The two most common treatments for depression are psychotherapy and antidepressant medications. The most widely prescribed antidepressants belong to a class of drugs called selective serotonin reuptake inhibitors, or SSRIs, and include the medications Prozac, Zoloft, Paxil, Luvox, Celexa, and Lexapro. Wellbutrin, Remeron, and Effexor are also widely prescribed; while these drugs are not SSRIs, they act in similar ways on the brain, affecting neurotransmitters. All of these drugs are considered “second generation” antidepressants because they have, since their creation in the 1980s and 1990s, largely replaced older tricyclic antidepressants such as Elavil and Sinequan.
Over the past fifteen years there has been a dramatic increase in the number of people taking these drugs, with women far outnumbering men. Most people think—and pharmaceutical companies would have us believe—that these medications are a cure-all for depression. However, research trials have shown them to be only slightly to moderately more effective than placebos.12
In addition, the negative effects of the second generation antidepressants, including agitation, digestive problems, and sexual problems, tend to be downplayed or even concealed by the companies that sell them.13 Many of the clinical trials conducted to evaluate the safety of these drugs lasted only six weeks, with relatively few lasting up to six months or a year. Because women often take antidepressants for extended periods of time—often for years—this lack of data on long-term effects is particularly troublesome.
For women with mild to moderate depression, alternatives to medications such as talk therapy and exercise may be as or more effective than drug therapy, and have few, if any, harmful effects.
Women who experience severe clinical depression may find it helpful to combine drug and nondrug treatments. Because it is important to be monitored while taking these medications, and because finding the best drug or combination of drugs and the appropriate dosage can be difficult, it is best to work with an experienced physician, psychiatrist, or psychopharmacologist (a psychiatrist who specializes in psychoactive drugs).
Discontinuing these medications can cause withdrawal symptoms such as a worsening of depression, appetite changes, insomnia, and agitation. Women who decide to stop taking the medication should do so slowly and under the supervision of a knowledgeable health care provider.
Excerpted from Chapter 15: Memory and Mood in Our Bodies, Ourselves: Menopause © 2006 Boston Women's Health Book Collective. Updated 7/7/10.
Excerpted from Our Bodies, Ourselves: Menopause, © 2006, Boston Women's Health Book Collective.
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