The 6 types of antidepressants (and their characteristics)

Depression is a common mental disorder, with an estimated 300 million patients worldwide suffering from it. According to the World Health Organization (WHO), this syndrome is the leading cause of disability worldwide and, in addition, some 800,000 people kill themselves each year due to depressive disorders, without receiving medical attention adequate.

Depression goes far beyond sadness or apathy: there are underlying physiological mechanisms that explain it, at least in part. For example, low levels of circulating serotonin (a neurotransmitter) put a person at risk for depression, and certain neurotrophins (such as the factor neurotrophic derived from the brain, which promotes neuronal growth) decrease its expression in altered states of stress and anxiety, something that could be linked to the state depressant.

Even more shocking is the knowledge that brain-derived neurotrophic factor (BDNF) is displayed in levels alarmingly low in the brains of people who have committed suicide, regardless of their disorders psychiatric. These data and many more show that, clearly, hormones, neurotransmitters, neurotrophins and others Substances are linked to depressive states, far beyond a negative event in the life of a person.

As we talk about chemistry within our own body, we must accept that sometimes the treatment of altered states comes from the same premise: chemistry and pharmacology. Based on this very necessary idea, we tell you the 6 types of antidepressants that exist and their uses.

• We recommend you read: "8 signs of depression you might be ignoring"

How are antidepressants classified?

Today, about 15.5 million Americans have been using antidepressants for more than 5 years, triple the number in 2000. These data are usually presented in the non-specialized media as catastrophic, but nothing is further from the truth: the problem is the social conflict that causes depression and anxiety, not the drugs that help fight it.

Therefore, if you have seen a psychiatrist and they have prescribed a long-term treatment with antidepressants, do not be afraid: some may have certain effects. but their use may be very necessary to allow patients to overcome an emotional state that could end in disaster without this help chemistry. To help you alleviate the uncertainty a bit, we tell you closely the 6 most common types of antidepressants. Go for it.

1. Selective serotonin reuptake inhibitors (SSRIs)

As we have said before, low levels of circulating and brain serotonin are usually linked to depression disorders. Selective serotonin reuptake inhibitor (SSRI) antidepressants block serotonin absorption neurotransmitter by the presynaptic neuronal bodies, which allows the extracellular increase of serotonin in the synaptic cleft.

Serotonin modulates many processes in the human mind, including mood, sexual desire, attention, the feeling of reward and many other emotions. For this reason, drugs that increase their available concentration are used in disorders such as depression, in anxiety disorders generalized (chronic anxiety for more than 6 months), eating disorders, OCD and other events in people with problems of any kind psychological.

These drugs have been approved by the FDA (Food and Drug Administration), so do not it is necessary to distrust them, as long as a psychiatrist has prescribed it to the patient after an analysis previous. Some of the more common brand names for SSRIs are Celexa, Lexapro, Prozac, Sertraline, and Citalopram, among others.

2. Serotonin and norepinephrine reuptake inhibitors (SNRIs)

They are similar to SSRIs but, as their name suggests, they also inhibit the reuptake of the neurotransmitter norepinephrine, in conjunction with serotonin. Norepinephrine is an essential neurotransmitter that increases the rate of heart contractions, improves attention, increases blood pressure and blood sugar levels, a fact that translates into greater "activity" of the body at the level physiological.

It is not surprising, therefore, that a lack of norepinephrine in the patient results in fatigue, apathy, inattention and difficulty concentrating, very common symptoms in depressive disorders. Venlafaxine and duloxetine are the most marketed SNRIs for the treatment of depression.

3. Bupropion

This drug is part of a completely different category than those we have described previously. Bupropion is a psychostimulant, since it slightly inhibits the uptake of norepinephrine and dopamine, but its effectiveness has not been proven for more than 8 weeks of treatmentWhile SSRIs and IRSNs are prescribed for months and even years.

When drugs are used to treat depression, a very common secondary effect is a lack of sexual desire in the patient: we do not We are moving on anecdotal grounds, since it is estimated that 30 to 60% of the patients who consume the previously described drugs suffer from dysfunction sexual. Bupropion is usually used in those people who have experienced this effect from the consumption of other antidepressants, as it seems to increase libido.

4. Tricyclic antidepressants

These drugs receive their name due to their chemical structure, since they have 3 rings in their composition, with chemical names so bombastic like the following: 3- (10,11-dihydro-5H-dibenzo [a, d] cycloheptene-5-ylidene) -N, N-dimethyl-1-propanamine (formula corresponding to the amitriptyline).

Like the drugs named above, they limit the reuptake of neurotransmitters norepinephrine and serotonin, which allows the increase in their extracellular concentration to brain level. Anyway, the prescription of these drugs has decreased significantly since the popularization of SSRIs, from the 90s.

This decrease in their consumption is due to the fact that, generally, they cause more side effects than the previously described antidepressants. Some of the discomfort derived in patients can be constipation, a feeling of constant sleepiness, blurred vision, sporadic dizziness and other clinical events. For all these reasons and many others, today they are not usually prescribed.

5. Tetracyclic antidepressants

As their name suggests, these drugs are chemically composed of 4 rings instead of 3. The only examples that we can cite you in this category are maprotiline and mirtazapine., since the rest of the variants have been withdrawn from the market or have not yet begun to be marketed.

Unlike tricyclic antidepressants, these do not inhibit serotonin reuptake, but they do do this job with norepinephrine. They also act in a different physiological way with respect to the rest of the named drugs, but we are not going to dwell on their particularities in terms of the mechanism of action.

6. Monoamine oxidase inhibitors (MAOIs)

In this last group, we find completely atypical drugs on the list, as they do not prevent the reuptake of neurotransmitters at the neuronal level. MAOIs inhibit the activity of monoamine oxidase enzymes, which catalyze the degradation of neurotransmitters at the metabolic level.

Due to their properties, they have shown usefulness to treat disorders such as agoraphobia, social phobia, panic attacks and atypical depressions. MAOIs can have very serious adverse effects, so they are only used in clinical conditions where the rest of antidepressants have not had an effect.

Without going any further, there are foods (such as very strong cheeses, cured meats, certain sauces, alcoholic beverages and others) that may negatively interact with these drugs, so patients should follow a diet strict. For all these reasons, they are almost never the first choice when it comes to treating depression.

Resume

We want to take advantage of these last lines to make a small reflection that deals with the following sentence: antidepressants are not the enemy. It is common to see how many sources stain these drugs with negativity and dependence with “alarming” statistics and figures, but we repeat that the problem lies in the reasons that cause depression at both the individual and social level, not in the drugs devised to be able to treat it.

"Being well" is often not achieved by trying or only with psychological help, so you have to go to chemical compounds that help solve the physiological deficiencies derived from (or causing) certain disorders emotional Sometimes there is no other, whether the patient likes it or not, because the concern for their health and the danger of a Neurological imbalances are much greater than any expected side effects of an SSRI or SNRI.

Therefore, we hope that the day will soon come when a patient can say “I take antidepressants” without a deathly silence in the room. They are drugs that, like any other, have been devised to treat a physiological imbalance in the patient and say absolutely nothing about the person beyond the existence of a problem, like any other that is treated with antihistamines, non-steroidal anti-inflammatory drugs and a long etcetera. When society stops stigmatizing emotional imbalances, we can talk openly about them in familiar settings and save more lives.