Health Mental health General wellbeing Antidepressants - what you need to know LGBT+ people are several times more likely than average to experience mental health problems. If you’ve been diagnosed with depression then your doctor may recommend treatment with a course of antidepressants. For some people, these drugs provide relief from depression’s negative effects, improving their overall mental health. Antidepressants have changed a great deal since the drugs were introduced in the 1950s. Newer drugs generally have fewer side-effects and better outcomes, but they’re still no cure-all for mental health problems. Talking therapy, exercise, and other alternatives remain important to the maintenance of mental health. What are antidepressants? The term ‘antidepressants’ refers to a drugs which are used to treat depression and its symptoms such as low mood, anxiety, and lack of energy. They’re usually taken orally by via a solid pill and are only available via prescription from a GP. Most antidepressants are taken daily over long periods of time. How effective are they? Whilst often effective in combating symptoms, antidepressants aren’t guaranteed to help in every instance. Somewhere between 50% and 65% of patients prescribed antidepressants experience improvement (NHS), but each case is unique, and some people seem to respond better than others. There is also increasing evidence that antidepressants are less effective at treating cases of mild depression than moderate to severe cases. How do they work? Antidepressant is an umbrella term which refers to several families of drug, each of which works differently on the brain. The most common types are SSRIs and SNRIs, but there are also several other types available when these frontline drugs are not effective. SSRIs (selective serotonin reuptake inhibitors) – SSRIs are the most commonly-prescribed type of antidepressants. They work by increasing levels of a neurotransmitter called serotonin in the brain. Serotonin has several functions including regulating bowel movements and blood clotting, but most importantly in this case, it also directly contributes to our mood. Low levels are associated with poor mood, anxiety, and depression. Higher levels contribute to feelings of happiness and wellbeing. SNRIs (serotonin and norepinephrine reuptake inhibitors) – As the name implies, SNRIs also increase levels of serotonin in the brain, and also prevent reuptake of another neurotransmitter called norepinephrine, which is key to the body’s fight or flight response. For more information on the different types of antidepressants, consult the NHS guide. How long until I feel better? It usually takes a few weeks from starting the treatment for patients to experience relief from their symptoms. For SSRIs like fluoxetine and citalopram, this period is generally between 4-6 weeks. Before the benefits kick in, you may also experience some negative side-effects like nausea, constipation, or anxiety. If any of these symptoms are severe, then consult with your GP immediately. Are there side-effects? Anti-depressants can cause longer-term side-effects, but they vary between person to person and drug to drug. One person may experience no ill-effects where another person may experience nausea. Luckily, anti-depressants have far fewer side-effects than they used to as better drugs have been developed over the past 60 years. Mind’s website has more specific information on the types of side-effect each type of antidepressant may produce. What if I want to stop taking them? If want to stop taking your antidepressants, you should to consult with your doctor before taking action. If you stop taking them suddenly, you may experience unpleasant withdrawal symptoms including anxiety and headaches. You may also risk re-igniting your depression. Your doctor will tell you how to come off the medication safely. Most often this involves tapering your dosage, and slowly taking less and less over a period of weeks. It’s best not to conduct this process on your own, as the amount of time required to stop completely will vary depending on the drug you’ve been taking and how long you’ve been taking it. Are there alternatives to medication? Antidepressants aren’t for everyone, and research has shown that other forms of treatment can be equally as effective in alleviating the symptoms of depression. Many NHS trusts offer other treatments which can be accessed through your GP such as cognitive behavioural therapy, counselling, or other forms of talk therapy. Depending on the severity of your depression, you may also find mindfulness or exercise helpful in alleviating symptoms.