Antidepressants – types, indications and side effects. Antidepressants and alcohol

Proven content

According to doctors, anti-depressants are becoming more and more often new, too easily available happiness pills. Meanwhile, they have many negative side effects: they increase weight, promote type 2 diabetes, can be addictive, and if taken during pregnancy, they increase the risk of prematurity.

Definition of antidepressants

Antidepressants are drugs that have a strong effect on the nervous system. Their task is to balance the level of brain neurotransmitters that are responsible for well-being and mood. The deficiency of key neurotransmitters, which include serotonin and dopamine, can cause depressive disorders.

Antidepressants belong to the group of psychotropic drugs used in the treatment of mental disorders, such as depression or affective diseases. Antidepressants are used in the treatment of obsessive-compulsive disorders, social phobias, panic disorders, anxiety-depressive disorders and post-traumatic stress disorder. People struggling with neurasthenia, chronic and neuropathic pain also take antidepressants.

Types of antidepressants

Due to the mechanism of action and chemical structure, we divide antidepressants into several groups. The first of these are neurotransmitter reuptake inhibitors. Their task is to inhibit the reuptake of such hormones as dopamine, serotonin and noradrenaline in the central nervous system. Thanks to this increase in the concentration of these compounds, the patient’s condition improves.

We include reuptake inhibitors:

1. tricyclic drugs to prevent depression, such as imipramine, doxepin or clomipramine,
2. noradrenaline and dopamine reuptake inhibitors, i.e. reboxetine, bupropion or amineptine,
3. tetracyclic antidepressants such as maprotiline
4. selective serotonin reuptake inhibitors such as paroxetine, citalopram or sertraline.

Tricyclic antidepressants, or TLPDs for short, are the first generation of drugs that were introduced to treatment in the 60s. They are usually used to treat endogenous depression and obsessive-compulsive syndrome. Most preparations of this type have a cholinolytic effect, they also lower blood pressure and increase heart rate. The use of this type of antidepressant is dangerous for patients with cardiac disorders.

Selective serotonin reuptake inhibitors, abbreviated as SSRIs, are among the most commonly used antidepressants. These are second-generation drugs classified as the most modern type of antidepressant. Many years of research and observations indicate that they are better tolerated than TLPDs.

They work well in the treatment of mild depression and in the treatment of emotional disorders, social phobias and panic attacks. SSRI antidepressants are not recommended for breastfeeding women, people suffering from epilepsy and parkinson’s disease, and patients with renal and hepatic insufficiency.

They are also available in the market drugs with receptor mechanisms of actionwhich include:

1. adrenergic antagonists such as mirtazapine,
2. serotonin reuptake inhibitors, such as trazodone and nefazodone,
3. mianserin-type α2 receptor antagonists.

Your doctor may prescribe drugs with other mechanisms of action, including acetylcholine precursor (e.g. deanol), increased serotonin reuptake (e.g. thianeptine), and melatonin and serotonin receptor agonists (e.g. agomelatine).

When should I take antidepressants?

Appropriate pharmacological treatment is selected after consultation with a psychiatrist or psychologist. Drug therapy usually lasts from several to several months and requires absolute systematic and dosing of drugs. Discontinuation of the treatment or reduction of the dose of medication without prior contact with a doctor may result in relapse of the disease.

Is it worth using the help of a psychologist? Read: Psychological consultation – when is it worth using?

Antidepressants in pregnancy

The use of antidepressants by pregnant women significantly increases the risk of prematurity. This means that prescribing such drugs at any time during pregnancy must be limited to those where there is no alternative to antidepressants.

According to team leader Dr. Krista Huybrechts of Brigham & Women’s Hospital, the number of premature births has increased over the past two decades in the US and across Europe and is becoming a huge problem. At the same time, the rate of antidepressant use during pregnancy quadrupled. It became necessary to find out if there is a relationship and what effect these drugs have on the course of pregnancy, she noted in a statement for CNN.

Risks of taking antidepressants in pregnancy

According to American scientists, pregnancy complications, including premature birth, are caused not by the mother’s depression, but by the antidepressants she used. In this situation, it is crucial that a woman who is pregnant during the first visit to her treating physician says that she is taking antidepressants and what medications they are.

Taking antidepressants poses the greatest risk to women in the third trimester of pregnancy. At the same time, they do not have a positive effect on the mental state of the future mother in this period. Taking antidepressants while pregnant may put your baby at risk of having a premature baby. Prematurity means an increased risk of neonatal death and the risk of conditions such as cerebral palsy and asthma.

Prematurity is also responsible for the development of many diseases and psychomotor delays that appear in later years, e.g. after the age of 15, such as a delay in physical development, a tendency to obesity or diabetes, but also mental disorders resulting in, for example, anorexia. The intellectual capacity of premature babies in many cases is also lower than that of full-term babies.

Pregnant women diagnosed with depression require non-standard, personalized therapy. This does not mean, however, that you should stop treating depression during pregnancy. But pharmacological agents can only be administered when other treatments, such as psychotherapy, are ineffective.

Do you want to know more about psychotherapy? Read: Psychotherapy – A Quick Guide

Negative effects of antidepressants

The negative side effects of treatment with antidepressants include the possibility of addiction. Overuse of antidepressants can lead to irreversible damage to health and death. Taking antidepressants results in frequent headaches and stomachaches, dry mouth and digestive system disorders.

Antidepressants can cause problems with concentration, they affect erectile dysfunction and decrease libido. After taking medications, patients may struggle with excessive sleepiness, muscle tremors and a feeling of internal shaking. A common side effect is also photosensitivity and increased sweating.

Do antidepressants increase the risk of suicide in sick people?

According to some scientists, the use of antidepressants can induce aggressive behavior, including suicide. The risk of such behavior increases at the start of treatment and when changing medications. The problem also appears after about 2 or 3 weeks from the start of treatment, when the patient’s body, although in a better condition, still has a depressed mood.

Treatment with antidepressants has the greatest effect on people who are teenagers. Studies show that the use of antidepressants by adolescents causes a 2-fold increase in the risk of suicide and significantly increases aggression.

Antidepressants and obesity

In addition to gastrointestinal disorders and dry mouth, the increase in body weight arouses the greatest reluctance towards people taking pharmacological therapy with antidepressants. Taking antidepressants results in an increase in weight of about 5 kg in a quarter of people suffering from depression. The anti-depressants that cause weight gain include mainly tricyclic drugs and MAO inhibitors.

Find out more about obesity. Read: Obesity

Antidepressants and alcohol

Combining antidepressants with alcohol is very dangerous because the two substances interact with each other. The toxicity of alcohol increases and its effect on the body is multiplied, which results in impaired concentration, hyperhidrosis, aggressiveness and slowing down of thought processes. At the same time, the effects of antidepressants, causing memory problems, unconsciousness and hallucinations, can be increased.

What Are Alcohol Diseases? Read: Alcohol Disease – What is it?