Other antidepressant medications. Bupropion ( Wellbutrin, Aplenzin) is a unique antidepressant option with side effects that are usually mild, including upset stomach, headache, insomnia, and anxiety. Bupropion may be less likely to cause sexual side effects or weight gain than most other antidepressants. Mirtazapine ( Remeron) is usually taken at bedtime. Side effects are usually mild and include sleepiness, weight gain, elevated triglycerides, and dizziness. Trazodone ( Desyrel) is usually taken with food to lower the chance for stomach upset. Other side effects include drowsiness, dizziness, constipation, dry mouth, and blurry vision.
For depression that's hard to treat, doctors sometimes pair an antidepressant with another prescription medicine, such as:
- Abilify ( aripiprazole)
- Lithium (Lithobid, Eskalith)
- Risperdal ( risperidone)
- Seroquel ( quetiapine)
- Zyprexa ( olanzapine)
All antidepressants carry a boxed warning about increased risks of suicidal thinking and behavior in children, teens, and young adults 18-24 years old. If you start taking an antidepressant and begin having troubling thoughts, tell your doctor and loved ones right away.
Working with your doctor, you can weigh the risks and benefits of treatment and find the medication and dose that work best for you.
ECT (Electroconvulsive Therapy)
This is a safe and effective treatment for people with depression that's resistant to multiple medications. It's typically recommended when depression symptoms are especially severe or when people haven't been helped by medicines or therapy.
In ECT, the patient is put to sleep under general anesthesia and the doctor then applies a small electric current to cause a brief controlled seizure. A course of ECT-induced seizures, done over a few weeks, seems to affect areas of the brain involved in controlling mood. It may sound scary, but during the procedure, a person receives anesthesia and a muscle relaxant, so they're asleep and won't feel anything.
ECT tends to work very quickly. It also works well -- about 70%-90% of people who receive it show improvement. The most common side effect is temporary memory loss.
You might have up to 12 sessions or more over a few weeks. Some people get further treatment with ECT to prevent depression from returning.