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Medications for Depression and Anxiety

The lists of medications below contain some of the drugs commonly used for depression, anxiety, and other mood disorders. Some these medications can interact with one another, but most of them can be used in combination, if appropriate. For some people with severe depression or anxiety, these medications may be necessary for a period of time. However in most cases, natural treatments are equally if not more effective than prescription drugs.

Naturopathic doctors in Arizona have prescription rights, meaning that your naturopathic doctor can write you a prescription for an antidepressant if he or she feels it is necessary. This also means that if you are currently on a prescription medication for depression or anxiety, and you want to taper down to a lower dose before going off the medication, your naturopathic doctor can write you a prescription for the lower dose, while transitioning you to natural therapies.

Typical Antidepressants:

·    Prozac (fluoxetine)

·    Effexor (venlafaxine)

·    Pristiq (desvenlafaxine)

·    Lexapro (escitalopram)

·    Celexa (citalopram)

·    Paxil (paroxetine)

These medications can decrease symptoms of depression by increasing the amount of serotonin between your nerve cells. Serotonin is released by the end of one nerve, and into the space (the synaptic cleft) between the two nerve endings. When serotonin is in the synaptic cleft, it sends a chemical signal to the next nerve that tells your brain, “I’m happy and relaxed.” In a normal healthy brain, serotonin will be released by the first nerve ending, send the signal to the next nerve, and be taken back into the first nerve.  In the presence of one of these antidepressant medications, serotonin is blocked from getting back into the first nerve cell, and is stuck in the synaptic cleft. While in the synaptic cleft, the extra serotonin sends an increased signal of “I’m happy and relaxed.” That is why these medications are called selective serotonin reuptake inhibitors (SSRIs). Some of the medications listed can also increase norepinephrine, which can increase energy and possibly decrease pain.

The side effects of SSRIs include an allergic reaction, restlessness, dizziness, difficulty concentrating, insomnia, dry mouth, bloating, nausea, low libido, decreased appetite, and (rarely) seizures. Drug interactions can occur between some other antidepressants, such as Marplan, Azilect, Nardil, and other monoamine oxidase inhibitors. You should not take SSRIs if you are pregnant. These medications have been shown to increase thoughts of suicide in teens and young adults. Anyone with a history of bipolar disorder should not take SSRIs without other medications to stabilize mood, because they can worsen the symptoms of mania.

Other Types of Antidepressants:

·    Wellbutrin (bupropion)

·    Cymbalta (duloxetine)

·    Marplan (isocarboxazid)

·    Desyrel (trazodone)

·    Surmontil (trimipramine)

·    Nardil (phenelzine)

·    Remeron (mirtazapine)

·    Eldepryl (selegiline)

·    Azilect (resagiline)

Most of these medications are monoamine oxidase inhibitors (MAOIs). These drugs stop an enzyme (called monoamine oxidase) from breaking down serotonin, dopamine, and norepinephrine. This can lead to increased energy and a reduction in depression symptoms. MAOIs can cause weight gain and sexual dysfunction. These medications and can also have a dangerous interaction with certain foods that contain high levels of tyramine, such as cheese, pickles, and wine. Because of this potential food interaction, most doctors choose not to prescribe MAOIs very often anymore. Wellbutrin is different from these medications in that it appears to affect only dopamine and norepinephrine, without altering serotonin activity. Its effects on dopamine may be the underlying reason for its usefulness in treating drug withdrawal, including smoking cessation. 

Anti-Anxiety Medications:

·    Ativan (lorazepam)

·    Xanax (alprazolam)

·    Serax (oxazepam)

·    BuSpar (buspirone)

·    Valium (diazepam)

Most of these medications are benzodiazepines, which reduce anxiety by sedating the brain and nervous system. BuSpar acts a little differently, but also has the same calming effect. These drugs generally work very well for treating the symptoms of anxiety. They are addictive, and can cause the patient to go into a coma if combined with alcohol or other central nervous system depressants.

Other Types of Anti-Anxiety Medications:

·    Compazine (prochlorperazine)

·    Dilantin (phenytoin)

·    Adapin (doxepin)

·    Klonopin (clonazepam)

·    Catapres (clonidine)

These are anti-seizure or sedative drugs, which have been used for people with anxiety disorders because of their sedating effect. Some patients do well with these medications, however, many people report that they do not feel like themselves while on these drugs. These medications can have a profound effect of sedation, and can cause headaches, nausea, dizziness, and blurred vision.

Bipolar Medications:

·    Abilify (aripiprazole)

·    Lamictal (lamotrigine)

·    Seroquel (quetiapine)

·    Lithium (lithium carbonate)

Bipolar disorder medications can have more serious side effects, because they tend to affect the nervous system and neurotransmitters on multiple levels rather than altering one neurotransmitter at a time.

Lithium is a medication used to stabilize bipolar symptoms. In high doses, it can be used to treat bipolar disorder. Unfortunately, the therapeutic dose is also very close to the toxic dose of lithium, so it is essential to have blood levels of lithium checked regularly to avoid an overdose. Lithium must not be taken during pregnancy, and can cause tremor, nausea, or heart arrhythmias at high doses. This medication is also available in a safer low dose (5-10 mg) as a natural supplement. At this low dose, it has been shown to act as a neuroprotectant, meaning that it can help to protect the brain cells from damage or degradation.

Abilify and Seroquel are antipsychotic medications, and effect a combination of serotonin and dopamine. Common side effects of Abilify and Seroquel are sedation, emotional “numbness,” restlessness, and tremor. Less common but more dangerous symptoms caused by taking Abilify or Seroquel include increased risk of suicidal thoughts (especially among teens), potentially permanent involuntary muscle movements, elevated blood sugar, and increased risk of heart attacks or infections in elderly patients with dementia.

Lamictal is an anti-seizure drug, so it can have similar effects to the atypical anti-anxiety medications listed above. Life-threatening skin rashes, multi-organ failure, and withdrawal seizures have developed in patients taking Lamictal.

These medications can be very helpful in some cases for people with severe bipolar symptoms, to help them get through the day. For some patients these drugs can work very well, however, other options should be considered, because of the possible risks of side effects.

Conventional medications may help reduce the symptoms of anxiety or depression, but these medications can cause unwanted side effects such as fatigue, restlessness, insomnia – symptoms that people with anxiety or depression usually already have! If you are interested in alternatives to the above medications, there are a variety of natural treatment options that are highly effective for improving your mood and helping you to feel like yourself again.  



This article has been contributed by a practicing Naturopathic Physician. East Valley Naturopathic Doctors is a multi-disciplinary group of alternative physicians who combine the best of conventional medicine with natural medicine for the benefit of the patient. Alternative treatments are offered for Arthritis, Attention Deficit, Autism, Cancer, Cholesterol, Depression, Diabetes, Environmental Toxicity, Fatigue, Heavy Metals, Hormone Replacement, Hypertension, Pain, Prostate, Weight Loss, Women’s Health and Many Others. East Valley Naturopathic Doctors is located in Mesa, Arizona and also serves Gilbert, Chandler, Tempe, Scottsdale, Apache Junction, and Queen Creek.

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