It's widely known that brain serotonin affects mood, and that most commonly used antidepressant treatment for depression blocks the absorption of serotonin by neurons. It is less widely known, though, that all the major organs of the body -- the heart, kidneys, lungs, liver -- use serotonin from the bloodstream.
Antidepressants work by balancing chemicals in your brain called neurotransmitters that affect mood and emotions. These depression medicines can help improve your mood, help you sleep better, and increase your appetite and concentration.
Antidepressants used in therapeutic dosing ranges are associated with causing several adverse drug reactions including hepatotoxicity. Paroxetine, fluoxetine, fluvoxamine, citalopram, mirtazapine and venlafaxine are associated with reversible liver injury upon discontinuation of the agent.
Despite these difficulties, we do know that short term use of antidepressants can cause irritability, anxiety and panic, emotional flattening, dyskinesias [9], sexual impairment [10, 11] and also suicidality and aggression [8], even in healthy adult volunteers [12].
Although antidepressants are commonly used in clinical setting, numerous negative effects of antidepressants on the cardiovascular system have been reported to date, including bradycardia, tachycardia, hypertension, hypotension, orthostatic hypotension, electrocardiogram (ECG) changes, electrolyte abnormalities, ...
Long-term antidepressant users are risking permanent damage to their bodies, according to leading medical experts. Dr Tony Kendrick, a professor of primary care at the University of Southampton, says more urgent action needs to be taken to encourage and support long-term users to come off the medication.
Fluvoxamine, fluoxetine and paroxetine are considered lower risk antidepressants with minimal effects on the cardiovascular system. Fluoxetine is contraindicated with metoprolol and paroxetine may increase cholesterol levels. Citalopram causes dose dependent QT interval prolongation and is generally avoided in CHD.
Those who had used antidepressants for >3 years reported more severe side effects, including “weight gain”, “addiction”, “feeling not like myself ”, “withdrawal symptoms”, and “suicidality”, than those who had been on antidepressants for ≤2 years.
You may have to keep taking antidepressants for a long time. Side effects—which can include nausea, diarrhea or constipation, sexual problems, weight gain, and trouble sleeping—cause many people to stop taking the medicine.
For people with chronic or severe depression, medication may be needed on a long-term basis. In these cases, antidepressants are often taken indefinitely. That is, in part, because depression is not an illness that can be cured.
Additionally, the use of antidepressant and other psychoactive drugs can induce kidney injury. Hyponatremia induced by second-generation antidepressant drugs is an important feature and can be a risk factor for elderly or patients with comorbidities such as cerebral edema, brain damage or coma.
The antidepressants associated with greater risks of hepatotoxicity are iproniazid, nefazodone, phenelzine, imipramine, amitriptyline, duloxetine, bupropion, trazodone, tianeptine, and agomelatine.
Antidepressant drugs inhibit the reuptake of monoamines (such as serotonin, noradrenaline and dopamine) into the presynaptic neuron; persistence of these monoamines in the synaptic cleft results in increased postsynaptic receptor stimulation and hence in increased postsynaptic neurotransmission.
Do Antidepressants Permanently Alter Brain Chemistry? Antidepressants are designed to alter brain chemistry to alleviate symptoms—thus, they do so while you are taking them. They may promote potentially beneficial structural brain changes, as well.
Some patients taking SSRIs develop insomnia, skin rashes, headaches, joint and muscle pain, stomach upset, nausea, or diarrhea. These problems are usually temporary or mild or both.
Cautions for specific antidepressants
a bleeding disorder. type 1 diabetes or type 2 diabetes. epilepsy – SSRIs should only be taken if your epilepsy is well controlled, and the medicine should be stopped if your epilepsy gets worse. kidney disease.
Avoid caffeine, tobacco and alcohol. Drink plenty of fluids. Take your antidepressant at bedtime if your doctor approves.
Clinicians generally recommend staying on the medication for six to nine months before considering going off antidepressants. If you've had three or more recurrences of depression, make that at least two years.
The length of treatment varies.
Even once you do start to feel better, you should expect to remain on your antidepressant for at least 4 to 6 additional months. Those experiencing depression for the first time may require even longer, from 6 to 12 months.
It's usually recommended that a course of antidepressants continues for at least 6 months after you feel better, to prevent your condition recurring when you stop. Some people with recurrent illness are advised to carry on taking medicine indefinitely.
What are the most common antidepressants? Sertraline hydrochloride, used for multiple mental health and mood disorders, is the most prescribed antidepressant on the list with more than 18 million prescriptions in 2021.
No evidence that SSRI users were at a higher risk of developing acute heart disease but significant between-study heterogenicity was observed. There was 29% increased risk of acute heart disease found for using TCAs.
Significant associations were found among SSRI use and low HDL, increased total cholesterol level, high triglyceride level, and increased risk for diabetes (34). An increase was demonstrated in total cholesterol level after SSRI treatment (35,36).