Depression is a serious illness that will likely require continued treatment, however the symptoms can be managed, and may even subside over time with treatment. Each person responds to treatment differently depending on their clinical diagnosis and symptoms. Treatment plans will typically include a combination of medication and therapy or counseling.
Which medications are prescribed to treat depression?
A form of drug therapy will typically be recommended for people with depression. Antidepressants are most commonly prescribed to treat symptoms. It’s important to keep in mind, for some people certain medications may work better than others. Some people may need to try several medications or doses before finding the right medication or combination of medications. It’s important to discuss any previous antidepressant prescriptions or known side effects with your doctor.
After prescribing a medication, our psychiatrists will educate patients on the medication, dosage, expectations, and possible side effects. The patient will then have several follow-up meetings with the psychiatrist to manage the medication’s performance and side effects, as well as adjust doses as necessary. Be sure to consult with your physician about the possible side effects or other concerns you may have about a prescribed medication.
There are several categories of antidepressants and each works differently. The following are some of the most commonly prescribed:
- Selective Serotonin Reuptake Inhibitors (SSRIs): These drugs are considered safer and generally cause fewer side effects than other types of antidepressants. SSRIs include citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac), paroxetine (Paxil, Pexeva), sertraline (Zoloft), and vilazodone (Viibryd)
- Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs): These are among the newer types of antidepressants. Examples include duloxetine (Cymbalta), venlafaxine (Effexor XR), desvenlafaxine (Pristiq, Khedezla), and levomilnacipran (Fetzima)
- Norepinephrine and Dopamine Reuptake Inhibitors (NDRIs): Another type of reuptake inhibitors, which includes one drug: bupropion (Wellbutrin)
- Tricyclic Antidepressants: These drugs can be very effective, but generally aren’t prescribed because they tend to cause more severe side effects, especially in elderly patients. Providers may suggest a tricyclic antidepressant if an SSRI didn’t improve symptoms. Examples include imipramine (Tofranil), nortriptyline (Pamelor), amitriptyline, doxepin, trimipramine (Surmontil), desipramine (Norpramin), and protriptyline (Vivactil)
- Monoamine Oxidase Inhibitors (MAOIs): MAOIs are typically prescribed when other drugs haven’t worked because they have serious side effects and require a strict diet. Examples include tranylcypromine (Parnate), phenelzine (Nardil), and isocarboxazid (Marplan)
Depending on your symptoms, your physician may recommend combining two antidepressants or adding another medication. Adding medications such as mood stabilizers, antipsychotics, and anti-anxiety and stimulant medications may enhance the effect of antidepressants.
Finding the right medication
It’s imperative to work with your doctor or psychiatrist to manage your drug therapy. Each patient responds differently to medication and many antidepressants can take several weeks to reach their full effect. It also takes time for your body to adjust to the medication and for side effects to ease. Sometimes patients need to try a few medications or combinations of medications before finding the one that works best.
What are the risks of abruptly stopping medication?
If your doctor has prescribed an antidepressant, it’s crucial you don’t stop taking the medication without first talking to your physician. Abruptly stopping your medication could suddenly worsen your depression symptoms or other side effects. In addition, stopping suddenly or missing several doses could cause withdrawal-like symptoms.
If you feel like your medication is doing more harm than good or if you’re experiencing negative side effects, talk to your doctor. He or she can work with you to safely change your medication or dosage.
Are antidepressants safe during pregnancy?
If you’re pregnant or breastfeeding, tell your doctor before starting an antidepressant. Some may pose a risk to your child. If you’re taking an antidepressant and become pregnant or plan to become pregnant, talk with your doctor.
What are the side effects?
Most antidepressants are safe, however the Food and Drug Administration (FDA) requires all to carry a black box warning, the strictest warning for prescriptions. In some cases, patients, especially children, teenagers, and adults under 25, may have an increase in suicidal thoughts immediately after starting an antidepressant or changing the dose. Typically, suicidal thoughts will subside as the body adjusts to the medication. Keep in mind that antidepressants are more likely to reduce suicide risk long term.
If you or someone you know is experiencing suicidal thoughts while taking an antidepressant, please seek help. You can contact your doctor or emergency help, or call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255).
How is therapy used to treat depression?
Our team of licensed therapists and counselors use various modalities of therapy that allow individuals to share their thoughts, feelings, and behaviors in a safe, confidential, and comforting setting. The MedStar Health team of Behavioral Health specialists will typically begin individual therapy sessions to allow patients to talk about their conditions, symptoms, and related issues. Your therapist may also recommend group or family therapy. In some cases, patients with mild forms of depression may not require medication and can be treated with therapy alone.
Many patients with major depressive disorder and other forms of depression can be treated in an outpatient setting. For some people, the illness is so severe that inpatient or partial hospitalization services may be recommended.
If you’re unable to care for yourself, or if you’re in immediate danger of harming yourself or others, an inpatient treatment facility may be recommended. Inpatient services at MedStar Harbor include recreational therapy, group therapy, crisis intervention, and medication management.
Learn more about Inpatient Behavioral Health Services at MedStar Harbor Hospital.
Partial Hospitalization and Intensive Outpatient programs
The Partial Hospitalization and Intensive Outpatient programs at MedStar Harbor provide treatment to patients who require more care than the typical outpatient setting, while avoiding an inpatient stay. These programs provide group therapy, education, and medication management to help patients get their symptoms under control. In some cases, family members are invited to be involved in the recovery and treatment process.