preparation for placement in the mental health sector
Antidepressant Medications
As an exercise physiology student in a mental health service, it can be helpful to have an understanding of the types of medications that maybe prescribed to the consumers you are working with, and to understand how this may impact your role.
Antidepressant medication is usually prescribed to help reduce the symptoms of depression in moderate to severe depression, and can be used in the treatment of some anxiety disorders (1). The length of time taken for an antidepressant to work varies from person to person, but usually an antidepressant effect occurs after approximately six weeks. For other people, it can take even longer to feel the effects of their medication, with the optimal effect usually occurring after six months of taking medication regularly (2).
Antidepressants were first developed in the 1950s. There are several different types of antidepressants used in Australia, as illustrated in the table below:
Categories of antipsychotic medication
The most commonly prescribed antidepressants are Selective Serotonin Reuptake Inhibitors (SSRIs). SSRIs are generally well tolerated by most people, and are generally non-sedating. SNRIs and RIMAs also tend to be better tolerated with fewer side effects than the older antidepressants, such as TCAs and MAOIs.
The information below about each class of antidepressant information is kindly provided by beyondblue (1).
Selective Serotonin Reuptake Inhibitors (SSRIs)
-
the most commonly prescribed antidepressants in Australia
-
often a doctors' first choice for most types of depression
-
generally well tolerated by most people
-
generally non-sedating.
Serotonin and Noradrenalin Reuptake Inhibitors (SNRIs)
-
have fewer side effects compared to the older antidepressants
-
are often prescribed for severe depression
-
are safer if a person overdoses.
Reversible Inhibitors of MonoAmine oxidase (RIMAs)
-
have fewer side effects
-
are non-sedating
-
may be less effective in treating more severe forms of depression than other antidepressants
-
are helpful for people who are experiencing anxiety or sleeping difficulties.
TriCyclic Antidepressants (TCAs)
-
effective, but have more harmful side effects than newer drugs (i.e. SSRIs)
-
more likely to cause low blood pressure – so this should be monitored by a doctor.
Noradrenaline-Serotonin Specific Antidepressants (NaSSAs)
-
relatively new antidepressants
-
helpful when there are problems with anxiety or sleeping
-
generally low in sexual side effects, but may cause weight gain.
Noradrenalin Reuptake Inhibitors (NARIs)
-
designed to act selectively on one type of brain chemical – noradrenalin
-
less likely to cause sleepiness or drowsiness than some other antidepressants
-
more likely to:
-
make it difficult for people to sleep
-
cause increased sweating after the initial doses
-
cause sexual difficulties after the initial doses
-
cause difficulty urinating after the initial doses
-
cause increased heart rate after the initial doses.
-
Monoamine Oxidase Inhibitors (MAOIs)
-
MAOIs are prescribed only under exceptional circumstances as they require a special diet and have adverse effects.
Are antidepressant medications addictive?
Antidepressant medications are not addictive medications, that is, an individual’s dose of medication will not need to continually increase in order to achieve the same effect. They do change the way people think and feel, so it is likely if someone ceases their medication against recommendations they may experience a relapse of symptoms (2).
What are the common side effects?
Antidepressant medication is generally effective, however, like with any medication, these drugs are not without side effects. The varying classes of antidepressant medication listed above each have a different side effect profile, but generally speaking, the most common side effects include those listed in the table below.
Common side effects of antipsychotic medication
Specific antidepressant medications
There are lots of different medications that patients may be on. This list below includes some of the antipsychotics that your patients may be on. Click on the hyperlinks below for specific information about individual medications.
SSRIs
-
Sertraline, such as Zoloft
-
Citalopram, such as Celepram
-
Escitalopram, such as Lexapro
-
Fluoxetine, such as Prozac
SNRIs
RIMAs
-
Moclobemide, such as Amira
TCAs
NaSSAs
NARIs
-
Reboxetine, such as Edronax
MAOIs
References:
-
beyondblue (2015) Treatments for depression Available from: https://www.beyondblue.org.au/the-facts/depression/treatments-for-depression/medical-treatments-for-depression (accessed on 23/11/2015)
-
Sane Austrlia (2015) Antidepressant medication Available from: https://www.sane.org/mental-health-and-illness/facts-and-guides/antidepressant-medication (accessed on 23/11/2015)
SSRIs
SNRIs
RIMAs
TCAs
NaSSAs
NARIs
MAOIs
Selective Serotonin Reuptake Inhibitors
Serotonin & Noradrenalin Reuptake Inhibitors
Reversible Inhibitors of MonoAmine oxidase
TriCyclic Antidepressants
Noradrenaline-Serotonin Specific Antidepressants
Noradrenalin Reuptake Inhibitors
Monoamine Oxidase Inhibitors
Sexual problems, agitation, nausea, dizziness, weight gain
Nausea, dizziness, weight gain , dry mouth, sleep problems
Sleep disturbances, dizziness, nausea, headache, dry mouth
Sexual problems, dizziness, weight gain, low blood pressure, constipation
Drowsiness, weight gain, headache, dry mouth, nausea
Difficulty sleeping, sexual problems, difficulty urinating, increased heart rate
Difficulty sleeping, sexual problems, dizziness, weight gain, somnolence, headaches, can’t eat food containing tyramine.
SSRIs
SNRIs
RIMAs
TCAs
NaSSAs
NARIs
MAOIs