How do antidepressants act in the brain?

What mechanisms of action do they use to operate? Is it true they can cause dependency? The answers to these questions here.

The consumption of this type of medication has increased considerably over the las two decades, and, we’re very sorry to report that depression is affecting more and more people every day. The cause of this is unclear: we know that it’s a multifaceted condition in which different variables intervene including personality, exposure to stressful situations and biological susceptibility. Without treatment, the symptoms can last for weeks, months and even years, which is why it’s fundamental to seek professional help as soon as possible so that a therapy of some kind can be prescribed.

In general terms, depression is treated with a combination of medication and psychotherapy. As far as pharmacological treatment goes, there are actually a multitude of options to treat this illness. Below, we’ll analyze how each one of these medications act on the brain.

Tricyclic Antidepressants

Classic tricyclic antidepressants are made up of a central ring formed with seven elements and a nitrogen terminal that contains three elements (tertiary amines) or two elements (secondary amines). The tertiary amines include amitriptyline, imipramine, doxepin, trimipramine and clomipramine, while the secondary amines include desipramine, protriptyline and nortriptyline.

Although these medications are quite effective, they also present a range of side effects that is greater than that of other antidepressants. These medications impede the reuptake of serotonin and noradrenaline, and as a consequence, allow for an increase in the levels of these neurotransmitters in the encephalon.

Selective Serotonin Reuptake Inhibitors (SSRIs)

Safe and effective, SSRIs are usually the go-to medications when treating depressive symptoms for the first time. Concretely, these antidepressants act by increasing extracellular levels of the neurotransmitter serotonin. To do so, they inhibit the reuptake of this neurotransmitter by the presynaptic cell.

The selective serotonin reuptake inhibitors got their name (selective) because they only act on this neurotransmitter (serotonin) and not others.

Serotonin Noradrenaline Reuptake Inhibitors (SNRIs)

They have a more potent impact than SSRIs and are considered as effective as tricyclic antidepressants. They act on two neurotransmitters that play a fundamental role in mood – serotonin and noradrenaline -, and the mechanism it uses is similar to that of tricyclic antidepressants.

These medications offer a great advantage: the majority result in little sedation and in general, the side effects are less severe than the ones associated with tricyclic antidepressants. However, they can cause blurred vision, headaches, nausea, changes in appetite and trembling.

Do antidepressants create dependency?

The short answer is no. However, it’s important that when discontinuing treatment, that the removal of these medications is progressive. In the event that you should experience any type of dependence, you should know that it’s probably psychological. Even so, it’s ideal that you consult with your doctor about any questions you have about the medication you’re taking. Your doctor is the best person to go to for answers.



Depression, Wellbeing, Symptoms, Diagnosis, Medication, Psychological aspects, Health professionals

Author: Purificación Salgado, Journalist

Last Modification: May 22, 2017

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