Antidepressant therapy is primarily a medication-based approach used to alleviate symptoms of depression and other related mood disorders. Its core goal is to regulate the balance of neurotransmitters in the brain, improving symptoms such as low mood, insomnia, and abnormal appetite.
This therapy typically requires combination with psychotherapy or lifestyle adjustments to enhance overall efficacy. Physicians select the most suitable medication type and dosage based on the patient's age, severity of symptoms, and physical condition.
Antidepressants are mainly divided into five categories: SSRIs (Selective Serotonin Reuptake Inhibitors), SNRIs (Serotonin-Norepinephrine Reuptake Inhibitors), NDRIs (Norepinephrine-Dopamine Reuptake Inhibitors), TCAs (Tricyclic Antidepressants), and MAOIs (Monoamine Oxidase Inhibitors). SSRIs like Fluoxetine are the most common, primarily increasing serotonin levels to enhance mood.
The mechanisms include blocking neurotransmitter reuptake, modulating receptor sensitivity, or affecting neurogenesis. For example, SNRIs can simultaneously elevate serotonin and norepinephrine levels, suitable for depressed patients with comorbid anxiety.
This therapy is applicable for moderate to severe depression, generalized anxiety disorder, panic disorder, and post-traumatic stress disorder (PTSD). Certain drugs like Venlafaxine can also be used for chronic pain or menopausal mood instability.
Physicians may combine it with other therapies, such as using Bupropion for seasonal depression or smoking cessation.
Medications are usually taken orally in tablet or capsule form, typically in the morning or before sleep to reduce side effects. The starting dose for SSRIs is generally 20-40 mg, while SNRIs like Duloxetine may start at 30 mg, with dose adjustments based on response.
Treatment requires 4 to 6 weeks to evaluate effectiveness. Patients should not stop medication on their own to avoid withdrawal reactions. Physicians will adjust doses or switch medication types based on symptom improvement.
Antidepressants can effectively reduce suicidal tendencies, improve cognitive function, and enhance social functioning. SSRIs are preferred as first-line treatments due to fewer side effects; SNRIs have significant effects on alleviating anxiety-related symptoms.
Common short-term side effects include dry mouth, nausea, dizziness, and sexual dysfunction. SSRIs may increase bleeding risk; concurrent use with anticoagulants should be avoided during treatment.
Serious risks include:
Contraindications include allergy to drug components, severe hepatic or renal impairment, and at least a 14-day interval when used with MAOIs.
Pregnant women should evaluate risks before use, as some medications may increase miscarriage or neonatal complications. Elderly patients should start with low doses due to slower metabolism and risk of accumulation and toxicity.
Combining SSRIs with non-steroidal anti-inflammatory drugs may increase gastrointestinal bleeding risk; combining with MAOIs may trigger hypertensive crises.
Electroconvulsive therapy (ECT) or psychotherapy can be combined with medication, but drug metabolism should be monitored during ECT sessions.
Large clinical trials show that SSRIs achieve remission rates of 50-60% after 6 weeks of treatment, with sustained effects observed over 6 months. Long-term follow-up studies confirm that medication can reduce the risk of suicidal behavior by 70%.
Individual responses vary; about 30% of patients need to try 2-3 medications to achieve optimal results. Genetic testing can help predict the metabolism efficiency of specific drugs, enhancing personalized treatment.
Non-drug therapies include Cognitive Behavioral Therapy (CBT), Mindfulness-Based Stress Reduction (MBSR), and Transcranial Magnetic Stimulation (TMS). Psychotherapy is preferred for mild depression or as an adjunct in severe cases.
Electroconvulsive Therapy (ECT) is effective for treatment-resistant depression but may cause memory impairment. Herbal remedies like St. John’s Wort are only suitable for mild symptoms and should be used cautiously due to potential interactions.
Common side effects such as dizziness and insomnia during the initial phase usually diminish within 2-4 weeks. If symptoms severely affect daily life, consult your doctor to adjust the dose or switch medications, but do not stop medication on your own. The doctor will evaluate whether to modify the treatment based on individual response.
Can I drink alcohol or take Chinese medicine while on medication?Alcohol may exacerbate side effects like drowsiness or dizziness and can cause abnormal liver metabolism. It is recommended to avoid alcohol completely during treatment. If you are using Chinese medicine or herbal preparations, inform your doctor to avoid interactions, as some herbs may reduce drug efficacy or increase side effects.
Can I adjust the medication dosage myself during treatment?No, do not alter the dose or stop medication without medical guidance. Dose adjustments should be made gradually as instructed by your doctor. If symptoms worsen, or if there are signs of increased anxiety or suicidal thoughts, seek medical evaluation immediately. Strict adherence to medical advice is essential for safety and effectiveness.
What lifestyle changes should I make during treatment?Regular sleep, exercise (such as 30 minutes of aerobic activity three times a week), and a balanced diet (including increased Omega-3 fatty acids) can enhance medication efficacy. Keeping a diary to track mood changes and medication responses is recommended. Avoid stressful lifestyles to improve treatment outcomes.
How long should I continue medication after successful treatment before stopping?Generally, medication should be continued for at least 6-9 months after symptom remission, followed by gradual tapering under medical supervision. Rapid discontinuation may cause withdrawal symptoms such as dizziness and anxiety rebound. Regular follow-up for at least 2 years is recommended to prevent relapse.
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