Antidepressants

antidepressant

antidepressant, any of a wide range of drugs used to treat psychic depression. They are given to elevate mood, counter suicidal thoughts, and increase the effectiveness of psychotherapy. Before the introduction of such drugs in the late 1950s, most patients with major depression had no recourse but hospitalization; only 45% improved after one year. In contrast, 80%–90% of such patients can expect significant relief from depression with one of the medications now prescribed.

Antidepressants act on the flow of the neurotransmitters epinephrine, serotonin, and norepinephrine across neural synapses. Common antidepressants include monamine oxidase inhibitors (MAOIs) such as isocarboxazid (Marplan), tricyclics such as imipramine (Tofranil) and amitriptyline (Elavil), and the newer selective serotonin reuptake inhibitors (SSRIs) as fluoxetine (Prozac) and sertraline HCL (Zoloft). Venlafaxine (Effexor) inhibits both serotonin and norepinephrine reuptake.

The choice of antidepressant often has more to do with its side effects (variously sedation, constipation, hypotension, tachycardia, weight gain, sexual dysfunction) than efficacy, as they are generally regarded to be equally effective. The newer drugs, especially SSRIs, are tolerated better and are currently by far the most widely prescribed, but SSRIs also appear to be less effective in children and teenagers and may cause some of them to become suicidal.

The Columbia Encyclopedia, 6th ed. Copyright© 2014, The Columbia University Press.

Selected full-text books and articles on this topic

Your Drug May Be Your Problem: How and Why to Stop Taking Psychiatric Drugs
Peter R. Breggin; David Cohen.
Perseus, 2000
Librarian’s tip: Includes discussion of antidepressants in multiple chapters
Better Than Prozac: Creating the Next Generation of Psychiatric Drugs
Samuel H. Barondes.
Oxford University Press, 2003
The Limits of Biological Treatments for Psychological Distress: Comparisons with Psychotherapy and Placebo
Seymour Fisher; Roger P. Greenberg.
Lawrence Erlbaum Associates, 1989
Librarian’s tip: Chap. 1 "Examining Antidepressant Effectiveness: Findings, Ambiguities, and Some Vexing Puzzles"
A Century of Psychiatry
Hugh Freeman.
Mosby, 1999
Librarian’s tip: "The Origin of Antidepressants" begins on p. 169
Dealing with Depression: A Commonsense Guide to Mood Disorders
Gordon Parker; David Straton; Kay Wilhelm; Philip Mitchell; Marie-Paule Austin; Kerrie Eyers; Dusan Hadzi-Paviovic; Gin Malhi; Sue Grdovic.
Allen & Unwin, 2004 (2nd edition)
Librarian’s tip: "Antidepressants" begins on p. 88
Psychopharmacology: Basic Mechanisms and Applied Interventions
John Grabowski; Gary R. Vandenbos.
APA Books, 1992
Librarian’s tip: "The Antidepressants" begins on p. 82
Depression in Later Life: A Multidisciplinary Psychiatric Approach
James M. Ellison; Sumer Verma.
Marcel Dekker, 2003
Librarian’s tip: Chap. 9 "Pharmacotherapy of Late-Life Depression Review and Recommendations"
Handbook of Chronic Depression: Diagnosis and Therapeutic Management
Jonathan E. Alpert; Maurizio Fava.
Marcel Dekker, 2004
Librarian’s tip: Chap. 19 "Management of Antidepressant-Induced Side Effects"
The Myth of Depression as Disease: Limitations and Alternatives to Drug Treatment
Allan M. Leventhal; Christopher R. Martell.
Praeger, 2006
Librarian’s tip: Chap. 2 "Welcome to the Brave New World"
Winter Blues: Everything You Need to Know to Beat Seasonal Affective Disorder
Norman E. Rosenthal.
Guilford Press, 2006 (Revised edition)
Librarian’s tip: Chap. Ten "Antidepressant Medications"
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