Trintellix helps with anxiety

Antidepressants

As the name suggests, substances in this group are effective against depressive states of all kinds, regardless of their origin and diagnostic classification. This normalizes not only the depressed, anxious or desperate mood, but also the accompanying symptoms that are usually present: inhibited or increased self-drive, brooding, loss of appetite, etc. However, this depression-relieving effect usually does not occur in the first few days, but with a delay of two up to three weeks, sometimes even later. Therefore, to alleviate the symptoms, it is often necessary to take other psychotropic drugs temporarily, such as sedatives or sleeping pills.

Effect on self-propulsion

When choosing the substance, its effect on self-propulsion plays a role: some of the antidepressants have a calming and dampening effect, can make you tired and make it easier to fall asleep and stay asleep. The other group has a more stimulating effect and can thus help to get excited about activities. Both modes of action can be very welcome to depressed people, depending on what burdens them most in their experience. Incidentally, these changes in drive already occur in the first few days of use.

Experience has shown that the majority of people, especially those with moderate or severe depression, benefit from taking an antidepressant, which can be explained partly by the effect of the substance itself and partly by the so-called placebo effect. If there is a significant improvement a few weeks after starting the drug at the latest, doctors usually recommend continuing this medication until the person concerned has completely overcome the depression. Withdrawal too early can lead to relapse.

Not every antidepressant is effective for every depression

However, not every antidepressant is effective for every depression. Anyone who does not feel any significant relief even after several weeks of use should speak to their doctor about changes to the prescription. There are then several options that cannot be listed here in detail for reasons of space.

Overall, most acute and prolonged depression can be at least considerably alleviated with medical help - possibly with combinations of several drugs. However, one should not rely solely on the medication treatment, patient support, psychotherapeutic help and possibly other measures are just as important!

If an antidepressant has been shown to be clearly effective, it can continue to be taken as a preventive measure, possibly for several years, depending on the previous course. However, this only applies if no manic or psychotic crises have occurred to date.

Antidepressants for other disorders

Antidepressants can also be used for generalized anxiety disorders and panic attacks, obsessive-compulsive disorder and eating disorders (especially bulimia). Similar to the solution of depressive disorders, their effect usually occurs with a delay of a few weeks. They are therefore not experienced as immediate anxiety relievers - like the benzodiazepines - but can reduce the level of anxiety after taking them for a while. Their supportive effect on obsessive thoughts and obsessive behavior is probably based on this. Finally, some antidepressants are also used as additives in the context of combined pain treatments, in this case not for the treatment of mental disorders.

Substances with a sedative effect can be used in the evening to support falling asleep and staying asleep. You can take advantage of the fact that there is no risk of addiction even after a longer period of use. However, antidepressants are not sleeping pills in the strict sense of the word.

Risks

Antidepressants can trigger manic or psychotic states, promote their occurrence or worsen the symptoms. This risk should be considered in particular by people who have experienced similar conditions before, so that an increased risk of recurrence can be assumed. In these cases, you can switch to some atypical neuroleptics, which are ascribed a certain antidepressant effect, or use additional drugs, e.g. B. Phase prophylactic drugs.

Side effects

There are also a number of other known side effects that you can read about in the package inserts or in the relevant specialist literature. The drive-modifying effects can of course also lead to undesirable effects in individual cases, for example if you cannot rest in the evening because of the stimulating effect - this is why these substances are usually taken in the morning and at noon - or if a depressant is taken the next day despite being taken in the evening in good time makes you tired. Then it is usually sufficient to change the intake, i.e. the dosage or the time of intake.

One of the main risks of severe depression is the risk of suicidal acts. This can even be temporarily increased by stimulating medication if the drive becomes stronger, but the depressive experience remains unchanged in the first few weeks of use. So special attention is required here!

Common antidepressants

For your orientation, the common antidepressant drugs are listed below. The first term in each case is the name of the active substance, followed by the first common brand name in brackets. The list is in alphabetical order, a rating is not linked to the order.

Substances with antidepressant and stimulating effects

Agomelatine (Thymanax® / Valdoxan®), Bupropion (Elontril®), Citalopram (Cipramil®), Clomipramine (Anafranil®), Desipramine (Pertofran®), Duloxetine (Cymbalta®), Escitalopram (Cipralex®), Fluoxetine) (Fluctin®) , Fluvoxamine (Fevarin®), imipramine (Tofranil®), moclobemide (Aurorix®), nortriptyline (Nortrilen®), paroxetine (Seroxat® / Tagonis®), reboxetine (Edronax® / Solvex®), sertraline (Gladem® / Zoloft® ), Venlafaxine (Trevilor®), vortioxetine (Brintellix®)

Substances with antidepressant and depressant (sedative) effects

Amitriptyline (Saroten®), Amitriptyline Oxide (Equilibrin®), Dosulepin (Idom®), Doxepin (Aponal®), Maprotilin (Ludiomil®), Mianserin (Tolvin®), Mirtazapine (Remergil®), Trazodone (Thombran®), Trimipramine ( Stangyl®) This group also includes St. John's wort, which in high doses has been shown to have an antidepressant effect, but is not sufficient for severe depression.

literature

  • Bandelow, B .; Bleich, S .; Kropp, S. (2012): Handbuch Psychopharmaka. Hogrefe Verlag, 3rd edition.
  • Benkert, O .; Hippius, H. (2013): Compendium of Psychiatric Pharmacotherapy. Springer Verlag, 9th edition.
  • Finzen, A .; Scherk, H .; Weinmann, S. (2017): Drug treatment for mental disorders - guidelines for everyday psychiatric life. Psychiatry Publishing House.
  • Lehmann, P; Aderhold, V .; Rufer, M .; Zehentbauer, J .: New Antidepressants, Atypical Neuroleptics - Risks, Placebo Effects, Low Doses and Alternatives. With an excursus on the recurrence of electric shock. Forewords by Andreas Heinz as well as Peter Ansari and Sabine Ansari, afterword by Marina Langfeldt. Berlin and Shrewsbury: Peter Lehmann Publishing 2017
  • Weinmann, S (2012): Success myth of psychotropic drugs - Why we have to reassess drugs in psychiatry (eBook). Psychiatry Publishing House.

Video