Primary Disease Name: Depression
What is Depression? What is a
Depressive Disorder?
Depression is a "whole-body" illness, involving your body, mood,
and thoughts. It affects the way you eat and sleep, the way you feel
about yourself, and the way you think about things. A depressive
disorder is not the same as a passing blue mood. It is not a sign of
personal weakness or a condition that can be willed or wished away.
People with a depressive illness cannot merely "pull themselves
together" and get better. Without treatment, symptoms can last for
weeks, months, or years. Appropriate treatment, however, can help
most people who suffer from depression.
The symptoms of depression may vary from person to person, and
also depend on the severity of the depression. Depression causes
changes in thinking, feeling, behavior, and physical well-being.
Changes in Thinking - You may experience
problems with concentration and decision making. Some people report
difficulty with short term memory, forgetting things all the time.
Negative thoughts and thinking are characteristic of depression.
Pessimism, poor self-esteem, excessive guilt, and self-criticism are
all common. Some people have self-destructive thoughts during a more
serious depression.
Changes in Feelings -
You may feel sad for no reason at all. Some people report that they
no longer enjoy activities that they once found pleasurable. You
might lack motivation, and become more apathetic. You might feel
"slowed down" and tired all the time. Sometimes irritability is a
problem, and you may have more difficulty controlling your temper.
In the extreme, depression is characterized by feelings of
helplessness and hopelessness.
Changes in
Behavior - Changes in behavior during depression are
reflective of the negative emotions being experienced. You might act
more apathetic, because that's how you feel. Some people do not feel
comfortable with other people, so social withdrawal is common. You
may experience a dramatic change in appetite, either eating more or
less. Because of the chronic sadness, excessive crying is common.
Some people complain about everything, and act out their anger with
temper outbursts. Sexual desire may disappear, resulting in lack of
sexual activity. In the extreme, people may neglect their personal
appearance, even neglecting basic hygiene. Needless to say, someone
who is this depressed does not do very much, so work productivity
and household responsibilities suffer. Some people even have trouble
getting out of bed.
Changes in Physical
Well-being - We already talked about the negative emotional
feelings experienced during depression, but these are coupled with
negative physical emotions as well. Chronic fatigue, despite
spending more time sleeping, is common. Some people can't sleep, or
don't sleep soundly. These individuals lay awake for hours, or
awaken many times during the night, and stare at the ceiling. Others
sleep many hours, even most of the day, although they still feel
tired. Many people lose their appetite, feel slowed down by
depression, and complain of many aches and pains. Others are
restless, and can't sit still.
Now imagine these symptoms
lasting for weeks or even months. Imagine feeling this way almost
all of the time. Depression is present if you experience many of
these symptoms for at least several weeks. Of course, it's not a
good idea to diagnose yourself. If you think that you might be
depressed, see a psychologist as soon as possible. A psychologist
can assess whether you are depressed, or just under a lot of stress
and feeling sad. Remember, depression is treatable. Instead of
worrying about whether you are depressed, do something about it.
Even if you don't feel like it right now.
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Causes of Depression
You may have heard people talk about chemical imbalances in the
brain that occur in depression, suggesting that depression is a
medical illness, without psychological causes. However, all
psychological problems have some physical manifestations, and all
physical illnesses have psychological components as well. In fact,
the chemical imbalances that occur during depression usually
disappear when you complete psychotherapy for depression, without
taking any medications to correct the imbalance. This suggests that
the imbalance is the body's physical response to psychological
depression, rather than the other way around.
Some types of
depression do seem to run in families, suggesting a biological
vulnerability. This seems to be the case with bipolar depression
and, to a lesser degree, severe major depression. Studies of
families, in which members of each generation develop bipolar
disorder, found that those with bipolar disorder have a somewhat
different genetic makeup than those who are not diagnosed.
However, the reverse is not true. Not everybody with the
genetic makeup that causes this vulnerability to bipolar disorder
develops the disorder. Additional factors, such as stress and other
psychological factors, are involved in its onset as well. Likewise,
major depression also seems to occur, generation after generation,
in some families, but not with a frequency that suggests clear
biological causes. Additionally, it also occurs in people who have
no family history of depression. So, while there may be some
biological factors that contribute to depression, it is clearly a
psychological disorder.
A variety of psychological factors
appear to play a role in vulnerability to these severe forms of
depression. Most likely, psychological factors are completely
responsible for other forms of mild and moderate depression,
especially reactive depression. Reactive depression is usually
diagnosed as an adjustment disorder during treatment.
People
who have low self-esteem, who consistently view themselves and the
world with pessimism, or who are readily overwhelmed by stress are
more prone to depression. Psychologists often describe social
learning factors as being significant in the development of
depression, as well as other psychological problems. People learn
both adaptive and maladaptive ways of managing stress and responding
to life problems within their family, educational, social and work
environments. These environmental factors influence psychological
development, and the way people try to resolve problems when they
occur. Social learning factors also explain why psychological
problems appear to occur more often in family members, from
generation to generation. If a child grows up in a pessimistic
environment, in which discouragement is common and encouragement is
rare, that child will develop a vulnerability to depression as well.
A serious loss, chronic illness, relationship problems, work
stress, family crisis, financial setback, or any unwelcome life
change can trigger a depressive episode. Very often, a combination
of biological, psychological, and environmental factors are involved
in the development of depressive disorders, as well as other
psychological problems. When you feel depressed, and don't know
where to turn, talk to someone who can help.... a psychologist.
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Depression in Women
Women experience depression about twice as often as men.1 Many
hormonal factors may contribute to the increased rate of depression
in women-particularly such factors as menstrual cycle changes,
pregnancy, miscarriage, postpartum period, pre-menopause, and
menopause. Many women also face additional stresses such as
responsibilities both at work and home, single parenthood, and
caring for children and for aging parents.
A recent NIMH
study showed that in the case of severe premenstrual syndrome (PMS),
women with a preexisting vulnerability to PMS experienced relief
from mood and physical symptoms when their sex hormones were
suppressed. Shortly after the hormones were re-introduced, they
again developed symptoms of PMS. Women without a history of PMS
reported no effects of the hormonal manipulation.
Many women
are also particularly vulnerable after the birth of a baby. The
hormonal and physical changes, as well as the added responsibility
of a new life, can be factors that lead to postpartum depression in
some women. While transient "blues" are common in new mothers, a
full-blown depressive episode is not a normal occurrence and
requires active intervention. Treatment by a sympathetic physician
and the family's emotional support for the new mother are prime
considerations in aiding her to recover her physical and mental
well-being and her ability to care for and enjoy the infant.
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Depression in Men
Although men are less likely to suffer from depression than
women, three to four million men in the United States are affected
by the illness. Men are less likely to admit to depression, and
doctors are less likely to suspect it. The rate of suicide in men is
four times that of women, though more women attempt it. In fact,
after age 70, the rate of men's suicide rises, reaching a peak after
age 85.
Depression can also affect the physical health in
men differently from women. A new study shows that, although
depression is associated with an increased risk of coronary heart
disease in both men and women, only men suffer a high death
rate.
Men's depression is often masked by alcohol or drugs,
or by the socially acceptable habit of working excessively long
hours. Depression typically shows up in men not as feeling hopeless
and helpless, but as being irritable, angry, and discouraged; hence,
depression may be difficult to recognize as such in men. Even if a
man realizes that he is depressed, he may be less willing than a
woman to seek help. Encouragement and support from concerned family
members can make a difference. In the workplace, employee assistance
professionals or worksite mental health programs can be of
assistance in helping men understand and accept depression as a real
illness that needs treatment.
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Depression in the Elderly
Some people have the mistaken idea that it is normal for the
elderly to feel depressed. On the contrary, most older people feel
satisfied with their lives. Sometimes, though, when depression
develops, it may be dismissed as a normal part of aging. Depression
in the elderly, undiagnosed and untreated, causes needless suffering
for the family and for the individual who could otherwise live a
fruitful life. When he or she does go to the doctor, the symptoms
described are usually physical, for the older person is often
reluctant to discuss feelings of hopelessness, sadness, loss of
interest in normally pleasurable activities, or extremely prolonged
grief after a loss.
Recognizing how depressive symptoms in
older people are often missed, many health care professionals are
learning to identify and treat the underlying depression. They
recognize that some symptoms may be side effects of medication the
older person is taking for a physical problem, or they may be caused
by a co-occurring illness. If a diagnosis of depression is made,
treatment with medication and/or psychotherapy will help the
depressed person return to a happier, more fulfilling life. Recent
research suggests that brief psychotherapy (talk therapies that help
a person in day-to-day relationships or in learning to counter the
distorted negative thinking that commonly accompanies depression) is
effective in reducing symptoms in short-term depression in older
persons who are medically ill. Psychotherapy is also useful in older
patients who cannot or will not take medication. Efficacy studies
show that late-life depression can be treated with
psychotherapy.
Improved recognition and treatment of
depression in late life will make those years more enjoyable and
fulfilling for the depressed elderly person, the family, and
caretakers.
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Depression in Children
Only in the past two decades has depression in children been
taken very seriously. The depressed child may pretend to be sick,
refuse to go to school, cling to a parent, or worry that the parent
may die. Older children may sulk, get into trouble at school, be
negative, grouchy, and feel misunderstood. Because normal behaviors
vary from one childhood stage to another, it can be difficult to
tell whether a child is just going through a temporary "phase" or is
suffering from depression. Sometimes the parents become worried
about how the child's behavior has changed, or a teacher mentions
that "your child doesn't seem to be himself."
In such a
case, if a visit to the child's pediatrician rules out physical
symptoms, the doctor will probably suggest that the child be
evaluated, preferably by a psychiatrist who specializes in the
treatment of children. If treatment is needed, the doctor may
suggest that another therapist, usually a social worker or a
psychologist, provide therapy while the psychiatrist will oversee
medication if it is needed.
Parents should not be afraid to
ask questions: What are the therapist's qualifications? What kind of
therapy will the child have? Will the family as a whole participate
in therapy? Will my child's therapy include an antidepressant? If
so, what might the side effects be?
The National Institute
of Mental Health (NIMH) has identified the use of medications for
depression in children as an important area for research. The
NIMH-supported Research Units on Pediatric Psychopharmacology
(RUPPs) form a network of seven research sites where clinical
studies on the effects of medications for mental disorders can be
conducted in children and adolescents. Among the medications being
studied are antidepressants, some of which have been found to be
effective in treating children with depression, if properly
monitored by the child's physician.
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Diagnostic Evaluation for Depression
The first step to getting appropriate treatment, for depression
or any emotional problem, is a complete psychological evaluation to
determine whether you have a depressive illness, and if so, what
type of depression. Consultation with a psychologist will include a
review of your physical health history. Some medications as well as
some medical conditions can cause symptoms of depression, so your
psychologist will ask your family physician to rule out these
possibilities if other physical symptoms are evident.
However, physicians often focus only on the physical aspects
of depression, and may prescribe medication without referring you
for psychological treatment or evaluation. If you experience the
symptoms of depression, as described on this website, you should
talk to a psychologist, to assess whether psychological treatment is
indicated, even if it not suggested by your physician. As a general
rule, you should never take antidepressant medication alone, without
also beginning psychotherapy, or at least seeing a psychologist for
an evaluation.
A good psychological diagnostic evaluation
will include a complete history of your symptoms, i.e., when they
started, how long they have lasted, how severe they are, whether
you've had them before and, if so, whether you were treated and what
treatment you received. Your psychologist should ask you about
alcohol and drug use, and if you have had thoughts about death or
suicide. Further, a history should include questions about whether
other family members have had depression and if treated, what
treatments they may have received and which were effective. Lastly,
the psychological diagnostic evaluation will include a mental status
examination to assess the full range of psychological symptoms and
problems. This will help identify any other psychological problems
that might be present, and will help determine the most appropriate
treatment for you.
Treatment choice will depend on the
outcome of the evaluation. Most people do well with psychotherapy,
but some require treatment with antidepressants in addition to
psychotherapy. Medication can allow you to to gain relatively quick
symptom relief, if you are experiencing severe and disabling
symptoms. However, medication does not "cure" the depression, it
only treats the symptoms. If you are depressed, you need
psychotherapy to help you to learn more effective ways to deal with
life's problems, and to change the negative thoughts and attitudes
that have caused you to develop depression.
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Types of Depression
Depressive disorders come in different forms. There are several
different diagnoses for depression, mostly determined by the
intensity of the symptoms, the duration of the symptoms, and the
specific cause of the symptoms, if that is known.
Psychology
Information Online provides information on the following depressive
disorders. Follow the title link for more information about each
type of depression:
1. Major Depression -
This is the most serious type of depression, in terms of number of
symptoms and severity of symptoms, but there are significant
individual differences in the symptoms and severity. You do not need
to feel suicidal to have a major depression, and you do not need to
have a history of hospitalizations either, although both of these
factors are present in some people with major depression. There is
no official diagnosis of "moderate depression."
2.
Dysthymic Disorder - This refers to a low to moderate level
of depression that persists for at least two years, and often
longer. While the symptoms are not as severe as a major depression,
they are more enduring and resistant to treatment. Some people with
dysthymia develop a major depression at some time during the course
of their depression.
3. Unspecified
Depression - This category is used to help researchers who
are studying other specific types of depression, and do not want
their data confounded with marginal diagnoses. It includes people
with a serious depression, but not quite severe enough to have a
diagnosis of a major depression. It also includes people with
chronic, moderate depression, which has not been present long enough
for a diagnosis of a Dysthymic disorder. (You get the idea!)
4. Adjustment Disorder, with Depression -
This category describes depression that occurs in response to a
major life stressor or crisis.
5. Bipolar
Depression - This type includes both high and low mood
swings, as well as a variety of other significant symptoms not
present in other depressions.
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Symptoms of Depression
Not everyone who is depressed or manic experiences every symptom.
Some people experience a few symptoms, some many. Severity of
symptoms varies with individuals and also varies over time.
Depression
Persistent sad,
anxious, or "empty" mood
Feelings of hopelessness, pessimism
Feelings of guilt, worthlessness, helplessness
Loss of
interest or pleasure in hobbies and activities that were once
enjoyed, including sex
Decreased energy, fatigue, being
"slowed down"
Difficulty concentrating, remembering, making
decisions
Insomnia, early-morning awakening, or oversleeping
Appetite and/or weight loss or overeating and weight gain
Thoughts of death or suicide; suicide attempts
Restlessness, irritability
Persistent physical symptoms that
do not respond to treatment, such as headaches, digestive disorders,
and chronic pain
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Symptoms of Mania
Mania
Abnormal or excessive elation
Unusual irritability
Decreased need for sleep
Grandiose notions
Increased talking
Racing thoughts
Increased sexual desire
Markedly increased energy
Poor judgment
Inappropriate social behavior
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Psychotherapy Treatment
Psychological treatment of depression (psychotherapy) assists the
depressed individual in several ways. First, supportive counseling
helps ease the pain of depression, and addresses the feelings of
hopelessness that accompany depression. Second, cognitive therapy
changes the pessimistic ideas, unrealistic expectations, and overly
critical self-evaluations that create depression and sustain it.
Cognitive therapy helps the depressed person recognize which life
problems are critical, and which are minor. It also helps him/her to
develop positive life goals, and a more positive self-assessment.
Third, problem solving therapy changes the areas of the person's
life that are creating significant stress, and contributing to the
depression. This may require behavioral therapy to develop better
coping skills, or Interpersonal therapy, to assist in solving
relationship problems.
Unfortunately, many poorly trained
counselors never move beyond providing supportive counseling. This
alone will not eliminate the depression. As a result, the
depression, and the therapy, continues indefinitely, with little
improvement.
Supportive counseling "feels" helpful, and as
part of the overall treatment plan does help. But, unless the
depressed person makes critical life changes, the depression will
continue. These changes are both internal and external. Internal
changes are usually needed in problem assessment, self-evaluation,
the evaluation of others, and the expectations the depressed person
has for himself/herself, others and about life. External changes may
be needed in problem solving skills, stress management,
communication skills, life management skills, and the skills needed
to develop and sustain relationships.
The length of treatment
will vary, according to the severity of the depression, and the
number and kind of life problems that need to be addressed. Most
people will begin to experience some relief with 6 to 10 sessions,
and approximately 70-80% of those treated notice significant
improvement within 20-30 sessions. Mild depression may be treated in
less sessions, and more significant depression may require extended
treatment. Treatment sessions are usually scheduled once per week,
although they may be scheduled more frequently initially, or if the
person is experiencing significant life crises.
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Depression Medication Treatment
Except in the more severe depressions, and bipolar depression,
medication is usually an option, rather than a necessity.
Antidepressant medication does not cure depression, it only helps
you to feel better by controlling certain symptoms. If you are
depressed because of life problems, such as relationship conflicts,
divorce, loss of a loved one, job pressures, financial crises,
serious medical problems in yourself or a family member, legal
problems, or problems with your children, taking a pill will not
make those problems go away.
However, some symptoms of
depression, such as sleep and appetite disturbances, significant
concentration problems, and chronic fatigue, interfere with your
ability to make the life changes necessary to eliminate the
depression. In more serious depression, suicidal thoughts and urges,
and preoccupation with death, may require medication in addition to
psychotherapy.
Antidepressant medication can help relieve
those symptoms, and allow you to make needed life changes. The
decision to take medication, in addition to participating in
psychological treatment, should be discussed with your treating
psychologist and your primary care physician. Your thoughts and
feelings regarding medication, after considering information about
both the benefits and risks involved, are an important part of a
collaborative treatment approach between psychologist and client. If
medication is part of your treatment, either your primary care
physician or a psychiatrist will supervise the medical part of your
treatment, while you continue psychotherapy with a psychologist. If
you have a chronic medical condition or a serious illness, and you
are taking medication for that condition, then the medical
specialist treating that problem should be involved in your
treatment. The medical specialist may supervise all of your
medications, or coordinate the medical treatment with the physician
providing the antidepressant medications.
Antidepressant Medications
The kind
of depression that will most likely benefit from treatment with
medications is more than just "the blues." It's a condition that's
prolonged, lasting 2 weeks or more, and interferes with a person's
ability to carry on daily tasks and to enjoy activities that
previously brought pleasure.
The depressed person will seem
sad, or "down," or may show a lack of interest in his surroundings.
He may have trouble eating and lose weight (although some people eat
more and gain weight when depressed). He may sleep too much or too
little, have difficulty going to sleep, sleep restlessly, or awaken
very early in the morning. He may speak of feeling guilty,
worthless, or hopeless. He may complain that his thinking is slowed
down. He may lack energy, feeling "everything's too much," or he
might be agitated and jumpy. A person who is depressed may cry. He
may think and talk about killing himself and may even make a suicide
attempt. Some people who are depressed have psychotic symptoms, such
as delusions (false ideas) that are related to their depression. For
instance, a psychotically depressed person might imagine that he is
already dead, or "in hell," being punished.
Not everyone who
is depressed has all these symptoms, but everyone who is depressed
has at least some of them. A depression can range in intensity from
mild to severe.
Antidepressants are used most widely for
serious depressions, but they can also be helpful for some milder
depressions. Antidepressants, although they are not "uppers" or
stimulants, take away or reduce the symptoms of depression and help
the depressed person feel the way he did before he became depressed.
Antidepressants are also used for disorders characterized
principally by anxiety. They can block the symptoms of panic,
including rapid heartbeat, terror, dizziness, chest pains, nausea,
and breathing problems. They can also be used to treat some phobias.
Your physician will choose a particular antidepressant based
on your symptoms. When you begin taking an antidepressant,
improvement generally will not begin to show immediately. With most
of these medications, it will take from 1 to 3 weeks before changes
begin to occur. Some symptoms diminish early in treatment; others,
later. For instance, energy level, or sleeping and eating patterns
may improve before the depressed mood lifts. If there is little or
no change in symptoms after 5 to 6 weeks, a different medication may
be indicated, and you should discuss this with your physician. Some
people respond better to one medication than to another. There is no
certain way to determine which medication will be effective, so your
doctor may have to prescribe first one, then another, until an
effective one is found. Treatment with medication is continued for a
minimum of several months and may last up to a year or more.
While some people have one episode of depression and then
never have another, or remain symptom-free for years, others have
more frequent episodes or very long-lasting depressions that may go
on for years. Some people find that their depressions become more
frequent and severe as they get older. For these people, continuing
(maintenance) treatment with antidepressants can be an effective way
of reducing the frequency and severity of depressions. Those that
are commonly used have no known long-term side effects and may be
continued indefinitely. The prescribed dosage of the medication may
be lowered if side effects become troublesome. Lithium may also be
used for maintenance treatment of repeated depressions whether or
not there is evidence of a manic or manic-like episode in the past.
The dosage of antidepressants varies, depending on the type of
drug, the person's body chemistry, age, and, sometimes, body weight.
Dosages are generally started low and raised gradually over time
until the desired effect is reached without the appearance of
troublesome side effects.
There are a number of different types
of antidepressant medications available. They differ in their side
effects and, to some extent, in their level of effectiveness.
Tricyclic antidepressants (named for their chemical
structure) used to be the most commonly used medications for
treatment of major depressions.
Monoamine oxidase inhibitors
(MAOIs) were often used for "atypical" depressions in which there
are symptoms like oversleeping, anxiety, panic attacks, and phobias.
More recently, newer antidepressants have been developed.
Several of them are called "selective serotonin reuptake
inhibitors" (SSRIs). Some examples of SSRIs are fluoxetine (Prozac),
fluvoxamine (Luvox), paroxetine (Paxil), and sertraline (Zoloft).
(Luvox has been approved for obsessive-compulsive disorder , and
Paxil has been approved for panic disorder.) Though structurally
different from each other, all the SSRI antidepressant effects are
due to their action on one specific neurotransmitter, serotonin. Two
other antidepressants that affect two neurotransmitters serotonin
and norepinephrine have also been approved by the FDA. They are
venlafaxine (Effexor) and nefazodone (Serzone). All of these newer
antidepressants seem to have less bothersome side effects than the
older tricyclic antidepressants.
The tricyclic
antidepressant clomipramine (Anafranil) affects serotonin but is not
as selective as the SSRIs. It was the first medication specifically
approved for use in the treatment of obsessive- compulsive disorder
(OCD). Prozac and Luvox have now been approved for use with OCD.
Another of the newer antidepressants, bupropion
(Wellbutrin), is chemically unrelated to the other antidepressants.
It has more effect on norepinephrine and dopamine than on serotonin.
Wellbutrin has not been associated with weight gain or sexual
dysfunction. It is contraindicated for individuals with, or at risk
for, a seizure disorder or who have been diagnosed with bulimia or
anorexia nervosa.
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Side Effects of Antidepressant Medications
Side Effects of Antidepressant Medication
1. Tricyclic Antidepressants :There are a number
of possible side effects with tricyclic antidepressants that vary,
depending on the medication. For example, amitriptyline (Elavil) may
make people feel drowsy, while protriptyline (Vivactil) hardly does
this at all and, in some people, may have an opposite effect,
producing feelings of anxiety and restlessness. Because of this kind
of variation in side effects, one antidepressant might be highly
desirable for one person and not recommended for another. Tricyclics
on occasion may complicate specific heart problems, and for this
reason the physician should be aware of all such difficulties. Other
side effects with tricyclics may include blurred vision, dry mouth,
constipation, weight gain, dizziness when changing position,
increased sweating, difficulty urinating, changes in sexual desire,
decrease in sexual ability, muscle twitches, fatigue, and weakness.
Not all these medications produce all side effects, and not
everybody gets them. Some will disappear quickly, while others may
remain for the length of treatment. Some side effects are similar to
symptoms of depression (for instance, fatigue and constipation). For
this reason, the patient or family should discuss all symptoms with
the doctor, who may change the medication or dosage.
Tricyclics also may interact with thyroid hormone,
antihypertensive medications, oral contraceptives, some blood
coagulants, some sleeping medications, antipsychotic medications,
diuretics, antihistamines, aspirin, bicarbonate of soda, vitamin C,
alcohol, and tobacco.
An overdose of these antidepressants
is serious and potentially lethal. It requires immediate medical
attention. Symptoms of an overdose of tricyclic antidepressant
medication develop within an hour and may start with rapid
heartbeat, dilated pupils, flushed face, and agitation, and progress
to confusion, loss of consciousness, seizures, irregular heart
beats, cardiorespiratory collapse, and death.
2. The
Newer SSRI Antidepressants : The most common side effects
of these antidepressants are gastrointestinal problems and
headaches. Some people complain of insomnia, anxiety, and agitation.
Because of the potentially serious interaction between these
medications and monoamine oxidase inhibitors, it is advisable to
stop taking one medication from 2 to 4 or 5 weeks before starting
the other, depending on the specific medications involved. In
addition, some SSRIs have been found to affect metabolism of certain
other medications in the liver, creating possible drug interactions.
As with all medications, be sure to tell your physician if any other
doctor, including your dentist, has prescribed any medications for
you. This is necessary to prevent potentially dangerous drug
interactions.
3. Monoamine Oxidase Inhibitors
(MAOIs): MAOIs may cause some side effects similar to those
of the other antidepressants. Dizziness when changing position and
rapid heartbeat are common. MAOIs also react with certain foods and
alcoholic beverages (such as aged cheeses, foods containing
monosodium glutamate (MSG), Chianti and other red wines), and other
medications (such as over-the-counter cold and allergy preparations,
local anesthetics, amphetamines, insulin, some narcotics, and
antiparkinsonian medications). These reactions often do not appear
for several hours. Signs may include severe high blood pressure,
headache, nausea, vomiting, rapid heartbeat, possible confusion,
psychotic symptoms, seizures, stroke, and coma. For this reason,
people taking MAOIs must stay away from restricted foods, drinks,
and medications. They should be sure that they are furnished, by
their doctor or pharmacist, a list of all foods, beverages, and
other medications that should be avoided.
Precautions to be Observed When Taking
Antidepressants
When taking antidepressants, it is
important to tell all your doctors (and dentists) about all
medications being used, including over-the-counter preparations and
alcohol. Antidepressants should be taken only in the amount
prescribed and should be kept in a secure place away from children.
When used with proper care, following the doctor's instructions,
antidepressants are useful medications that can control many of the
physical symptoms of depression, while you work on changing the life
stressors that contributed to its cause.
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