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Antidepressant Medication

Those who suffer from bipolar disorder are often prescribed antidepressant medications to help control symptoms of depression often associated with the condition.

Antidepressants may be prescribed on their own for some patients but are often prescribed in conjunction with treatments that address other bipolar disorder symptoms.

Antidepressant medications work to correct hormone imbalances in the brain that cause depression.

Antidepressant Types

Antidepressants are not all created equal. Different types of antidepressants work in different ways and have different effects on the body and on symptoms.

The most commonly prescribed antidepressant medications include:

monoamine oxidase inhibitors (MAOIs)
selective serotonin reuptake inhibitors (SSRIs)
tricyclics.

MAOIs

Monoamine oxidase inhibitors are older antidepressants and are often used in cases where bipolar disorder is not responsive to other antidepressants. MAOIs are typically only given to bipolar patients with severe depression.

Some foods and other medications interact badly with MAOIs, so it's important to discuss all dietary and medicinal requirements with a doctor when taking MAOIs.

Common MAOIs include:

isocarboxazid (Marplan®)
phenelzine (Nardil®)
tranylcypromine (Parnate®).

SSRIs

Selective serotonin reuptake inhibitors are newer treatment options that increase the amount of serotonin between nerve cells. These medications have also been shown to grow new brain cells in some patients. Many bipolar disorder patients prefer SSRIs to other treatments because they often have fewer side effects.

Common SSRIs include:

citalopram (Celexa®)
escitalopram (Lexapro®)
fluoxetine (Prozac®)
fluvoxamine (Luvox®)
paroxetine (Paxil®)
sertraline (Zoloft®).

Tricyclics

Tricyclics were the first type of treatment used for bipolar disorder. While they are just as effective at treating depression symptoms as newer drugs, they are not usually the first choice of patients or medical professionals because of severe side effects. Sometimes tricyclics are also used to treat nerve pain and sleep problems.

Common tricyclics include:

amitriptyline
desipramine
imipramine
nortriptyline.

Antidepressant Side Effects

While many side effects are not permanent, they can often occur with the use of antidepressant medications. Many side effects can be treated with other medications that are safe to take in conjunction with antidepressants, but finding the right combination can take time.

Antidepressant medications may also take a little while to control symptoms, so it's important to keep taking them and not give up quickly.

Not all side effects will occur in all patients taking antidepressant medications.

Here's a list of common side effects:

MAOI Side Effects: Because MAOIs create so many restrictions for patients, they are most often not prescribed. Decongestants, certain cheeses, wines, pickles and other foods can lead to a very sharp increase of blood pressure, which may cause a stroke. Patients are often required to carry a list of prohibited foods with them to avoid any serious problems.
SSRI Side Effects: Sexual problems are a main complaint of many SSRI patients. These are reversible, however, so consulting a doctor can be helpful.

Headache and nausea may also occur with the use of SSRIs, but these side effects usually subside quickly.

Nervousness, agitation and insomnia may also occur, but if these do not disappear quickly, dosage can be altered to avoid these effects.
Tricyclic Side Effects: Dry mouth is a common tricyclic side effect and can be combated through water sipping and gum chewing. Constipation and bladder problems also may occur, but certain dietary changes can combat these side effects.

Blurred vision and dizziness may also occur, but these symptoms are most often temporary and can be helped by moving slowly.

Drowsiness is also a common tricyclic side effect, so patients should not drive until they know whether or not their medication has this effect on them.

Despite these side effects, antidepressant medications are effective for many bipolar disorder patients. They can decrease or eliminate depression symptoms and can prolong the time in between depressive episodes.

Resources

About.com (2006). Antidepressant Medications. Retrieved July 17, 2007, from the About.com Web site: http://mentalhealth.about.com/od/psychopharmacology/
a/antidepress.htm.

Health A to Z (2006). Antidepressant Medications. Retrieved July 17, 2007, from the Health A to Z Web site: http://www.healthatoz.com/healthatoz/Atoz/common/
standard/transform.jsprequestURI=/healthatoz/Atoz/
dc/caz/ment/depr/antidepressant.jsp.

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