Antidepressants and Autism Ranking:

Key Features

Antidepressants are types of medications which are normally used to treat people with moderate to severe depressive illness and a range of other conditions. 

Antidepressants are normally prescribed in combination with other treatments, such as talking treatments and lifestyle changes. This is because, according to the Royal College of Psychiatrists (2015),

“It is not enough just to take the pills. It is important to find ways of making yourself feel better, so you are less likely to become depressed again. These can include finding someone you can talk to, keeping physically active, drinking less alcohol, eating well, using self-help techniques to help you relax and finding ways to solve the problems that have brought the depression on.”

Types

There are several types of antidepressants including:

• Selective serotonin reuptake inhibitors (SSRIs) such as citalopram (Cipramil), fluoxetine (Prozac) and sertraline (Lustral).
• Selective serotonin reuptake enhancers (SSREs) such as tianeptine (Stablon).
• Serotonin noradrenaline reuptake inhibitors (SNRIs) such as such as duloxetine (Cymbalta and Yentreve).
• Noradrenaline and specific serotonergic antidepressants (NASSAs), such as mirtazapine (Zispin).
• Tricyclic and tricyclic-like antidepressants (TCAs) such as amitriptyline (Tryptizol), clomipramine (Anafranil) and imipramine (Tofranil).
• Monoamine oxidase inhibitors (MAOIs) such as isocarboxazid (Marplan), phenelzine (Nardil) and tranylcypromine (Parnate).

In practice, you are more likely to be prescribed with the newer antidepressants (such as the SSRIs and the SNRIs) than the older antidepressants (such as the tricyclics and the MAOIs) because they tend to have fewer side effects.

Mechanism – how they work

According to Mind (2016),

“Antidepressants work by boosting or prolonging the activity of particular brain chemicals, such as noradrenaline and serotonin, which are thought to be involved with regulating mood.

“Noradrenaline and serotonin are neurotransmitters. This means that they pass messages between nerve cells in your brain, and between nerves and other target organs in the rest of your body.

“By causing a change to your brain chemistry, antidepressants may lift your mood. However, antidepressants don't work for everyone, and there is no scientific evidence that depression is caused by a chemical imbalance which is corrected by antidepressants.”

It is also possible that some antidepressants may disrupt pain signals in the brain, leading to the relief of long-term pain.

Format and Brands

Antidepressants are available as tablets, capsules, liquids and drops, although most people take them as tablets.

The same antidepressant may have several different brand names. For example, fluoxetine is sold under a variety of brand names including Olena, Oxactin, Prozac and Prozep.

Dosage

According to NHS Choices (2015),

“When prescribing antidepressants, your GP usually selects the lowest possible dose thought necessary to improve your symptoms.

“This approach is intended to reduce the risk of side effects. If this dose doesn't work, it can be gradually increased.

“Antidepressants are usually taken in tablet form. Depending on the type of antidepressant prescribed and the severity of your depression, you'll usually have to take one to three tablets a day.”

For the latest information on specific formulations and recommended dosages please see our website entries on specific antidepressants or refer to the BNF (British National Formulary).

Usage

If antidepressant medication is prescribed, you should start with a low dose, use the minimum effective dose needed and regularly review the benefits and any adverse events.
 
When choosing antidepressant medication, you should take into account any side effects, the costs, your preference, and your response to any previous treatment with an antidepressant.

In general the newer SSRIs and SNRIs should be chosen over the older MAOIs and tricyclics because they are safer and produce less severe side effects. 

Updated

17 Jun 2022

Last Review

01 Jan 2017

Next Review

01 Jul 2023