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How Antidepressants Actually Work

If you are someone who is considering or already taking antidepressant medication, it’s important to know facts such as what an antidepressant is, how they metabolize in your body, and how they actually help you feel better.

By Dr. Mona Amini, MD

Nearly 1 in 10 of Americans currently take an antidepressant, with millions more considering them as they become an increasingly viable way to address depression. Antidepressants are proven to help regulate mood and relieve symptoms of depression. In fact, a meta-analysis by Oxford University concluded that of 21 common antidepressants studied, all 21 antidepressants were more effective than placebo medications in treating major depression.

If you are someone who is considering or already taking antidepressant medication, it’s important to know facts such as what an antidepressant is, how they metabolize in your body, and how they actually help you feel better. While your doctor will certainly be able to help you select the right antidepressant(s), dosage, and treatment plan, it’s a good idea to be an informed consumer about your medication.

Here, you can get a basic overview of what antidepressants are and how they might affect your body. Use this information to better inform your mental health journey!

What are antidepressants?

Before we can understand how antidepressants work, let’s first lay out how depression itself works. We know that there are three factors that can commonly lead to depression: genetics, chemical imbalances in the brain, and difficulty in managing emotional responses. Any combination of these factors, or even less common ones such as stressful life events, can lead to depression.

So, how are antidepressants supposed to help? 

The most common types of antidepressants are reuptake inhibitors, which essentially work to boost the activity of neurotransmitters. Neurotransmitters such as serotonin or dopamine are released all the time to help deliver information between cells. After releasing the neurotransmitters, the cells then reuptake, or reabsorb, these chemicals so that they can be used again. 

Antidepressants work by pausing the reuptake process so that the neurotransmitter can remain in the gap between your brain cells for a longer amount of time. This increases the amount of time that the neurotransmitter can stimulate activity in the next brain cell. Many scientists believe that affecting neurotransmitter activity can improve mood regulation; there has been a ton of research that shows how increasing neurotransmitter activity can help counter the symptoms of depression, anxiety, and other mental health conditions. 

The most common reuptake inhibitors boost the activity of three types of neurotransmitters: serotonin, dopamine, and norepinephrine.

  • Serotonin: helps regulate mood, sleep, memory, emotional stability, sexual function and desire, and appetite.
  • Dopamine: involved in reward, motivation, memory, and pleasure. You may have heard of the “dopamine” rush you get when something great happens.
  • Norepinephrine: mobilizes the brain by boosting alertness, focus, and memory.
  • Increasing the brain activity for these three neurotransmitters can often boost your mood and/or improve your emotional stability. 

If you’re interested in learning more, check out our blog post on how antidepressants work.

How do antidepressants differ from each other?

Reuptake inhibitors are traditionally sorted into three families. They have acronyms that you might have heard of: SSRIs, SNRIs, and NDRIs. 

There are many other types of antidepressants, but these are the main families that have generic brand names that you might be familiar with. You might know of antidepressants such as Zoloft, Prozac, or Wellbutrin or their respective generic names: sertraline, fluoxetine, and bupropion. 

Full nameSelective serotonin reuptake inhibitorSerotonin-norepinephrine reuptake inhibitorNorepinephrine-dopamine reuptake inhibitor
Neurotransmitters affectedSerotoninSerotonin, norepinephrineDopamine, norepinephrine
Brand examplesProzac, Lexapro, Celexa, ZoloftCymbalta, Pristiq, EffexorWellbutrin
Generic namesFluoxetine, escitalopram, citalopram, sertralineDuloxetine, desvenlafaxine, venlafaxineBupropion

Each family (and each individual antidepressant within a family) has differences that affect how your body might be affected. Your doctor will prescribe you a certain antidepressant, or combination of antidepressants, with the goal of tailoring them to your medical history and symptoms. Some antidepressants may cause certain already underlying medical issues to worsen so it is important to tell your doctor all relevant medical history. 

For example, Wellbutrin (bupropion), an NDRI, may interact negatively with an asthma medication you might be already taking, and so it might be better to take Prozac, an SSRI, instead. Conversely, you might want to avoid Prozac if you are taking medication for migraines or seizures. As always, your doctor will know the best type of antidepressant, dosage, and treatment plan for you.

The bottom line

Antidepressants are proven to help most people for whom they are prescribed, but there’s no guarantee they will work for everyone. Working with a psychiatrist gives you a great chance of finding an appropriate medication since they specialize in mental health treatment and are familiar with many more medications and their interactions with other medications compared to general medical providers. 

Even when working with an expert, there is some amount of trial and error when selecting what treatment will be best for you. One way to reduce the guesswork for your doctor is to take a pharmacogenomic test, which details how your body is likely to respond to medication based on your genes. The result is fewer side effects, less number of different medication trials, and overall better outcomes in your mental health.

Want to learn more? Take this free pharmacogenomics quiz that will tell you whether or not a DNA test might help you in your mental health journey, or learn more about how Prairie offers personalized mental healthcare through its psychiatrists.

Take Our Pharmacogenomics Quiz

Wed Feb 24 2021

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