What are The Best Depression Medications?
The statistics attached to depression across North America are rather staggering. Of the roughly 388 million people living in the U.S.A. and Canada, it's estimated that some 22 million people have depression to at least some degree. It is a mental health condition that affects men and women equally and can come on at any age. It's fair to say that there are a lot of grey areas when it comes to defining what depression is exactly, but one of the most important things to understand is that it's nearly always much more than just feeling 'down'.
If it were that insignificant then it wouldn’t be a fact that depression medications are some of the most prescribed meds in the country and have been for quite some time now.
Depression is a mood disorder marked by persistent feelings of sadness and loss of interest, and it affects how you think, feel, and behave as well as having emotional and physical symptoms. It’s very important that others do not make judgments about people suffering from depression, as it is easy to do so considering the sufferer will not show any physical signs of being unwell. There is an unfortunate stigma attached to mental illness, and it affects depression sufferers most profoundly simply because of the sheer number of them.
We’ll discuss depression symptoms briefly here, but the bulk of this page will focus on what should guide you and your physician when choosing a medication for anxiety and depression. As is the case with any class of prescription medications, your best depression medication will depend on your physiology specifics and which depression symptoms you’re experiencing most pronouncedly.
The symptoms of depression a person is experiencing are almost always easy for that individual to lay out for a physician or mental health care professional. That’s because they experience them constantly and nearly every moment of the day, which is what makes depression so debilitating.
Standard depression symptoms include:
- Feelings of sadness, tearfulness, emptiness, or hopelessness
- Loss of interest or pleasure in most or all normal activities the individual enjoyed previously
- Angry outburst and expressed irritability or frustration
- Tiredness and chronic lack of energy
- Sleep disturbances, including insomnia (inability to sleep) or hypersomnia (sleeping too much)
- Reduced appetite and weight loss or increased food cravings and weight gain
- Anxiety, agitation, or restlessness
- Slowed thinking, speaking, or body movements
- Feelings of worthlessness or guilt, self-blaming, or fixations on past failures
- Inability to focus thoughts, concentrate, make decisions, or remember things
- Thoughts of suicide, and in suicide attempts in extreme cases
There is also a whole host of complications stemming from depression that become health risks. These include excess weight or obesity (heart disease / diabetes), alcohol and substance abuse, family conflicts or workplace difficulties, social isolation, and pain and physical illness among many others.
Best Depression Medications, and Supplementary Approaches
For most people suffering from depression a combination of depression medication use and short-term, goal-oriented psychotherapy. This discussion is on the best depression medication for you, so we’ll only discuss psychotherapy in brief. CBT (cognitive behavioral therapy), IPT (interpersonal therapy), and PSDT (psychodynamic therapy) have all shown themselves to be very helpful for people working to overcome depression.
However, mental health experts all agree that the success of using these psychotherapeutic approaches is dependent on getting the benefits provided by antidepressant medication.
The best place to start here regarding medication for anxiety and depression is to say that these meds are classified into 5 different categories:
- Selective serotonin reuptake inhibitors (SSRIs)
- Serotonin-norepinephrine reuptake inhibitors (SNRIs)
- Monoamine oxidase inhibitors (MAOIs)
Is an SSRI the best depression medication for you? Quite likely, as these class of drugs are the most commonly prescribed and the ones most taken by depression sufferers. For these people they provide sufficient relief from depression and the fact they come with very few major side effects for most people and are very safe overall make them the go-to medication for anxiety and depression.
Common SSRI drugs include Celexa(Citalopram), Prozac(fluoxetine) , Paxil(Paroxetine), Zoloft (Sertraline), and Viibryd (Vilazodone). The first four there are basically household names when it comes to depression medication.
This class of antidepressants is very similar to SSRIs in the way they are widely prescribed and have excellent track records for improving the conditions of depression sufferers. How they differ is that SNRIs focus on retaining norepinephrine in the brain, while SSRIs focus on retaining serotonin. Serotonin deficiencies are behind most people’s depression symptoms, but for some the issue may be with more of a norepinephrine deficiency.
Common SNRI drugs include Cymbalta(duloxetine) and Effexor(Venlafaxine)
These drugs are named as ‘atypical’ in the classification here because they don’t really fit into other categories, and in particular with the way they don’t focus on preventing reuptake of neurotransmitters exclusively. However, this doesn’t make them any less effective and physicians will often prescribe them with great success with SSRI or SNRI drugs are insufficient for the patient’s recovery.
Common atypical drugs prescribed as medication for anxiety and depression include Wellbutrin(Bupropion), Remeron(Mirtazapine) , and Trintellix(Vortioxetine)
These antidepressants are very effective for some people who don’t get enough response from SSRI, SNRI, or atypical depressants. However, they also come with a greater risk of more severe side effects. As a result, physicians are always very careful about prescribing these depression medications. If you’re willing to take the risks of side effects - and tolerate them if they occur - then these meds can be an answer. They’re not the best depression medication for most people, however.
Examples of tricyclic antidepressants are Tofranil(imipramine), Pamelor (nortriptyline), and Surmontil(trimipramine)
While extremely effective, the reason that MAOI (Monoamine oxidase inhibitor) antidepressants aren’t the best depression medication is because they can have serious side effects AND the possibility of serious health-risk interactions with foods (cheeses, pickles, wine, among others). MAOIs will only be prescribed if the patient has not received benefit from SSRIs, SNRIs, or atypical antidepressants. A tricyclic antidepressant is often a safer choice as well.
All that said, some depressions sufferers don’t experience suitable relief from their depression symptoms until they try an MAOI antidepressant.
Examples of MAOIs are Parnate(tranylcypromine) Nardil (phenelzine), and Marplan (isocarboxazid). A newer one, Emsam (Selegiline), is applied as a patch and may pose less of the risks known for other MAOIs.