There has been a lot of talk about antidepressants in the media and how effective they really are for certain groups of people effected by depression. The main gripe I have with this particular class of medication is that doctors hand them out to easily without exploring other methods such as therapy first but what can you do as we live in a world where people want results fast.

Most people believe for some reason that an antidepressant is going to make them happy and this is not the case, not even close for that matter. What antidepressant may do is provide that kick in the ass to get you motivated and hopefully reduce the symptoms of depression to make the battle a little bit more easier. The problem is not every person reacts the same way to medication so finding the right med requires a little, or a lot, of trial and error. So lets look at the variety of antidepressants that are out there.

Selective Serotonin Reuptake Inhibitors (SSRI)

- This class makes the serotonin that your brain produces to hang around longer then usual basically. By keeping the levels sustained then technically this will overcome the depression.
- Paxil, Lexapro, Celexa, Prozac are the most common of the SSRI class

Multiple Reuptake Inhibitors

- This class effects a number of chemicals within the brain especially serotonin and norepinephrine. Basically the same theory as SSRI but with more then one chemical at play
- Effexor, Cymbalta, Wellbutrin are the big three.

Monoamine oxidase inhibitors (MAOI)

- This group prevents the breakdown of the main chemicals in the brain. Not used as often as the before mentioned classes as the side effects can be rather dangerous and a pretty strict diet needs to be followed. This drug class is known for breaking through depressions that have shown little progress with other forms of drug therapy.
- Nardil, Parnate and recently a MAOI patch are the common ones.

There are the big three so the question becomes which one is right for you and this is where the guessing game begins as for whatever the reason there is no test to tell the doctors what chemicals you are lacking or if there is one I have never seen or heard about it being used at least with any regularity.

It takes up to six weeks for a med to hit its full potential but the side effects tend to show up after a day or so. For some people the new med may be the piece they had been looking for, for others you just wasted six weeks for nothing and for a select few the new med may send you to a very bad place rather quickly. Paxil put me into the hospital in under a week and the guess why would be is that my serotonin levels really did not need to be adjusted so the manic state was a nice little warning that too much of a good thing can be rather unpleasant.

I am also drug resistant which basically means in my case that I respond well to most drugs but my body very quickly becomes adjusted to it so the med either has to be continually increased or another med needs to be found. To say I felt like a human lab rat for a while is probably an understatement. The best combo for me so far has been Effexor, Wellbutrin, Remeron, Lithium, Zyprexa and Temazapam which lasted for about nine months before it was discontinued (the Zyprexa was stopped six months in for it made me fat really quickly). The problem with drug combos is when it stops working it is difficult to figure out which med is to blame so my doctor stopped them all and I moved on to the MAOI class for a while.

Of course when it comes time to picking an antidepressant side effects should be kept in mind for some of them can seem like more of a pain in the ass then the actual depression plus a few of them are rather dangerous. Instead of listing out the long list of potential side effects I am just going to list the ones associated with Effexor but keep in mind this list comes from the maker of the drugs and they have a tendency of underplaying the dirty parts of the medication.

Important Safety Information

Suicidality and Antidepressant Drugs (Black Box Warning)

Antidepressants increased the risk compared to placebo of suicidal thinking and behavior (suicidality) in children, teens, and young adults. Depression and certain other psychiatric disorders are themselves associated with increases in the risk of suicide. Patients of all ages who are started on antidepressant therapy should be monitored appropriately and observed closely for clinical worsening, suicidality, or unusual changes in behavior. EFFEXOR XR® (venlafaxine HCl) is not approved for use in children and teens.

* People taking MAOIs should not take EFFEXOR XR.
* All patients taking antidepressants should be watched closely for signs that their condition is getting worse or that they are becoming suicidal, especially when they first start therapy, or when their dose is increased or decreased. Patients should also be watched for becoming agitated, irritable, hostile, aggressive, impulsive, or restless. Such symptoms should be reported to the patient’s doctor right away.
* Before starting EFFEXOR XR, tell your doctor if you’re taking or plan to take any prescription or over-the-counter drugs, including migraine headache medication, herbal preparations, and nutritional supplements, to avoid a potentially life-threatening condition.
* EFFEXOR XR may raise blood pressure in some patients. Your blood pressure should be controlled before starting treatment and should be monitored regularly.
* Mydriasis (prolonged dilation of the pupil of the eye) has been reported with EFFEXOR XR. You should notify your physician if you have a history of glaucoma or increased eye pressure.
* When people suddenly stop using or quickly lower their daily dose of EFFEXOR XR, discontinuation symptoms may occur. Talk to your doctor before discontinuing or reducing your dose of EFFEXOR XR.
* Pregnant or nursing women shouldn’t take any antidepressant without consulting their doctor.
* Until you see how EFFEXOR XR affects you, be careful doing such activities as driving a car or operating machinery. Avoid drinking alcohol while taking EFFEXOR XR.
* In clinical studies, the most common side effects with EFFEXOR XR (reported in at least 10% of patients and at least twice as often as with placebo) were constipation, dizziness, dry mouth, insomnia, loss of appetite, nausea, nervousness, sexual side effects, sleepiness, sweating, and weakness. Ask your doctor if EFFEXOR XR is right for you.

Nice eh. Anyway my normal reminder which is anytime your doctor wants to put you on a med make sure that you do your homework first and know exactly what your getting into. My favorite med resource is www.crazymeds.us Take Care.

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