Do you know any albino black Jewish lesbians on Zoloft? J That?s the name of an off-broadway play written by a friend of mine. It illustrates how much drugs for depression have woven into all of our lives. I?m not here today to tell you that you need these drugs, but I certainly won?t discourage their use because frankly I make a living prescribing them. Instead I?m here to do three things: 1) to help you know when you might need these drugs, 2) to explain how these drugs work, and 3) to show how a doctor might pick the best drug for you.
Deciding to take a drug for depression can be hard for some people. It?s easy for me to tell someone they should take a drug, but in the end the patient decides for himself and I can?t force him. Some reasons I might recommend someone to take a drug for depression are: 1) missing work, 2) being suicidal, 3) having no energy or motivation, and 4) being blue for no apparent reason.
Like many things in life, it?s a judgment call. You have to weight the risk of not taking the drug against the possible benefits of being on it.
If someone?s life drags to the point of missing work, using a drug could mean a big difference. For those who are able to work and care for their family, taking a drug can give them enough of a boost to keep their heads above water. Other people may only be mildly depressed, but they either won?t or can?t find other ways to deal with their depression without medicine. Of course, other options exercise, meditation, finding a new hobby or interest, or just eating better.
The bottom line goes back to the pros and cons for using or not using a drug. You know like deciding on whether you want to be married or not. J
How do drugs for depression work? The theory hinges on what is called a neurotransmitter. This is a chemical that carries a message from one nerve cell to another. In the brain, three main chemicals paint the picture of depression in a person?s life. Today we are going to talk about serotonin, and call it the S chemical, because it is the most popular target of depression drugs.
Let's look at how Prozac works. Let?s take that door to be the entrance to this room. Let?s say that the S chemical, a few humans like us, need to come in from this entrance and exit this other door to get a message across to the brain to "Be Happy". These messengers are blindfolded and groping around for the exit, bumping into walls in the meantime. J What?s more is they are also being constantly pulled back out the door by a rope around their necks.J If their message to "Be Happy" is not sent enough times out this exit, then depression occurs.
Prozac stops the S chemical from being pulled back out the entrance. This leaves more of the S chemical to exit and convey the message to "Be Happy". Don?t worry, use Prozac! J
A common question asked by a patient is, "Which is the best drug for depression?" This is not an easy question. I am sorry to inform you that there is no way for a doctor to know for sure which drug is best for any given person. Everyone?s body and brain are different and each drug has a different effect on each person. Even if statistics show a drug had less side effects than another, we don?t know if that would hold true for that one person because his unique reaction is still unpredictable.
In general, most doctors today use drugs from a group that Prozac is in. Other drugs in this class are: Zoloft, Celexa, and Paxil. After prescribing medicine for over twenty years, drugs have taken on personalities for me. Knowing these traits helps a doctor decide which drug would fit a person?s kind of depression.
Prozac is like a tall, distinguished gentlemen, dressed in a tuxedo, who is quite the life of the party. Prozac has been around the longest and still is the most popular. Its effect in the body also lasts long and in general it has an activating effect on a person. It is known as the "gold" standard to which all others are compared.
Zoloft and Celexa are like a clean and neat professor and his prot?, both of them medium built -- Zoloft is the older and Celexa is the newer. I?ve put them together because they share similarities Neither activates or sedates too much. They also both have what is called linear pharmacokinetics: this means when you take more of each drug, you will find more in the blood stream; they are predictable. The other SSRI?s don?t act this way. Both Zoloft and Celexa also are felt to have fewer side effects and rare reactions when mixed with other drugs.
Paxil is like a short, mellow fellow that drifts around. It stays the shortest in the body and has been noted to have some withdrawal effects when stopped. Paxil has tended to be more sedating and has been indicated for a number of anxiety disorders.
Any of the drugs I've discussed can be used to begin a course of treatment for depression. All of them work at about the same rate -- about 70% of all patients treated will get better.
Having the blues is no fun for anyone, but just know that drugs are out there to help if you ever need them. I?ve talked about some of the reasons to use drugs for depression. Each of us has to decide when we feel enough of a need to take them. I?ve talked about how these drugs work. I?ve talked about the traits of some of the more popular drugs. We have no reason the sing the blues. Let?s be assured we can beat the blues if they ever come around!
- ‹ previous
- 3 of 6
- next ›