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how can I choose a good antidepressant?


Posted by sarah

i'm 19 years old and i suffers from a depression and insomnia and I thimk alot about every thing so i want to know what can i take?

thanks 

 
Answers (3)
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Sarah:

All antidepressants are available by prescription only - so you'll have to see a doctor and should get a diagnosis of depression +/- anxiety (they often appear together) versus some other physiologic cause for your symptoms.  All currently marketed antidepressants are effective in approximately 70% of persons at starting doses.  It usually takes at least 6 weeks to see an mood lightening, though anti-anxiety effect may appear more quickly.  Teens have been noted to have a higher tendancy towards suicidal ideation with some antidepressants so this should be monitored carefully by the prescriber.

 

Peace,

Daniel A.

You may want to consider alternatives to drugs, since depression is not caused by a drug deficiency. If you live in a northen climate, ensure you're getting enough sunshine during the winter months, otherwise take a vitamin D supplement. Increase your intake of omega 3 fatty acids - found best in fatty fish and organ meats. Also, get exercise and try to practice some meditation. Good Luck

Both Daniel A. & organicproductsplus make excellent points.  As a family physician & geriatrician, I would recommend going the non-pharmacologic route first.  In other words, consider what organicproductsplus wrote.  Do you feel any better?  Are you back to your normal self?  If so, you don't need medicines.  

If not, before you move onto medicines, you could consider some over-the-counter (at least here in the States) dietary supplements and herbs, such as St. John's wort or SAM-e.  And as mentioned, there are many reasons to take extra vitamin D & fish oils besides mood.

So let's say you've exercised, gotten outdoors w/some sun exposure, and added the above supplements to your daily regimen for the last several months, but to no avail.  And to make my life easier, let's say that your mom, sister & maternal aunt all suffer from depression (there's a familial trend or tendency, genetics if you will) and all have responded to Drug X.  As a family physician with that information, it would be silly of me not to offer you the same.  

But let's say that there's no family history of depression, or if there is, that everyone responds to different medicines, so you really don't have a consensus.  Daniel A. made some excellent points, especially about the black box warning against suicide risk in teenagers.  We would start by asking if you're more anxious or more lethargic.  That might help us determine whether you need an anti-depressant that's anxiolytic (helps get rid of anxiety) or more activating (gives you more energy).  

The concern that's been brought up is that sometimes the activation occurs before the anti-depressant effects.  The risk in teens is that they now have energy to commit suicide since they're still depressed.  That's why you need to find a family physician, pediatrician or psychiatrist who is willing to meet w/you every week to 2 weeks initially to help you find the medicine & dose that's right for you.  As Daniel A noted, it can take some time for you to notice benefit.  So don't give up too early in the beginning.  And plan to take the medicine for at least a year.  You don't want to have another episode b/c you quit too soon.

One last point.  Although it may feel like it, you're not alone.  Studies report that as many one in two teenagers are depressed.  Make sure you have physician who listens well and will see you regularly to help you through this time in your life.  Good luck!

NOTICE: The information provided on this site is not a substitute for professional medical advice, diagnosis, or treatment. Never delay or disregard seeking professional medical advice from your physician or other qualified health provider because of something you have read on Wellsphere. If you have a medical emergency, call your doctor or 911 immediately.
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