How do antidepressants work?

“Antidepressants” can actually be used for a variety of conditions, but I’ll focus on depression here. It’s also important to know that a discussion between you and your doctor is critical in determining which treatment for depression is right for you. Sometimes it’s counseling, sometimes it’s counseling plus antidepressants, and sometimes it’s antidepressants until the right counseling can be identified and arranged. 

One of the main causes of depression is low serotonin levels. For this reason, the first-line medication for treating depression is an SSRI (selective-serotonin reuptake inhibitor). The basic way SSRIs work is that they prevent your own serotonin from being “recycled” and instead push serotonin forward in positive signaling pathways (essentially increasing your serotonin levels). There are lots of different SSRIs, so if you’re finding that one isn’t totally helping, talk with your doc. 

The most common side effects of SSRIs are nausea, headaches and dizziness, though these generally improve with time. It’s also important to note the “black-box” warning on antidepressants. There are some older studies that have shown an increase in suicidal behavior with the use of SSRIs. It is also important to note that the patients who exhibited these behaviors were already experiencing suicidal thoughts and extreme depression, and it’s believed that medication provided just enough relief from severe sadness to find the motivation to carry out suicidal behavior. So what to take from this? Talk openly and regularly with your doctor about side effects, sadness and thoughts of suicide.