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Antidepressants
Why are antidepressants used?
As the name suggests, antidepressants were developed specifically to
treat people with depression. However, in recent years antidepressants
have become increasingly used to treat chronic pain conditions and in
particular chronic pain caused by nerve dysfunction (neuropathic pain;
for example Trigeminal Neuralgia, Diabetic Neuropathy, Shingles,
Phantom limb pain etc).
How do antidepressants work?
Whilst their mode of action is slightly different for different classes
of antidepressants, the principle action of antidepressants is to
increase the levels of certain neurotransmitters (signalling chemicals
in the brain).
Tryciclic Antidepressants (TCA)
Different areas of the brain are connected through the use of special
signalling chemicals called neurotransmitters including noradrenaline
and serotonin. Tricyclic antidepressants increase the levels of
serotonin and noradrenaline in the brain by slowing the rate of
reuptake (reabsorption) by nerve cells. Unfortunately, tricyclic
antidepressants can also block the reuptake of other important
chemicals in the body, leading to a number of side effects.
Selective Serotonin Reuptake Inhibitors (SSRIs) & Serotonin and Noradrenaline Reuptake Inhibitors (SNRIs)
Similarly to tryciclic antidepressants, selective serotonin reuptake
inhibitors (SSRIs) and serotonin and noradrenaline reuptake inhibitors
(SNRIs) were developed to reduce the reuptake of serotonin and
noradrenaline, in order to boost their levels in the brain. SSRIs and
SNRIs have been developed to be more selective in their action than
TCAs, which reduces their side effects.
Monoamine Oxidase Inhibitors (MAOIs)
A number of important signalling chemicals in the brain are monoamines
such as dopamine, adrenaline, noradrenaline and serotonin. MAOIs
prevent a chemical called monoamine oxidase from breaking down
monoamines which can boost their levels in the brain.
What are the side effects of antidepressants?
It is important to remember that side effects will depend on the type
of antidepressant you are taking. However, some of the more common side
effects can include:
dry mouth
constipation
weight gain or loss
low blood pressure on standing
rashes
increased heart rate
blurred vision
appetite changes
drowsiness
Every drug has possible side effects and so it is important to talk to
your doctor or pharmacist about these before taking a new medication.
What drugs are classified as antidepressants?
Aventyl (Nortriptyline)
Elavil (Amitriptyline)
Tofranil (Imipramine)
Norpramin (Desipramine)
Pamelor (Nortriptyline)
Celexa (Citalopram)
Lexapro (Escitalopram)
Paxil (Paroxetine)
Prozac (Fluoxetine)
Zoloft (Sertraline)
Marplan (Isocarboxazid)
Nardil (Phenelzine)
Parnate (Tranylcypromine)
Effexor (Venlafaxine)
Cymbalta (Duloxetine)
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