Know Your Anti-Depressants – Even If You Don’t Plan to Take Them

It’s important to know your anti-depressants, before you reject them. Traditional anti-depressants do have their place, when dealing with severe forms of depression – but there are also very real hazards, too.

Serotonin Re-Uptake Inhibitors are modern psychiatrists’ first choice. These include such brand names as:

• Paxil

• Zoloft

• Effexor

• Wellbutrin

• Prozac

• Sarafem

They are considered the least potentially harmful of all the anti-depressants – though Mary P., of Newmarket, Ontario, would no doubt say otherwise, after spending the afternoon “paralyzed, but suspended above my body, feeling insanely powerful”, after her first (and only) dose of one of the above.

Tri-Cyclic Anti-Depressants block cell “receptors” and inhibit reabsorption of serotonin and norepinephrine. Another major job they do – which really works for some people – is to lower their sensitivity to glutamate.

Common Tri-Cyclics include:

• Amitriptyline

• Doxepin

• Imipramine

• Nortriptyline

All anti-depressants can cause common side effects such as:

• Loss of sexual interest and ability

• Constipation

• Headaches

• Weight gain (or loss)

• Exhaustion and lethargy; “loginess”

• Drowsiness

• Insomnia

And several more.

When it comes to taking anti-depressants, it’s really a case of “lesser evils” – the depression or the side effects.

Monoamine oxidase inhibitors (MAO-A inhibitors) are sometimes indicated, when Serotonin Re-Uptake inhibitors don’t work, particularly in cases of Atypical depression, Agoraphobia (fear of open spaces) and “social anxiety”.

MAO-A inhibitors decrease monoamine oxidase, which breaks down monoamine transmitters. Some common brands include:

• Parnate

• Nardil

• Emsam (patch)

With MAO-A inhibitors, there are normally-beneficial natural herbs that are actually contra-indicated:

• Passion Flower (Passiflora Incarnata)

• St. John’s Wort (Hypericum Perforatum)

Also, some foods can actually interact with MAO-A’s in a lethal fashion, causing death. Foods containing Tyramine and Tryptophan are the main offenders (almost everyone on MAO-A inhibitors has been cautioned about eating cheese.)

Fava beans, alcohol and liver are also on the “do not eat” list. Also, so many other medications that you are advised to waste no time in checking with your doctor for a complete list.

The old MAO-A inhibitors permanently destroyed monoamine oxidase, but newer ones do not do this. They are still a powerful drug it’s better not to mess with – and better to be 100% sure that you absolutely have to take! They can also be deadly, if you suffer from diabetes. Natural remedies may be your best solution, in this case. (Check with your health care professional.)

Anti-Psychotics are a class of drug often added to anti-depressants when auditory or visual hallucinations are involved.

This is a complex class of drugs, involving 2 generations. The first consists of 3 major groups: Butyrophenones, Phenothiazines and Thioxanthenes.

The second generation consists of one single group, including brand names such as:

• Zyprexa

• Clozaril

• Risperdal

Never let a doctor prescribe an anti-psychotic without also prescribing an anti-cholinergic medication to neutralize deadly reactions between anti-psychotic and anti-depressant – as patient Rosemary R., of Aurora, Ontario, found out the hard way. Fortunately, a fellow patient was with her when Rosemary suffered an anti-cholinergic reaction, shortly after taking her first dose of Clozapine. Her friend called 911.

I’d love to say everything went right at that point, but the truth is, even the medical staff at the hospital Emergency department completely missed the connection between the anti-psychotic and Rosemary’s Serotonin Re-Uptake inhibitor; and she herself had no idea what the problem was. The staff dismissed her severe shortness of breath, tight chest, racing heart and ominous feelings as a “panic attack” – and she spent “a nasty day” in the emergency ward, until the effects luckily wore off. (They can be fatal!)

Rosemary correctly tied her “attack” to the first dose of anti-psychotic, Clozapine, she had taken, and promptly discontinued the medication – a decision which she is now convinced may have saved her life.

It wasn’t until a week later, when Rosemary was accompanying her new friend and fellow-patient to a psychiatrist’s appointment, that the friend chatted to her own doctor about Rosemary’s frightening experience. Escorting her patient out of the office after the appointment, Dr. S. found Rosemary waiting, and asked her if she had been prescribed an anti-cholinergic, either with her new medication or at the Emergency Ward.

Rosemary’s answer – “What’s an anti-cholinergic?” – told Dr. S. everything she needed to know. She advised Rosemary to speak to her physician immediately.

Rosemary did. Her doctor’s stunning response? “Oops. I forgot about that…”

He also “forgot” to warn her about another potentially serious side effect called agranulocytosis, for which her blood needed to be carefully monitored bi-weekly. (“…Though he did remember to warn me about cheese…”)

The truth is, being informed and aware of what you are about to take is your best bet in making sure your treatment is right for you – and that your depression is severe enough to warrant these powerful, mind-altering drugs.

If your depression is mild to moderate, and you have experienced no suicidal thoughts, you may be much better off visiting a naturopath and looking into natural remedies, instead of blindly taking a heavy-duty anti-depressant.