Medications for Depressions

Medications for Depression - here are some medications for depression and how they work - from emotionalhealth.com

Selective Serotonin Reuptake Inhibitors (SSRIs)
Generic name (brand name) Side effects
citalopram (Celexa) Nausea; diarrhea or constipation; weight loss or gain; anxiety; insomnia (occasionally drowsiness); headache; sweating; dry mouth; and sexual problems (see “Sexuality and SSRIs”). Bleeding problems are uncommon, but do sometimes occur.
escitalopram (Lexapro)
fluoxetine (Prozac)
fluvoxamine (Luvox)
paroxetine (Paxil)
sertraline (Zoloft)
Note: For precautions regarding the use of these medications during pregnancy, see Expectant and New Mothers.



How SSRIs Work
When neurotransmitters such as serotonin bind with receptors on a neighboring neuron, they carry the impulse to the next cell. But in someone with an anxiety disorder, the cell that released the serotonin may reabsorb it too quickly. As a result, there may not be enough serotonin available to bind to the next cell and allow the signal to pass. SSRIs slow the reuptake of serotonin, leaving more of this neurotransmitter in the synapse. This permits it to work for a longer time, improving the transmission of nerve impulses.


Newer Antidepressants
Generic name (brand name) Side effects
bupropion (Wellbutrin) Anxiety; dry mouth; sweating; loss of appetite; sleep problems
Can trigger seizures and psychosis in people who have an underlying condition that makes them vulnerable to these problems
duloxetine (Cymbalta) Nausea; dry mouth; dizziness; sexual problems; anxiety; loss of appetite; at higher doses, rise in blood pressure
mirtazapine (Remeron) Drowsiness or sedation; constipation; dry mouth; increased appetite; weight gain
venlafaxine (Effexor) Nausea; insomnia; dry mouth; dizziness; sleep problems; sexual problems; blurred vision; anxiety; loss of appetite; at higher doses, rise in blood pressure
Note: For precautions regarding the use of these medications during pregnancy, see Expectant and New Mothers.



Tricyclic Antidepressants (TCAs)
Generic name (brand name) Side effects
amitriptyline (Elavil, Endep) Dry mouth; blurred vision; dizziness when changing postures (for example, going from sitting to standing); drowsiness; weight gain; constipation; trouble urinating; disturbance of heart rhythm (arrhythmia)
clomipramine (Anafranil)
imipramine (Tofranil)
nortriptyline (Aventyl, Pamelor)
Note: For precautions regarding the use of these medications during pregnancy, see Expectant and New Mothers.



Mood Stabilizers
Generic name (brand name) Side effects
lithium carbonate (Eskalith, Lithonate) Excessive thirst; frequent urination; memory problems and poor concentration; tremors; weight gain; drowsiness; diarrhea; occasional low-thyroid problems or, more rarely, heart or kidney problems over time
carbamazepine (Tegretol) Fatigue; nausea; dizziness; unsteadiness; double or blurred vision
Rarely: lowered blood cell counts; impaired liver function
gabapentin (Neurontin) Coordination problems; abnormal dreams or thinking; anemia; irregular heartbeat; agitation or nervousness
lamotrigine (Lamictal) Fatigue; rash; headache; blurred or double vision; dizziness; nausea; memory or concentration problems
Rarely: lowered blood cell counts; impaired liver function
topiramate (Topamax) Lack of coordination; dizziness; abdominal pain; fatigue; memory difficulties; nervousness; drowsiness; speech problems; nausea; tremors; sensations such as tingling, burning, or hypersensitivity; rapid movement of the eyes; upper respiratory infections; mood problems
Rarely: abdominal pain; weight loss
valproate (Depakote) Nausea, indigestion, vomiting, or diarrhea; tremors; sedation; hair loss; increased appetite and weight gain
Rarely: impaired liver function; lowered blood cell counts; inflamed pancreas
Note: For precautions regarding the use of these medications during pregnancy, see Expectant and New Mothers.



Antipsychotics
Generic name (brand name) Side effects
clozapine (Clozaril) Drowsiness; excess salivation; dry mouth; blurred vision; constipation; dizziness; transient fever; rapid heartbeat; seizures at higher doses; potentially dangerous drop in white blood cell counts, which requires frequent, regular monitoring
olanzapine (Zyprexa) Drowsiness; weight gain; dry mouth; dizziness; weakness; upset stomach or constipation; anxiety or agitation; headache; fast heartbeat
Rarely: movement disorders; seizures; very low blood pressure
quetiapine (Seroquel) Headache; drowsiness; dizziness; constipation; dry mouth; weight gain; rapid heart rate or low blood pressure; upset stomach; altered liver or thyroid function
Rarely: movement disorders; low blood cell counts; seizures
risperidone (Risperdal) Drowsiness; anxiety; dizziness; constipation or diarrhea; nausea or stomach upset; rapid heart rate; increased dreaming; visual disturbances; weight gain
Rarely: movement disorders
Note: For precautions regarding the use of these medications during pregnancy, see Expectant and New Mothers.



Anti-Anxiety Medications
Generic name (brand name) Side effects
Benzodiazepines including:
alprazolam (Xanax)
clonazepam (Klonopin)
lorazepam (Ativan) Clumsiness or unsteadiness; drowsiness; cognitive impairment; dizziness; headache; tolerance may develop
buspirone (BuSpar) Chest pain; dizziness; headache; nausea
Note: For precautions regarding the use of these medications during pregnancy, see Expectant and New Mothers.



Monoamine Oxidase Inhibitors (MAOIs)
Generic name (brand name) Side effects
isocarboxazid (Marplan) Dizziness when changing postures; diarrhea; nervousness or trembling; drowsiness; mild headache; weight gain, with cravings for sweets; disturbed sleep
Rarely: dangerously high blood pressure if foods containing tyramine are eaten; abnormal liver function
phenelzine (Nardil)
tranylcypromine (Parnate)
Note: All antidepressants may cause agitation and restlessness; involuntary movements, such as tics and tremors; and suicidal thoughts or behaviors, particularly in the first weeks of treatment. These side effects are rare.
Note: For precautions regarding the use of these medications during pregnancy, see Expectant and New Mothers.


Sexuality and SSRIs


One drawback to SSRIs is that they frequently dampen sexual response. One study suggested that as many as half of all people taking these medications may experience some sexual problems. In addition to reducing interest in sex, SSRIs can make it difficult to become aroused, sustain arousal, and reach orgasm. Some people taking SSRIs aren’t able to have an orgasm at all. If you experience any sexual problems while taking an SSRI, talk with your doctor or therapist. In some cases, sexual difficulties may stem not from the medication, but rather from the underlying depression. If your medication is the problem, your doctor or therapist may suggest one of the following strategies:
Lowering the dose. Sexual side effects may subside at a lower, although still therapeutic, dose.

Taking a drug holiday. Depending on how long the drug usually remains in your body, you might stop taking it for a few days before a weekend, if that’s when you hope to have sex. This is hardly spontaneous, but it can work if you carefully follow your doctor’s directions about how to stop and resume your medication. However, there is always a chance that this might cause a relapse.

Switching to a different drug. Certain antidepressants, such as bupropion (Wellbutrin), mirtazapine (Remeron), TCAs, and MAOIs, are less likely to cause sexual problems. There are some reports that bupropion may actually boost sexual drive and arousal, as well as the intensity or duration of an orgasm.
Adding a drug. In both men and women, sildenafil (Viagra) may counteract the negative sexual effects of SSRIs. Adding bupropion (Wellbutrin) to your treatment may also help.

Infidelity Forgive or Forget?

Many factors can ruin a relationship. Infidelity is one of the top reasons. Why is it that infidelity is hard to forgive and forget? The aftermath is usually longer than the actual affair. What are the effects of infidelity on a relationship?


Trust



Infidelity affects the trust level in a relationship. A relationship is a commitment to each other, together and apart. Infidelity breaks the trust that one has for their partner when they are apart. An affair is cloaked in location and activity lies. Therefore it is difficult to believe what one says.

If there are children in the relationship, they are being lied to also. The time spent away with the lover, is time away from the children. One must lie to them about their absence. Older children are keener, thus they can see through and dissect lies. Too many disappointments can lead to resentment in children. With resentment and lack of trust, it is impossible to have a healthy relationship with one’s children.


Lack of trust may cause constant suspicion and interrogation. This can create a tense and hostile home environment, even if the affair is over. The lingering aura of the affair is enough to cause spontaneous arguments.


Self Esteem


Infidelity hurts one’s partner, because it may attack their self-esteem. One begins to question their value and worth against their partner’s lover. What is it that he/she has that I don’t have? Are they younger, slimmer, more handsome? Self-analysis easily transpires into self-criticism.


Self-destructive criticism manifests into a self-fulfilling prophecy. One who feels ugly, sometimes becomes ugly. Depression is a highly plausible result of destructive self-criticism. Depression literally depresses drives and motivation. The desire to care for one’s physical appearance begins to decline, and then disappear. The infidelous partner uses this as an excuse for their infidelity. In actuality they have directly contributed to it. Low self-esteem in one’s partner can manifest in any ways other than depression. It can cause the offended partner to become adulterous, themselves.


Partners and spouses are not the only ones to suffer a self-esteem blow when one cheats. Children begin to question their worth when they witness a parent’s infidelity. Many may blame themselves for the parent’s absence. They may feel that they are not good enough, or behave well enough for the parent to want to be with them. They may feel that they have driven the parent away.


These can lead to anxieties in a child such as perfectionist behavior or obsessive-compulsive disorder. Girls who grow up with an adulterous father may develop trust issues with men when they grow up. Or she may have hostile feelings towards men because of what she witnessed her mother endure, when she was a child.


Boys who witness infidelity may have low respect for women as their father did for their mother. They may feel that being a man is equal to being adulterous. If their mother is the adulterous one, he may view women as immoral and have issues of trust or resentment towards them.


Image


If one holds a high profile position, locally or internationally, infidelity can ruin one’s public image. Politicians, religious leaders and activists cannot afford any moral based scandals. Infidelity can cost a high profile person their career. The American public is infatuated with infidelity on the big and small screen. But many are quite unforgiving of infidelity in their leaders.


Infidelity is an expensive habit. If it leads to divorce of a marriage, the legal judgments may be affected by infidelity. Pain, suffering and alimony allotments are weighed against the reason of the marriage dissolution.


Infidelity can also affect child custody rulings. Character judgments will be filtered through the affair. It may be embarrassing for the adulterer and their lover to be publicly scrutinized. Infidelity usually makes for a messy divorce. And post divorce relationships can often be bitter and hostile.

Infidelity causes inter-generational as well as career damage. Some of this damage can be repaired through professional counseling. But some damage is irreparable. Before entering into an affair, remember that the effects of infidelity are sometimes temporary, but many times it can be permanent.