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At this point in time, pharmaceuticals (medicines) comprise the most utilized treatment for depression. In the past 15 or so years, more specific forms of antidepressants have entered the market, and new ones are in the pipeline even as I write this. The reason for the popularity of pharmaceuticals: any given antidepressant medication will work for approximately 80% of all people who take it. For the remaining 20%, there still exists a vast array of medicines from which to choose. You might ask, "But how does the doctor know which antidepressant is the best one for me?" To answer this question properly, I will have to digress a little into a brief explanation of brain biochemistry. When you see the doctor, she or he will ask you questions about your symptoms: How is your energy level? Your sex drive? Your appetite? Do you have difficulty focusing your attention? These questions not only help to diagnose depression, but also give the doctor a clue about which medication to prescribe. As far as researchers know at this time, three neurotransmitters (brain chemicals) are involved in keeping us in a good mood - dopamine, norepinephrine, and serotonin. They enhance, modulate, and balance each other; and, as you can see from the diagram, their functions overlap a bit. When something goes wrong, one or more chemicals may be in short supply - which, in turn, can result in depression. When dopamine levels fall too low, the person suffers from a lethargic depression and is unable to focus on anything. If serotonin levels fall, the person may have an agitated, anxious type of depression. Low levels of norepinephrine may result in the person feeling dull and unmotivated. Of course, in real life, depression is never this straightforward. But I hope this brief lesson gives you an idea about the roles played by specific neurotransmitters. Antidepressants are classified according to their effects upon the three brain chemicals we have just reviewed. Since there are scores of antidepressants available, I will discuss only one or two of the more well-known medications in each catoegory. Tricyclic Antidepressants (TCA's) worked on the norepinephrine system, but weren't very "clean" - they also enhanced the action of neurotransmitters that cause sedation, dry mouth, and constipation. Until the advent of Prozac, in the 1980's, the TCA's were the most commonly used antidepressants. Elavil (amitriptyline) was one of the more propular TCA's, and indeed is helpful for a depression accompanied by insomnia. Nowadays it is most often used as a sleep aid. Tofranil (imipramine) is still used with some frequency for agitated, sleepless depressions.
The copyright of the article Pharmaceutical Treatment of Depression in Female Depression is owned by Mari Brodersen. Permission to republish Pharmaceutical Treatment of Depression in print or online must be granted by the author in writing.
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