General Overview of Antidepressant Medications

Following are examples of the different major types of medical treatment used for depression.  This information is easily found on WebMD.  The next several post will be an in depth discussion about the mechanism of action of each of these major types of medication. The hope is to allow one to be able to have a better understanding of how each of these medications work and why one may be work better than another.  Personally, I do better with reuptake inhibitors, but this may not be the case for everyone.  Unless requested by the readers, we will go from the top of this list to the bottom.  These post will be followed by an examination of anti-anxiety medications, their mechanism of action, and the combined use of both antidepressants and anti-anxiety medications with focus on the interaction of these two medications.

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• Tricyclic antidepressants (TCAs) were some of the first medications used to treat depression. Examples are amitriptyline (Elavil),desipramine (Norpramin, Pertofrane), doxepin (Adapin, Sinequan),imipramine (Tofranil), nortriptyline (Aventyl, Pamelor), protriptyline(Vivactil), and trimipramine (Surmontil). Side effects include stomach upset, dizziness, dry mouth, changes in blood pressure, changes in blood sugar levels, and nausea.
• Monoamine oxidase inhibitors (MAOIs) were among the earliesttreatments for depression. The MAOIs block an enzyme, monoamine oxidase. Examples are phenelzine (Nardil),tranylcypromine (Parnate) , isocarboxazid (Marplan), and transdermal selegiline (the EMSAMskin patch). Although MAOIs work well, they're not prescribed very often because of the risk of serious interactions with some other medications and certain foods. Foods that can negatively react with the MAOIs include aged cheese and aged meats.
• Selective serotonin reuptake inhibitors (SSRIs) were launched in the mid to late 1980s. This generation of antidepressants is now the most common class used for depression. Examples include citalopram (Celexa), escitalopram (Lexapro), paroxetine (Paxil, Pexeva), fluoxetine (Prozac, Sarafem),  and sertraline (Zoloft). Two newer medicines, classified as "serotonin modulators and stimulators" or SMS's (meaning they have some similar properties as SSRIs but also affect other brain receptors) are   vilazodone (Viibryd) and vortioxetine (Brintellix) Side effects are generally mild, but can be bothersome in some people. They include nausea, stomach upset, sexual problems, fatigue, dizziness, insomnia, weight change, and headaches.
• Serotonin and norepinephrine reuptake inhibitors (SNRIs) are a newer type of antidepressant. This class includes venlafaxine(Effexor), desvenlafaxine (Pristiq and Khedezla), duloxetine(Cymbalta), and, levomilnacipran (Fetzima). Side effects includeupset stomach, insomnia, sexual problems, anxiety, dizziness, andfatigue.
• Other medications:
  • Bupropion (Wellbutrin, Aplenzin) is a unique antidepressant that is thought to affect the brain chemicals norepinephrine and dopamine. Side effects are usually mild, including upset stomach,headache, insomnia, and anxiety. Bupropion may be less likely to cause sexual side effects than other antidepressants.
  • Mirtazapine (Remeron) is also a unique antidepressant that is thought to affect mainly serotonin and norepinephrine through different brain receptors than other medicines.  It is usually taken at bedtime because it often causes drowsiness. Side effects are usually mild and include sleepiness, weight gain, elevated triglycerides, and dizziness.
  • Trazodone (Desyrel) is usually taken with food to reduce chance for stomach upset. Other side effects include drowsiness, dizziness, constipation, dry mouth, and blurry vision.

How I survived the holidays

So I'm sure we all know that the holidays are generally a rough time for anyone who battles anxiety and depression.  I personally have issues with my birthdays too, but that is for another reason.  I find that sometimes facing the whole family is just a tough situation because they tend to ask a lot of questions which I never really want to answer, although I know with my family it is coming from a place of love and not judgement.

This holiday season was especially hard for me for some reason and I actually did not do any major family functions at all.  This, of course, upset my parents and on top of just feeling depressed, I actually had a head cold on top of it so I felt extra bad.

So, how I survived this time;
Basically I spent most of my time on my couch watching TV and being alone.  While I do not feel this was the most effective way to accomplish this, my social anxiety was pretty intense and any kind of really crowded place put me in panic mode, so I just avoided them as much as I could.  I did everything I could to surround myself with positive people and a overall feeling of being in control and safe.  I really hated not being with my family on Christmas, but I just did not feel I could have made the trip and been there all day.

So my questions for you all out there:

• How do you deal with this sort of thing?  
• Anything which you know which definitely does not work for you?  
• Is your anxiety and/or depression during the holidays caused more from the dread of facing the family, or from a feeling of being alone?  

I thought this could be a good start to a group discussion about this issue because, as I said in the introduction, we are not alone with this battle and together we can help each other.

I am doing some research for my next blog post which will be a discussion on medications used, how they work, and asking for you all's input again....

Introduction

I am not a medical doctor, a psychologist, or have any advanced degree to speak.  I am just someone who has dealt with depression and anxiety for as long as I can remember and want to share my story and my thoughts in hopes that it may at least help one person not feel so alone, as I once did, and still do at times....  

Following, is a brief introduction and background from some writing I have done just to give an idea of things:

I remember this winter clearly, or as clearly as any of them, because at that time they were all pretty much the same, depressingly dark, gray, and cold.  The sun would not shine for months at a time, even during the middle of the day.  I was living the largest lie of my life.  Yes, largest, but I’ll get back to that.  I wasn’t even being honest with myself, much less those who truly cared about me.  My entire existence was a lie and I did not want to continue it.  My actions toward myself, toward others, and toward life in general, were so self-destructive that some days I cannot believe, but I do thank God that I am actually still alive.  I wanted to drive myself off the side of a mountain and even had picked the spot to where I was going to do it.  I would swing from utterly depressed where I would not even leave my bed for days at a time, to being so disgusted with myself and who I was, but more so, what I was not, that I would want to shatter any reflective surface with my bare hands, to wanting to do nothing more but just breath fire and destroy anyone and anything which would cross my path.  To this day, I still do not fully understand why I ever did some of the things that I did and I truly regret that I do not think I will ever understand.  Not for my own satisfaction, but rather my desire to maybe try to shed some light on my own completely horrid actions to those who did nothing but support me even though I don’t know what good it would really do.  The “damage has been done” as they say and the trust has been broken, not to mention the absolute grief, stress, and pain which I have caused so many people in my life.  People I love more than anything which I have truly been blessed to call my family and friends.  I do know one thing 100% though, if it were not for those people in my life, even those I lost due to my actions, I would never have made it this far.  

Anxiety and Depression is an ever present battle many of us face, some of us for only a short period of time, others, like myself, the battle has always been and will always be a part of my life. The important thing to remember is that we are not alone in this, and together, we can share, understand, cope and live productive lives.