Antidepressants are a group of medications that are used to treat depression.
Depression is very common and can affect anyone. Key symptoms include always feeling down or hopeless and loss of enjoyment or interest in doing the things you used to enjoy doing. Depression is a medical problem that can usually be effectively treated with a combination of psychological therapies, lifestyle changes and antidepressant medication. Read more about depression.
Which antidepressants are available in New Zealand?
There is a variety of groups or classes of antidepressants available in New Zealand. Each class works on different chemicals in your brain and may cause different side effects.
|Class of antidepressant||Examples|
|Tricyclic antidepressants||Also called TCAs. Examples include amitriptyline, clomipramine, imipramine, doxepine and nortriptyline. In the past these were a common treatment, but these days doctors usually prescribe newer classes of antidepressants.|
|Selective serotonin reuptake inhibitors (SSRIs)||Also called SSRIs. Examples include fluoxetine, fluvoxamine, sertraline,paroxetine, citalopram and escitalopram.
SSRIs have fewer side effects than the TCAs. Read more about SSRIs.
|Serotonin and noradrenaline reuptake inhibitors||Also called SNRIs. Examples include venlafaxine and duloxetine. These are used for severe depression or when SSRIs have not been successful.|
|Monoamine-oxidase inhibitors||Example include moclobemide, phenelzine, tranylcypromine. These are an option when other antidepressants are not suitable. You cannot drink alcohol or eat food that contains tyramine (for example, cheese, liver, yoghurt or Marmite®) while you are taking an MAOI.|
How do antidepressants work?
Antidepressants work by balancing the levels of neurotransmitter chemicals within your brain. The main neurotransmitter chemicals that seem to be related to depression are serotonin, dopamine and noradrenaline. By restoring the chemical balance within your brain, antidepressants help to control both depression itself and many of the signs and symptoms of depression, including anxiety, agitation, exhaustion, insomnia and lack of concentration and appetite. Antidepressants do not cure depression. To improve the symptoms of depression, antidepressants are most effective when used together with psychological therapies and lifestyle changes.
What are the considerations when choosing an antidepressant?
The exact antidepressant medication you are prescribed will depend on the severity and type of your illness, if you have other medical conditions, if you are taking other medication, your response to antidepressant medication in the past and possible side effects.
When deciding on the best medication for you, it is important to discuss with your healthcare provider the possible side effects of the medication and how they are likely to impact your lifestyle. The following resources provides more information about what to think about when choosing antidepressant medication and may be useful for discussions with your health care provider. Be aware that these are from other countries and may contain information that differs from New Zealand recommendations.
- Antidepressants: Selecting one that's right for you
- Depression: Should I take an antidepressant?
- Depression: treatment options Option Grid
How long will I need to take antidepressants for?
You will need to be on the medication for at least 6 to 12 months. SSRIs work by helping your body to build up its own levels of serotonin, so it might take up to 4 weeks before you feel your mood improving. Even once your chemical balance has stabilised, your doctor is likely to recommend that you keep taking the antidepressants for up to a year before you slowly reduce the dose.
If you have troublesome side effects or little improvement in your symptoms after 6 weeks, talk to your doctor about changing the dose, trying a different antidepressant (switching), or adding a second antidepressant or another medication (augmentation). A medication combination may work better for you than a single antidepressant.
If this is not your first experience of depression, your doctor may prescribe longer treatment. You may be able to stop these medicines after a while. They are not addictive.
If you plan to stop taking antidepressants, talk with your doctor first about how to do it safely. It's best to slowly decrease your dose. Suddenly stopping can cause side effects. It may also cause your depression to come back or get worse.
What about the side effects of antidepressants?
Different antidepressants have different side effects and risks. A few people experience agitation, nausea, insomnia, headaches, sexual problems and suicidal thoughts when taking SSRIs. Talk to your healthcare provider if these things happen to you. Read more about SSRIs.
SNRIs such as venlafaxine have similar side effects to the SSRIs, and may also cause loss of appetite, sweating and rashes.
Side effects are more common with TCAs, and these can include drowsiness, blurred vision, weight gain, constipation and difficulty urinating (peeing), a dry mouth and sexual problems. Let your doctor know if you experience any side effects while on antidepressants, so they can adjust the dose or try a different medication.
If you suspect you or someone you know might be suffering from depression, read more on our depression section or visit thelowdown.co.nz or depression.org.nz for helpful information, including a self-test.
The following links provide further information on antidepressants. Be aware that websites from other countries may contain information that differs from New Zealand recommendations.