Question: I’m a 20 year old that has been dealing with depression for 4 months. What are good anti-depressants? Or should I see a doctor?
Answer: (Dr. Ziv Cohen): Fortunately, there are many good antidepressants. The first antidepressants–developed in the 1950s–were highly effective but caused side effects like constipation, dry mouth, and sleepiness. Today’s first line antidepressants are SSRIs–Selective Serotonin Re-uptake Inhibitors. Unlike the older antidepressants, SSRIs have a very favorable side effect profile. They may cause mild to moderate weight gain in some patients, and they may cause reduced sex drive, particularly at higher doses. But for most patients, they are well tolerated and effective at treating depression. However, some patients do not respond to the antidepressant they are first prescribed. In some studies, as many as 60 percent of persons do not respond to the first antidepressant they are prescribed. This means a psychiatrist is needed to assess the patient and prescribe an alternative medication. Some patients have Treatment Resistant Depression. Fortunately, this is only about 20% of patients. However, given the prevalence of depression, this turns out to be more than a million people in the United States. For these patients, treatment may include more than one antidepressant, or treatment with an antidepressant plus an “augmenting” agent, like an atypical antipsychotic. These individuals may especially benefit from cutting edge treatments like Transcranial Magnetic Stimulation and Spravato (Esketamine) or IV Ketamine infusions. Given that depression can be a complicated condition to treat, it is strongly recommended you see a mental health professional in order to discuss the treatment options that are best for you.
N.B. This blog is for informational purposes only and nothing in this should be construed as establishing a doctor patient relationship or the provision of medical advice.