They don’t fit neatly into any of the other classes, which is why they are called atypical. Often, psychiatrists prescribe them as a first-line treatment, or they might try them after other antidepressants haven’t been effective. Atypical antidepressants work by changing the levels of certain neurotransmitters in the brain, such as serotonin, norepinephrine, or dopamine.
Some examples of atypical antidepressants include Wellbutrin (bupropion), Remeron (mirtazapine), Spravato (esketamine), and Trintellix (Vortioxetine).
Tricyclic Antidepressants
Tricyclic antidepressants (TCAs) are considered “first generation” antidepressants because they were first introduced in the 1950’s. Like the other classes, they work by preventing the reuptake of neurotransmitters like serotonin and norepinephrine. Unfortunately, they come with a number of unpleasant side effects like drowsiness, fatigue, nausea, blurred vision, constipation, difficulty urinating, low blood pressure, heart palpitations, sexual dysfunction, weight gain, and other issues. For this reason, they are only prescribed for people whose depression doesn’t respond to other medications.
Examples of TCAs include Amitriptyline, Amoxapine, Desipramine (Norpramin), Doxepin, Imipramine (Tofranil), Nortriptyline (Pamelor), Protriptyline, and Trimipramine.
How Effective Are Antidepressants for Anxiety and Depression?
There are many different medications for treating depression and anxiety. Unfortunately, it’s difficult to predict how well a particular antidepressant will work for a particular patient. Usually, prescribers will suggest starting with a drug that might work and has mild side effects. If it isn’t as effective as the patient would like it to be, the prescriber might switch to a different medication. Sometimes individuals try several antidepressants before they find one that works.
Studies show that the more severe the symptoms, the greater the benefits will be. Antidepressants are most effective in treating moderate and severe depression and anxiety. They might not help with milder problems.
What Are the Side Effects of Antidepressants for Anxiety and Depression?
All medications include the possibility of side effects. Since antidepressants affect the neurotransmitter serotonin, which also plays a role in sleep, pain, digestion, and mental clarity, these drugs can cause a variety of side effects. These might include:
- Nausea, stomach aches, vomiting
- Diarrhea or constipation
- Insomnia
- Fatigue or sleepiness
- Restlessness
- Anxiety or agitation
- Sexual side effects
- Tremors
- Dizziness
- Headaches
- Weight gain
- Dry mouth
- Blurred vision
- Elevated blood pressure
Most of these side effects typically resolve within one to two months of taking the drug. As mentioned above, TCAs can cause more severe side effects.
In addition, it’s important to be aware that antidepressants can cause severe withdrawal symptoms, especially if they are stopped abruptly. Always talk to your prescriber before stopping antidepressants so that you can safely wean off of them.
How Do I Find a Psychiatrist Near Me?
If you are experiencing severe depression or anxiety and you would like to speak to a prescriber about taking antidepressants, Gladstone Psychiatry and Wellness can help. We have many psychiatrists and psychiatric nurse practitioners who specialize in treating these problems. Our providers see adults, children, and adolescents, and we offer in person or virtual appointments. We have offices in Baltimore, Hunt Valley, Bethesda, Columbia, and Frederick, Maryland.
If you would like to schedule an appointment, please call 443-708-5856 or email new.patient@gladstonepsych.com.