The Pros and Cons of Antidepressants

Antidepressants

The Pros and Cons of Antidepressants

Several treatments can be used as alternatives to antidepressants for treating depression and other mental health conditions.

Cognitive behavioural therapy

Cognitive behavioural therapy (CBT) is a type of talking therapy that's increasingly being used in the treatment of depression. Most experts recommend that people with moderate to severe depression are treated with a combination of CBT and antidepressants.

However, if you're unable or unwilling to take antidepressants, you have the option of receiving CBT on its own.

CBT helps you understand your thoughts and behaviour, and how they affect you. It helps you recognise that events in your past may have shaped you, but it concentrates mostly on how you can change the way you think, feel and behave in the present. It also teaches you how to overcome negative thoughts.

CBT is usually available on the NHS, although the waiting lists are usually long. You normally have a short course of sessions, usually 6 to 8 sessions, over 10-12 weeks, on a one-to-one basis, with a therapist trained in CBT. In some cases, you may be offered group CBT.

Online CBT

Computerised CBT is a form of CBT that works through a computer screen, rather than face-to-face with a therapist.

These therapies can be prescribed by your GP or a mental health specialist and are carried out with their advice and support.

Ask your GP for more information or read more about self-help therapies.

Interpersonal therapy (IPT)

Interpersonal therapy (IPT) focuses on your relationships with other people and on problems you may be having in your relationships, such as difficulties with communication or coping with bereavement.

A course of IPT is usually structured in the same way as a course of CBT.

There's some evidence that IPT can be as effective as antidepressants or CBT, but more research is needed.

Counselling

Counselling is a form of therapy that helps you think about the problems you're experiencing in your life to find new ways of dealing with them. Counsellors support you in finding solutions to problems, but don't tell you what to do.

Counselling on the NHS usually consists of 6-12 sessions lasting an hour each. You talk in confidence to a counsellor, who supports you and offers practical advice.

Counselling is ideal for people who are healthy but need help coping with a current crisis, such as anger, relationship issues, bereavement, redundancy, infertility or the onset of a serious illness.

Exercise

Research suggests that regular exercise may be a more effective treatment for mild depression than antidepressants.

Exercise helps boost levels of chemicals called serotonin and dopamine in the brain, which can lift your mood.

Exercising on a regular basis can boost self-esteem and confidence, which can help to relieve symptoms of depression.

Your GP may refer you to a qualified fitness trainer for an exercise scheme, or you can read about starting exercise.

Read more about exercise for depression.

Self-help groups

Talking through your feelings can be helpful. You can either talk to a friend or relative, or you can ask your GP to suggest a local self-help group. There are also chat rooms on the internet that offer support.

Lithium

If you've tried several different antidepressants and seen no improvement, your doctor may offer you a type of medication called lithium, in addition to your current treatment.

There are 2 types of lithium – lithium carbonate and lithium citrate. Both are usually effective, but if you're taking one that works for you, it's best not to change.

If the level of lithium in your blood becomes too high, it can become toxic. So, you'll need blood tests every 3 months to check your lithium levels while you're taking it.

You'll also need to avoid eating a low-salt diet because this can also cause the lithium to become toxic. Ask your GP for advice about your diet.

Side effects of lithium include:

  • dry mouth
  • a metallic taste in your mouth
  • some mild shaking of your hands
  • diarrhoea

These side effects usually pass with time once your body gets used to the medication.

Electric shock treatment

Sometimes a treatment called electroconvulsive therapy (ECT) may be recommended if you have severe depression and other treatments haven't worked, as it can be highly effective.

During ECT, you'll first be given an anaesthetic and medication to relax your muscles. Then you'll receive an electric current to your brain through electrodes placed on your head.

You may be given a series of ECT sessions. It's usually given twice a week for 3 to 6 weeks.

It's not exactly clear how ECT works, but recent studies suggest it may help reduce connections in an area of the brain linked to depression.

For most people, ECT is good for relieving severe depression, but the beneficial effect tends to wear off after several months. Some people get unpleasant side effects, including short-term headaches, memory problems, nausea and muscle aches. However, these risks need to be balanced against the risks of other treatments and the effects of not treating depression.

Источник: https://www.nhsinform.scot/tests-and-treatments/medicines-and-medical-aids/types-of-medicine/antidepressants

What You Need to Know About Anxiety Medication: Pros and Cons

The Pros and Cons of Antidepressants

Anxiety is a broad term used to describe a naturally occurring phenomenon in the human body.  Stress, worry, and anxiety are all natural reactions to the problems of life.

And while a healthy amount of anxiety can be helpful motivation, for some, it can be a recurring hindrance to productivity rooted in a biological condition known as anxiety disorder. In fact, it’s estimated that more than 40 million adults in the U.S.

, roughly 18 percent, suffer from some form of anxiety disorder. In other words, nearly 1 in 5 American adults.

There is a whole family of diagnoses that fall under the anxiety classification. The most common include:

Common Anxiety Diagnoses

  • General Anxiety Disorder
  • Social Anxiety Disorder
  • Separation Anxiety Disorder
  • Panic Disorder
  • Posttraumatic Stress Disorder (PTSD)
  • Obsessive Compulsive Disorder (OCD)

To treat these and other anxiety disorders, there are a variety of medication options available.

However, medication is most helpful when combined with some form of therapy and treatment that addresses the underlying psychological triggers of anxiety.

If you’re considering pursuing some form of medication to treat anxiety, here’s what you need to know about the options available to you.

Benzodiazepines

Benzodiazepines are one of the most widely used forms of medication used to treat anxiety, and among the most prescribed drugs in the world. However, they are also one of the most highly abused.

Used properly, “benzos” can provide significant relief from anxiety, but they contain physically addictive qualities and are highly dangerous when combined with other depressants such as alcohol.

There are hundreds of variants, but the most commonly prescribed forms are:

  • Valium (Diazepam)
  • Xanax
  • Rohypnol (Flunitrazepam or Roofies)
  • Restoril
  • Librium (Chlordiazepoxide)
  • Serax
  • Ativan (Lorazepam)
  • Klonapin (clonapezam)

Benzos work in a similar manner to most sedative drugs in that they shut down neurotransmitters, reducing feelings such as anxiety and tension.

Un most sedatives, benzodiazepines operate by connecting to specific receptor molecules of non-critical body functions.

In other words, while most sedatives partially shut down our whole body, benzos only shut down cells that participate in thinking and worrying, not breathing and surviving.

It may seem a miracle drug, but benzos are known to hamper brain function and in some cases cause amnesia. Benzos suppress brain synapses from firing, meaning long term use can significantly hinder brain function.

Rohypnol (roofies) are an especially potent form of benzos that have been known to be slipped in drinks, causing temporary amnesia or blackouts.

When taken in small doses, benzos are known to cause lightheadedness, poor muscle coordination, and vertigo among other side effects.

Benzodiazepines are used to address anxiety because of their relaxing effects, but their potential for abuse is high. Tolerance will develop to any drug over time, and benzos are no different. Even after using for a period of two weeks or more, withdrawal can cause negative side effects.

By suppressing the central nervous system for so long, sudden withdrawal can cause brain synapses to overfire. This can result in panic attacks, tremors, headaches, insomnia, sweating, and ironically, increased anxiety. For some, this could even result in epileptic seizure.

There is also the challenge of psychologically overcoming a reliance on the numbing effects produced by these drugs.

Pros

  • Effective for short term relief
  • Not dangerous to life critical body functions (unless combined with other sedatives)
  • Useful sedative for surgery, immediate seizure prevention

Cons

  • Highly addictive when used for long term treatment
  • Dangerous withdrawal symptoms such as seizures, anxiety, physical cravings
  • Long term use can hamper brain function

Only use benzos when prescribed by a physician.

Even then, be careful about how much you are taking and how frequently, and make sure that you only plan being on benzos for a short period of time.

lihood of addiction varies from person to person, but it is safe to say you should not rely on benzo usage for more than a month, unless you’re experiencing chronic physical pain.

Antidepressants (SSRI’s & SNRI’s)

Antidepressant is an umbrella term for a wide variety of medications used to treat symptoms of depression. However, due to the way they increase the brain’s availability of feel good chemicals such as serotonin and dopamine, they can also help alleviate symptoms of anxiety.

One of the most common types of antidepressants are SSRI’s, or Selective Serotonin Reuptake Inhibitors. When compared to benzodiazepines, SSRI’s and SNRI’s have a much lower risk for dependency and abuse. That is because they typically take 4-6 weeks of regular use before effects take place.

Some of the most common include:

SSRI’s

  • Prozac (Fluoxetine)
  • Zoloft (Sertraline)
  • Paxil (Paroxetine)
  • Lexapro (Escitalopram)
  • Celexa (Citalopram)

SNRI’s

  • Cymbalta (Duloxetine)
  • Fetzima (Levomilnacipran)
  • Effexor (Venlafaxine)
  • Pristiq (Desvenlafaxine)

There are many variations of antidepressant drugs, but most do the same thing.

The main goal of these drugs is to bring neurotransmitters back into balance and alleviate symptoms of depression. SSRI’s and SNRI’s do this by increasing the availability of feel good chemicals in the brain.

SSRIs increase serotonin, while SNRIs increase both serotonin and norepinephrine, which along with the dopamine are three chemicals most closely linked to depression.

Antidepressants aren’t considered addictive, however treatment needs to be carefully administered. Stopping abruptly or missing several doses can cause withdrawal- symptoms such as nausea, dizziness, lethargy, and anxiety.

It also takes time for SSRI’s and SNRI’s to take effect. In the 4-6 weeks that the body becomes acclimated to the medication, a variety of symptoms could occur.

A small number of users report thoughts of suicide, and many report occasional dry mouth, insomnia, nervousness, dizziness, and sexual dysfunction.

Beta Blockers

Beta blockers (known as beta-adrenergic blocking agents) are used to reduce blood pressure. They also block the effects of adrenaline, in effect reducing your heart rate. Doctors typically prescribe beta blockers to treat high blood pressure and chest pain, but they have also been mildly useful in treating symptoms of anxiety.

Antihistamines

The most common antihistamine for treating anxiety is Hydroxyzine. Antihistamines are traditionally used to reduce the effects of allergies, reducing swelling and inducing lethargy. Antihistamines are typically prescribed for anxiety on a short-term basis, and shouldn’t be considered for a long term solution.

Tricyclic Antidepressants

Tricyclic antidepressants work similar to SSRI’s and SNRI’s in that they increase the availability of feel good chemicals in the brain. However, these are typically pursued after other options haven’t worked.

Tricyclic antidepressants work by keeping more serotonin and norepinephrine available in the brain, but the side effects are considered more drastic than other similar antidepressants.

For example, nausea, diarrhea, constipation, and anxiety.

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