Maintenance Medications for Depression

Antidepressants are some of the best treatments we have for depression. But these drugs don't cure depression in the way that antibiotics cure infections. Instead, they can help ease the symptoms.

You will probably need to continue medication even after you feel better. The American Psychiatric Association recommends that people keep taking their medicine for four to five months after they recover. This helps reduce the risk of relapse.

Others may need medicine for even longer. Depression can sometimes be like any chronic illness, like diabetes or heart disease, and may need ongoing treatment. This is called maintenance treatment.

Here is a rundown of some of the most common medicines used to treat depression and prevent it from coming back.

• Newer Antidepressants
  In the past two decades, many new types of antidepressants have become available, each working in slightly different ways.
  
  Selective serotonin reuptake inhibitors (SSRIs) affect the level of a chemical in your brain called serotonin. This class of antidepressants include Celexa (citalopram), Lexapro (escitalopram), Luvox (fluvoxamine), Paxil (paroxetine), Prozac (fluoxetine), and Zoloft (sertraline). Side effects are generally mild. They include stomach upset, sexual problems, insomnia, dizziness, weight change, and headaches.
  
  Serotonin and norepinephrine reuptake inhibitors (SNRIs) affect levels of both serotonin and another brain chemical, norepinephrine. This class includes Cymblata (duloxetine) and Effexor (venlafaxine). Side effects are usually mild. They include upset stomach, sleep problems, sexual problems, headache, anxiety, and dizziness, and weakness.
  
  Norepinephrine and dopamine reuptake inhibitors (NDRIs) affect norepinephrine and a different chemical in the brain, dopamine. This class of drugs includes Wellbutrin (bupropion). Side effects are usually mild, and include upset stomach, headache, sleep problems, and anxiety. Wellbutrin may be less likely to cause sexual side effects than other antidepressants.
  
  Noradnergic and specific serotonergic antidepressants (NaSSAs) also affect serotonin and norepinephrine in your brain. This class of drugs includes Remeron (mirtazpine). Side effects are usually mild, and include upset stomach, sleep problems, anxiety, and dizziness.
• Older Antidepressants
  Some of the first medicines used to treat depression were tricyclic antidepressants and monoamine oxidase inhibitors (MAOIs). Both types affect the chemical balance in the brain. While these medicines can help, doctors don't use them as much anymore. They can have severe side effects and interact with other medicines and foods. However, they are still the right choice for some people with depression -- especially if newer antidepressants don't help.
• Other Medicines
  Other drugs that are not actually antidepressants can also help. For instance, some people recovering from depression will benefit from drugs for anxiety or insomnia.

Finding the Right Depression Medicine for You

Unfortunately, finding the right medicine and the right dose isn't always simple. People have very different reactions to these drugs. There's no way for your doctor to predict how well a medicine will work for you. You may even find that a medicine that used to help just doesn't anymore.

You may have to put up with some trial and error. While antidepressants begin to show significant effects within a few weeks, it can take several months before you feel the full effects of a new drug, so don't give up. Over time, your doctor may want to increase or decrease the dose, depending on how you're doing.

If you've given a depression drug a chance and it still isn't helping, talk to your doctor. Your doctor may recommend that you try another antidepressant. With time, you should be able to find a medicine that helps.

Don't ever stop taking a medicine without your doctor's approval, even if you're feeling better. Stopping a medicine suddenly can trigger a relapse.

Your doctor will want you to check in every once in a while to see how you're doing. Take advantage of these appointments to talk about any issues you have with your medication.