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Today we belong to a culture that demands instant gratification. Instant wealth, instant beauty, instant happiness, instant success. You get the drift… Modern medicine too has kept up with this ‘I want it all, and I want it now!’ trend. Beautiful skin? There is a pill, potion and lotion for that. Thick eyelashes? Use Bimatoprost, and voila! No more baldness? Certainly; with Finasteride. Do not want to go through those awkward teenage years sporting acne? Isotretinoin will do the trick. Want to lose weight? Sibutramine, Orlistat, and a host of other pills will promise you just that. Want to stop aging? Hundreds of products on the market for that one! All medical miracles; all promising a younger, thinner, more fit, more beautiful you; with lustrous hair and pearly teeth, and smooth satiny skin! Well, that is great for the outside, what about the inside? What about a pill that can promise ‘happiness’? Surprisingly, research shows that millions of Americans, and people in other parts of the world pop an anti-depressant every single day – whether they need it or not! Have you heard of Bupropion (Wellbutrin, Zyban)? Although this drug was formulated to help people stop smoking, it is now the most preferred daily anti-depressant! People using it every day (even if they are not depressed) say it makes them feel good and upbeat and happy all day long! And isn’t that ultimately what everybody is aiming for? Happiness! Finally, that elusive feeling can now be provided in a pill! Of course, everybody has heard about Fluoxetine (Prozac) and Sertraline (Zoloft). They must be good for you; after all they are advertised on television! But please do not get me wrong. Just because I sound sarcastic about this constant and unnecessary use of anti-depressants, does not mean I think they should not be used when needed. If you are suffering from clinical depression, if you are suffering from anxiety, from the physical expression of intense stress, certainly you must take the anti-depressant prescribed to you. MDD and GAD. MDD (Major Depressive Disorder) is different from normal depression that we all go through during our lives. In people suffering from MDD, feelings of depression, anger, frustration, helplessness, loss, take over so completely that they cause an inability to function normally. GAD (General Anxiety Disorder) is characterised by constant, uncontrollable, even irrational worry and anxiety over any and every situation. This worry interferes with daily functioning, and must be treated. If you suffer from MDD or GAD or any other related condition, an anti-depressant is right for you. There are so many anti-depressants on the market today, so how do you know which one is right for you? This is a question only your doctor can answer. Your doctor will take a number of issues into account before prescribing the anti-depressant, and even after doing so, may adjust the dose or change the product altogether depending on your response to the medicine. It can take a number of weeks before your doctor can find the right anti-depressant to fit your condition. There are many factors that have to be taken into account when selecting the right anti-depressant. For example, if you have a past history of depression, and a particular medicine worked well for you, your doctor may just prescribe it again. Or, if you have a family history of depression or anxiety, your doctor may decide that an anti-depressant that works well for another member of your family will do the same for you. Again, your doctor will take into consideration your state of health and other medications you use before prescribing an anti-depressant to suit your particular condition. The most prescribed anti-depressants belong to a class of medicines called SSRIs, or Selective Serotonin Reuptake Inhibitors. These include Sertraline (Zoloft), Escitalopram (Lexapro), Citalopram (Celexa), and Paroxetine (Paxil). SSRIs are preferred by doctors, because they are comparable in efficacy to tricyclic anti-depressants, but with fewer side effects and lower toxicity. The most common side effects of this group include nausea, somnolence, and sexual side effects. There is some risk attached of serious withdrawal symptoms if SSRIs are stopped suddenly. Another group of anti-depressant medicines is SNRIs, or Selective Norepinephrine Reuptake Inhibitors. These include Venlafaxine (Effexor) and Duloxetine (Cymbalta). SNRIs have been developed more recently than SSRIs, and are supposed to have fewer side effects. They are preferred for male patients because they do not cause negative sexual side effects. Unlike SSRIs, they are supposed to have increased libido as a side effect. The Tricyclic group of anti-depressants are the first group of anti-depressants on the market. Although most doctors today prefer to prescribe the newer SSRIs and SNRIs, they may prescribe a Tricyclic anti-depressant depending on the individual case. Commonly used Tricyclic anti-depressants include Amitriptyline (Elavil), Clomipramine (Anafranil), Doxepine (Adapin), and Imipramine (Tofranil). Each anti-depressant has its own benefits and drawbacks. Only your doctor can decide which one will work best for you. Research shows that today Escitalopram (Lexapro) is the most widely prescribed anti-depressant, followed by Sertraline (Zoloft) and then Venlafaxine (Effexor). Anti-depressants are not used only to treat MDD and GAD. Many are used in the treatment of other conditions such as OCD (Obsessive Compulsive Disorder), ADHD (Attention Deficit Hyperactivity Disorder), Chronic Pain, Panic Disorder, PTSD (Post-Traumatic Stress Disorder), and many more. So make sure you know why an anti-depressant has been prescribed for you. An anti-depressant will not give you a ‘high’. The effect is gradual and subtle. Mostly it allows you to feel well and calm, and more able to handle any stress that may come your way. So please do not use an anti-depressant as a ‘Happy Pill’. It is serious medicine, and can cause serious damage if abused. Using an anti-depressant as a lifestyle drug is dangerous. Life throws all kids of things at us – good and bad. You cannot feel the highs until you experience the lows. So unless your depression is taking over your life, use other ways to overcome the blues. Talk to a good friend, join a support group, exercise the blues away. Anti-depressants are for people who really need them. Clinical depression is a very real, debilitating disease, and anti-depressants are serious medicine. Happiness does not come in a bottle!
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