Antidepressants
Antidepressants are medications for treating depression and are also used for anxiety disorders, obsessive-compulsive disorders, panic disorders, and partly for borderline personality disorder.
How Do Antidepressants Work?
Section titled “How Do Antidepressants Work?”In contrast to everyday mood swings, depression is a common and serious illness. Much evidence suggests that the interplay of various neurotransmitters — chemical substances that transmit nerve signals — in the brain is disrupted.
The symptoms can be improved by medications that enhance the effect of certain neurotransmitters. The key messengers here are serotonin and norepinephrine.
Groups of Antidepressants
Section titled “Groups of Antidepressants”SSRIs (Selective Serotonin Reuptake Inhibitors)
Section titled “SSRIs (Selective Serotonin Reuptake Inhibitors)”SSRIs block transport molecules that return serotonin to storage sites after signal transmission. Serotonin remains longer at the site of action, and its effectiveness increases.
Effects:
- Mood-elevating
- Anxiolytic (anxiety-reducing)
- Generally no sedating or dampening effect
Examples:
- Paroxetine (Seroxat)
- Fluoxetine (Prozac)
- Sertraline (Zoloft)
- Citalopram
- Escitalopram (Cipralex)
SNRIs (Serotonin-Norepinephrine Reuptake Inhibitors)
Section titled “SNRIs (Serotonin-Norepinephrine Reuptake Inhibitors)”Examples:
- Venlafaxine (Effexor)
- Duloxetine (Cymbalta)
Tricyclic Antidepressants
Section titled “Tricyclic Antidepressants”An older group of medications with more side effects but still effective in certain cases.
Examples:
- Amitriptyline
- Clomipramine
- Doxepin
MAO Inhibitors
Section titled “MAO Inhibitors”Examples:
- Moclobemide (Aurorix)
Paroxetine (Seroxat) in Detail
Section titled “Paroxetine (Seroxat) in Detail”Indications
Section titled “Indications”- Depression — severe depressive episodes
- Obsessive-compulsive disorder — intrusive, compulsive thoughts or actions perceived as senseless
- Panic disorder — recurring panic attacks
- Social phobia — pronounced insecurity in social interactions
Mechanism of Action
Section titled “Mechanism of Action”Paroxetine is an SSRI (Selective Serotonin Reuptake Inhibitor). Involuntarily recurring thoughts or actions, characteristic of obsessive-compulsive disorder, can be reduced or prevented by paroxetine.
Warnings
Section titled “Warnings”Use with caution in:
- Patients with a history of seizures
Contraindications
Section titled “Contraindications”Paroxetine must not be taken:
- While taking MAO inhibitors simultaneously
- By children and adolescents under 18 years of age
Pregnancy and Breastfeeding
Section titled “Pregnancy and Breastfeeding”The medication must not be used during pregnancy and breastfeeding.
Side Effects
Section titled “Side Effects”The following side effects may occur but do not necessarily have to:
Common:
- Headaches
- Gastrointestinal complaints
- Dry mouth
- Nausea
- Fatigue
- Increased sweating
Occasional:
- Itching
- General weakness
- Sexual dysfunction
- Sensory disturbances with burning or numbness
Interactions
Section titled “Interactions”Further interactions:
- In combination with anticoagulants, the tendency to bleed is increased
- Alcohol and other sedating substances intensify the effect
Antidepressants for Borderline Personality Disorder
Section titled “Antidepressants for Borderline Personality Disorder”Antidepressants are frequently used for borderline personality disorder to treat accompanying symptoms:
| Symptom | Antidepressants can help with |
|---|---|
| Depression | Depressive episodes that often co-occur |
| Anxiety | Anxiety disorders, panic attacks |
| Impulse control | Partial improvement of impulse control |
| Compulsions | Compulsive behaviors |
Important Guidelines for Taking Medication
Section titled “Important Guidelines for Taking Medication”- Take regularly as prescribed
- Be patient — 2-4 weeks until full effect
- Report side effects — inform your doctor
- Keep follow-up appointments
Don’ts
Section titled “Don’ts”- Do not stop on your own — can cause discontinuation symptoms
- Do not adjust dosage on your own — neither more nor less
- Avoid alcohol — interactions possible
- Do not listen to non-professionals — only your doctor knows your situation
Discontinuation Symptoms
Section titled “Discontinuation Symptoms”When antidepressants are stopped abruptly, discontinuation symptoms can occur:
- Dizziness
- Nausea
- Headaches
- Sleep disturbances
- Flu-like symptoms
- Electric sensations (“brain zaps”)
- Mood swings