If you struggle with new or chronic depression don’t continue to suffer; the help is available. Depression can be very harmful and rare cases deadly. Please talk to your healthcare provider about depression.
Medication and psychotherapy are common treatments for depression. Psychotherapy, also referred to as talk therapy, entails receiving therapy from a therapist. Antidepressants, such as selective serotonin reuptake inhibitors (SSRIs), are among the medications. In cases of more severe depression, doctors might suggest taking antidepressants along with psychotherapy.
We might start you off with some simple anti-depressant medications called SSRIs.
Selective serotonin reuptake inhibitors (SSRIs) are a class of medications commonly used to treat depression. Here are some of the most frequently prescribed SSRIs:
Fluoxetine (Prozac) – Often chosen for its activating effects, which can be beneficial for patients with atypical depression or those who experience significant fatigue.
Sertraline (Zoloft) – Known for a slightly broader range of anxiety disorder treatment in addition to depression, making it a good choice for patients with co-occurring anxiety symptoms.
Citalopram (Celexa) – It’s favored for its simplicity and effectiveness, although doses higher than 40 mg per day are generally avoided due to the risk of QT interval prolongation.
Escitalopram (Lexapro) – Similar to citalopram but often preferred due to its potentially fewer side effects and greater efficacy for some patients.
Paroxetine (Paxil) – Effective but can be associated with weight gain and withdrawal symptoms, so it’s usually not the first choice for young people.
Fluvoxamine (Luvox) – Typically used more frequently for obsessive-compulsive disorder, it’s also effective for depression.
Each SSRI has a slightly different profile in terms of side effects, interactions, and specific indications, making the choice of which to prescribe dependent on individual patient factors.
SNRIs Usage in Depression
Serotonin-norepinephrine reuptake inhibitors (SNRIs) are a class of antidepressants that are used to treat major depressive disorder by increasing the levels of serotonin and norepinephrine in the brain. These neurotransmitters are believed to help regulate mood. SNRIs can be an alternative to SSRIs, especially if a patient has not responded well to SSRIs or has specific symptoms that may be better addressed by SNRIs.
Commonly prescribed SNRIs include:
Venlafaxine (Effexor) – Effective for severe depression and also used in the treatment of anxiety disorders.
Duloxetine (Cymbalta) – Used for depression and chronic pain conditions, which can be comorbid.
Desvenlafaxine (Pristiq) – Similar to venlafaxine but with a potentially simpler dosing regimen and fewer drug interactions.
Treatment of Treatment-Resistant Depression
Treatment-resistant depression (TRD) refers to depression that does not respond adequately to at least two different antidepressants taken at a therapeutic dose for an adequate duration. Managing TRD can be complex and may involve several strategies:
Optimization of Medication: Ensuring the dosage of the current medication is maximized within safe limits before switching.
Switching Antidepressants: Trying different classes of antidepressants, such as moving from an SSRI to an SNRI or other classes.
Combination Therapy: Using two or more antidepressants from different classes simultaneously. Sometimes adding a medication from another category, like a mood stabilizer or antipsychotic, can be beneficial.
Psychotherapy: Cognitive-behavioral therapy (CBT), psychotherapy, or counseling can be effective, especially when combined with medication.
Transcranial Magnetic Stimulation (TMS): A noninvasive procedure that uses magnetic fields to stimulate nerve cells in the brain to improve symptoms of depression. We currently do not offer (TMS) but can help you find someone who does!
Ketamine or Esketamine: These are used in cases of severe, refractory depression. Esketamine (nasal spray) has been FDA approved for treatment-resistant depression. We currently don’t offer Ketamine treatments but can help you find someone who does!
Each approach has its benefits and risks, and the choice often depends on individual patient factors, including past treatment history, current health status, and personal preferences. We cater treatment to the patient’s specific needs. Regular follow-up and close monitoring are crucial, especially when initiating a new treatment regimen for TRD.
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