Multiple Reuptake Inhibitors
MAOIsAnd miscellaneous antidepressants
As a class antidepressants don’t just deal with depression alone. Many are approved for use with a variety of other disorders, and the are used off-label for many more, including non-psychiatric applications like MS and arthritis. These are not happy pills, the idea is to keep you from getting depressed, or whatever, not to make you euphoric. If you are getting euphoric for more than a few of days (a few is all right, you deserve a vacation now and then), there could be a problem. Sorry.
Most of the commonly prescribed antidepressants act by inhibiting reuptake of one or more neurotransmitters in your brain. Basically that means bits of your brain get to soak in your own juices for longer periods of time and that marinating makes them more tender, and you happier. Really, that’s all the so-called chemical imbalance is, improper tenderizing of key bits of your noggin. There’s one hypothesis that SSRIs cause you to grow more brain cells. However, the study that backs that hypothesis was done on rats. When I have some proof of that in humans I’ll buy it. I don’t deny that is what’s happening, and you have to start your hypothesis with rats, it’s just drugs do different things in rats, too. So I’ll wait until they run MRIs on humans comparing before and after images before I jump on the “SSRIs grow new neurons” bandwagon. However, it’s as good an explanation as any as to why nothing happens for a month or more in some people, but they work in a matter of days in others.
A month? That’s right, it can take a month, sometimes two months with Prozac (fluoxetine hydrochloride), before you feel any positive results. Marinating your brain is more complicated than marinating a steak.
The other thing is picking the right marinade, er, antidepressant based on which neurotransmitter you’re a little short on. I’ll be covering that in another article. There might be a way of avoiding the guessing game that most doctors use in prescribing antidepressants. Most of what you’ll get these days deal with the big three – serotonin, norepinephrine and dopamine. My wild-ass guess / rule of thumb is that imbalances of one or more of these three are responsible for 80% of the depression issues. It’s all just a matter of figuring out exactly the extent of the tweaking and what neurotransmitters you exactly need to tweak.
The big problem with covering antidepressants is my own personal prejudice against them. Being bipolar and epileptic I’m just doomed to react badly to the entire class of medications, and that has probably come across. I try to be objective, but personal experience will color everything, and objectivity is a noble, but often unobtainable goal. It didn’t help that a couple of psychiatrists refused to believe I was bipolar, despite a previous diagnosis of such, and prescribed antidepressants inappropriately. Ooops. Anyway when the HON team pointed out this site’s shortcomings I realized that even in the new format the data on the antidepressants are pretty sketchy. So while I do plan on cleaning up sources and whatnot for this information, it’s going to have to wait. Sorry. But anticonvulsants and antipsychotics have priority because those are the meds for my community. Although with the popularity of Lexapro/Cipralex (escitalopram oxalate) in the searches that lead to this site, I might make an exception for that particular medication. It is, of course, the one antidepressant with which we have no personal experience. At least we can be objective about it. Lexapro (escitalopram oxalate) hasn’t fucked us over.