Antidepressants
Antidepressants are medicines used to improve low mood and are helpful in vast majority (70-80%) of people. Antidepressant act on areas of brain associated with mood and thinking and correct the imbalance of chemical messengers in the brain. Depression is thought to occur because of low levels of these chemicals or neurotransmitters. Most antidepressants take two to four weeks to build up and take effect. Our plan is to start you on the lowest effective dose of the antidepressant, which belongs to the group selective serotonin reuptake inhibitors and to see you in 1-2 weeks after commencing the treatment. The dose can then be gradually increased after consulting you about its effect and side effects. Side effects and discontinuation symptomsLike other medicines antidepressants also have some side effects and they occur because in addition to the areas of brain where we want them to work, they also have effect on some other sites. Most people have minor or no side effects but it is important that you are aware of the side effects so if you are troubled by any of them you can get in touch and seek help. The possible side effects include nausea, vomiting, diarrhoea, sleep problems, loss of appetite and restlessness or anxiety. Most of the side effects occur in the early part of the treatment and as the body becomes used to the medicine they gradually ease away. It is important to take the antidepressant regularly and it is not advisable to stop them suddenly even if you are feeling better in your mood. This can cause your depression to come back and you might experience mild discontinuation symptoms, which can include anxiety, agitation, headache, dizziness, electric shock sensations in the head and abdominal cramps. Non addictive Antidepressants are not addictive. A drug is said to be addictive if it causes craving, increasing amounts need to be taken to gain the same effect, withdrawal symptoms occur and when it is hard to control its use. Discontinuation symptoms are not the same as withdrawal symptoms. They occur when body is suddenly deprived of the medicine and does not have time to adjust to its absence. If the medicine is to be discontinued it’s dose is gradually decreased and then stopped. If you are asked about suicidal potential of Prozac There has been a lot of publicity in the media about the link between suicidal thoughts and Prozac (Fluoxetine). The Committee for the Safety of Medicines (CSM) has thoroughly investigated the evidence and did not find a link. Suicidal thoughts commonly occur as part of the depressive symptomatology. Interactions There are some over the counter medicines like painkillers, antihistamines and St John’s wort, which can interact with your antidepressants so it is best to discuss with the pharmacist or your doctor before starting any new treatment. Duration of treatment
The first episode of depression should be treated for 4-6 months after resolution of symptoms. Patients with two previous episodes should be treated for at least 2 years. In recurrent depression treatment may be required for many years.
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