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The best treatment for depression usually includes a combination of medication, psychological treatment and support in the community. While some people may only need psychological, ‘talking’ treatment, this pamphlet answers commonly-asked questions about antidepressant medication.

How do antidepressant medications help?
Antidepressant medications help reduce the symptoms of depression, such as: feeling extremely sad for no clear reason; loss of interest or pleasure in things you usually enjoy; sleeping too much or too little; feelings of worthlessness or excessive guilt or worry, and difficulty in thinking, making decisions or concentration. Antidepressants may also be helpful in the treatment of anxiety-related disorders, such as generalised anxiety disorder and eating disorders, obsessive-compulsive disorder, social phobia, and post-traumatic stress disorder.

How do antidepressant medications work?
People with depression and anxiety disorders often have an imbalance in certain natural chemicals in the brain. Antidepressant medications help the brain to restore its usual chemical balance and so reduce symptoms.

How long do they take to work?
It can take up to four weeks after the first dose of medication before it has an antidepressant effect. For some people it can take up to eight weeks or a little longer before they start to feel better, and the maximum benefit is felt after six months. Antidepressant medication is generally very effective. Around 70% of people with major depression start to feel better with the first type of antidepressant they are prescribed.

What else do we know about antidepressants?

They don’t change your personality.
While antidepressants make you feel better they do not change your personality. You may notice that you find it easier to get on with people because you feel less anxious.

They are not ‘happy drugs’
Antidepressants help relieve the symptoms of depression and associated anxiety. They do not make you euphoric, but simply help you react more realistically in your emotional responses. You may notice, for example, that you take in your stride little things that used to worry you or get you down.

They are not the only thing that helps people get better
Taking antidepressant medication is one important step in getting better but is rarely enough on its own. As well as medication, effective treatment for depression and anxiety-related disorders may include education about the illness and how to deal with it, and psychological therapies such as Cognitive Behavioural Therapy (CBT), for example. For some people, ongoing clinical support in the community, rehabilitation, accommodation and employment support are also essential.

They are not addictive
Antidepressants, like most medications, can change the way you feel. This means that if you stop taking the medication you may start to feel the way you did before the treatment. Some people confuse this with being addicted. Antidepressants are not addictive and you will not become dependent on them. However, it is important to talk to your doctor before you stop taking them. It is always advisable to reduce the dose slowly, with close monitoring, to minimise possible discomfort as your body adjusts to the lower dose.

What antidepressant medications are there?

There are many types of antidepressant medication available: an older group (known as tricyclics), and newer groups (known as SSRIs and SNRIs) which tend to have fewer side-effects and a wider safety margin in overdose than older ones. These newer medications include fluoxetine (Prozac, Lovan), paroxetine (Aropax), sertraline (Zoloft), citalopram (Cipramil), &Mac223;uvoxamine (Luvox), venlafaxine (Efexor), mirtazapine (Avanza, Mirtazon, Remeron), reboxetine (Endronax), escitalopram oxalate (Lexapro) and moclobemide (Aurorix).

Different medications work for different people. While there is usually a period of trial and adjustment, there are some things you and your doctor can do to consider what type of antidepressant is most likely to be right for you. Some things you should discuss with your doctor are:

How young you are

These medications are not generally recommended for treatment of depression in children and adolescents, but they may be prescribed in certain circumstances. It is important to discuss this issue with the treating doctor, and ensure effects are monitored if an antidepressant is prescribed. If a child or adolescent is currently being treated with an SSRI, they should not have the medication ceased abruptly, but reduced gradually by the doctor if it needs to be stopped.

Whether you have a history of physical problems

Certain antidepressants may interact adversely with some medications for physical illnesses. That is why it is important to tell your doctor if you are on any other medication.

How severe the symptoms are

People with mild or moderate depression seem to find SSRIs and SNRIs most effective, while some people who are severely depressed may find tricyclics (such as amitriptyline and dothiepin) more effective.

How do I find out more?
It is important to ask your doctor about any concerns you have. SANE Australia also produces a range of easy-to-read publications and multimedia resources on mental illness. For more information about this topic see:

- The SANE Guide to Depression
Helps people diagnosed with depression and their family and friends by explaining what it means to have depression, the treatments available and what a person can do to help themselves.

- Depression DVD or Video Kit (43 minutes)
People who've experienced depression and their carers talk about the things which have helped them cope better. The SANE Guide to Depression also included. See above for details.

- The SANE Guide to Medication and other Treatments
Explains how all the different aspects of treatment work, by looking at clinical care, medication, support in the community and helping yourself.

To order visit the SANE Bookshop at www.sane.org or call 1800 18 SANE (7263)

SANE Australia . . . Meeting the challenge of mental illness
Antidepressant Medication

©SANE Factsheet 7b
This Factsheet may be freely downloaded, copied and distributed on condition no change is made to the contents. SANE Australia is not responsible for any actions taken as a result of information or opinions contained in the Factsheet. SANE Australia is a business name of Schizophrenia Australia Foundation.
[Version English, 2005]