Why are antidepressants prescribed?

Antidepressants are prescribed to relieve the symptoms of depression, particularly the sadness and motor slowing that characterize this illness. They are not euphoric drugs and have no effect on people who do not suffer from depressive disorders. Some of them are also used for the treatment of certain forms of anxiety or bulimia, or to correct emotional disorders in the context of other psychological illnesses. Their use is only justified if the symptoms characterizing true depression result in a disability or a risk for the person, in addition to psychotherapeutic treatment.

Their beneficial effects are only felt after several weeks of treatment (two to six weeks). For this reason, a faster-acting anxiolytic treatment is often prescribed at the start of treatment. It is gradually stopped when the effects of antidepressants begin to be felt.

How do antidepressants work?

In the brain, information travels in the form of electrical messages, called nerve impulses. Synapses constitute areas for the exchange of information, in the form of chemical messages, between neurons. These chemicals, called neurotransmitters (such as serotonin or norepinephrine) are released by sending neurons and bind to specific molecules on receiving neurons.

Antidepressants modify this chemical communication between neurons, but their precise mode of action on depression treatment is not known and we are far from having elucidated the mysteries of how the brain functions. Research on these molecules essentially results from experimental observations on animals, then on human volunteers after selection of the products that appear to be the most effective and best tolerated in animals.

Depression therefore does not come down to a “lack” of this or that neurotransmitter and it is also impossible for the doctor to determine with certainty when prescribing which antidepressant will be effective in his patient. It is common to have to try several medications on a patient before finding the right one.

After a few weeks of treatment, antidepressants generally help restore sleep, appetite, increased energy, pleasure and positive thoughts. Unlike anxiolytics or sleeping pills, the vast majority of antidepressants are not addictive and it is very important not to stop treatment without talking to your doctor, even if you feel better. Untimely stopping exposes you to a significant risk of relapse: the duration of treatment is rarely less than 4 months.

What are the different types of antidepressants?

There are now more than twenty substances available for the treatment of depression. The doctor can thus prescribe the medication best suited to his patient. Antidepressant treatment can be started within a few weeks. A minimum of one consultation per week is essential at the start of treatment.

All antidepressant medications have similar effectiveness against depression, but some seem more suitable for also relieving associated signs, such as anxiety, fatigue or excitement. The doctor can change it after a few weeks if the effectiveness obtained is not sufficient or if the side effects are too bothersome.