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Medications
Several types of medications are used to treat depressive disorders. The newer medicines are known as the selective serotonin reuptake inhibitors (SSRIs). The older medicines are tricyclics and the monoamine oxidase inhibitors (MAOIs). The SSRIs and other new medications that affect neurotransmitters, like dopamine, norepinephrine, and serotonin, generally have fewer side effects than the tricyclics. But with all these medications, managing the side effects--like the loss of sex drive, nausea, sleeplessness, weight gain, and headaches--can be as challenging as dealing with the depression itself.
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Sometimes the doctor will try a variety of antidepressants before finding the most effective medication or combination of medications. Sometimes the dosage must be increased to be effective. Although some improvements may be seen in the first few weeks, antidepressant medications must be taken regularly for at least three or four weeks (in some cases, as many as eight weeks) before patients feel the full therapeutic benefit.
One great danger is stopping the medications too soon. Patients may feel better and think they no longer need medication, or they conclude that because the medication hasn't made them feel immediately better it isn't going to help them. But it is important to continue taking the medication until it has time to work, even if the side effects appear before the depression lifts. Once the individual begins to feel better, the medications should be continued for at least four to nine months to prevent a recurrence of the depression. Some medications must be stopped gradually to give the body time to adjust. No antidepressant medication should ever be stopped without a doctor's supervision and instructions on the safest approach. For individuals with bipolar disorder or chronic major depression, the medication may have to be maintained indefinitely.
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