Antidepressants #1: Selective Serotonin Re-uptake Inhibitors

When broaching the concept of mental health, one topic inevitably comes up: medication. It often comes up fearfully or, worse, disparagingly, with talk of happy pills, catatonic states, and other such psychiatriphobia. But despite this, medication proves time and again to be one of the most effective forms of emotional therapy. It is a phenomenon that is demonstrated both through personal testimony and hard data — antidepressants work for a great many people.

At times it’s disheartening to see that one of the main reasons people pass up on mental wellness is this sense of ungrounded fear of pharmaceuticals. Psychiatric medicine is good medicine.

Pharmaceutical therapy has been shown in no uncertain terms to treat serious and often debilitating mental conditions, such as major depressive disorder, bipolar disorder, obsessive-compulsive disorder, bulimia nervosa, schizophrenia, and more. For many of us, it is the medication we need simply in order to get by.

Just as a diabetic person needs their insulin, a clinically depressed person needs their antidepressants, a schizophrenic person their antipsychotics, a bipolar person their mood stabilizers, and so on down the line.

When faced with one of these conditions, why not consider one of the best-documented and reliable forms of therapy?

If you have a general physician, talk to them about medication. It can admittedly be frightening at first, with an alphabet soup of different classes of pills, tablets, and capsules to contend with — NDRIs, SNRIs, MAOIs, SSRIs, and so on.

Try not to let this deter you as you continue to speak with your doctor, who may recommend you to a specialist — a psychiatrist. Ask questions, and stay active in the process of personalizing your pharmaceutical regimen. Any good doctor will guide you properly through the process. With that said, it is best to come prepared for the conversation.

But where to start?

A good place is an understanding of what the most commonly used drugs are and how they work, if only on simple terms. More often than not, the drug prescribed to patients is an SSRI: a serotonin reuptake inhibitor.

To break it down: serotonin is one of the main feel-good chemicals in our brains, responsible for, but not limited to, senses of well-being and happiness.

Serotonin pulses through our brains, across gaps between our nerve-endings called synapses. In a functioning brain, some of the serotonin remaining in these synapses between pulses will be collected back up by the original nerve-ending, rather than to the target nerve-ending, making it unavailable for use.

This is a usually healthy process; however, for some, too much serotonin is taken up again and made unavailable, leading to conditions like depression, obsessive compulsive disorder, and bulimia nervosa, among other potentially debilitating psychiatric disorders.

SSRIs exist and are prescribed by doctors as an aid for our neurological system to ensure that the proper amount of serotonin is making its way through our bodies, blocking this reuptake process, hence calling the drug an inhibitor.

With this in mind, what may come across an intimidating name can be understood as a description of how the drug works, hopefully demystifying it in some regard.

SSRIs come in several different forms under several different names, a common one being (in the United States) fluoxetine, perhaps better known by its commercial name, Prozac.

Fluoxetine comes in a number of different forms, each one tailored for a different effect. When talking to your doctor about fluoxetine, should they choose to prescribe it and should you choose to take it, speak to them about your diagnosis and what it entails.

The more you know about your condition, the better prepared you will be to overcome it.

The drug is not a cure-all, however. For one, side effects have been commonly reported among patients on fluoxetine, including but not limited to sexual dysfunction, decreased appetite, and anxiety.

Rarely, but significantly, fluoxetine can have its opposite intended effect and cause thoughts of suicide and self-harm. It is so important to monitor such thoughts as your regimen continues, and report them to your doctor immediately should they ever come up.

Beyond this, adjustments in the dosage can mitigate side-effects; but remember that your treatment is in the end just that — yours. Should you feel the medication does not work, then it does not work.

There are other medications to try, or else alternatives to medication altogether.

Still, if you’re going to have the talk with a doctor, fluoxetine is a great conversation starter.

– Casey Dalrymple

Photos by Susan Im

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