An Overview of Common Antidepressants Prescribed

Depression is a common mental illness worldwide; however, people with chronic medical conditions are particularly susceptible to depression. Overall, mental health disorders are a common comorbidity for people living with chronic obstructive pulmonary disease (COPD).¹

Link between COPD & depression

One study found that the prevalence of depression is 26% higher in people with COPD; this is 2-3 times higher than in the general population. However, the authors noted that the prevalence is likely higher given that depression tends to be under-diagnosed.

It is often scary or uncomfortable for people to bring up depression with their primary care doctor; however, people often receive appropriate treatment once they do. Receiving help for depression does not mean that one is weak; on the contrary, it takes a lot of courage to do so!¹

The role of antidepressants

Treating depression requires a multi-faceted approach, and prescribed antidepressants may not be for everyone. Your doctor may recommend other approaches first, such as counseling or cognitive-behavioral therapy. Some people use antidepressants as first-line treatment, with or without counseling.²

Choosing the right antidepressant

There are many classes of antidepressants. Your doctor will consider various factors when selecting which drug to prescribe, including:^2-4

• Interactions with other medications - for example, some antidepressants can affect heart rhythm so may not be suitable for some people with prolonged heart rhythm disorders.
• Other medical conditions - antidepressants are not used to treat only depression; depending on the class of drug, they can be used for other conditions, such as anxiety, pain, or helping induce sleep for people who have troubles falling asleep. Your doctor may select an antidepressant based on its ability to treat your other medical conditions.
• Side effect profile - some antidepressants are notorious for certain side effects, such as drowsiness, sexual side effects, or weight gain. Because of this, patient preference can also dictate which drug is trialed.

Common classes of drugs

Some common classes of drugs include:^3-4

• Selective serotonin reuptake inhibitors (SSRIs) - SSRIs are commonly trialed first to treat depression because they are effective and have a favorable side effect profile. They include drugs such as Zoloft, Celexa, and Prozac.
• Serotonin-norepinephrine reuptake inhibitors (SNRIs) - this class of drugs includes medications such as Pristiq, Effexor, and Cymbalta. They may be a good option for people with chronic pain conditions, such as diabetic neuropathy. Effexor is also commonly used to treat menopausal hot flashes.
• Tricyclic antidepressants- this class have been around for quite some time. In fact, they were used first-line for depression for 30 years before the SSRIs became marketed. They include drugs such as Elavil and Pamelor. These drugs are also commonly used to help with smoking cessation, chronic pain syndromes, and insomnia (troubles sleeping).

What is the response time?

In general, people see a response from an antidepressant within one or two weeks, but the full effect can take 4-6 weeks. If no response is seen, your doctor may recommend weaning off your current drug and switching to an alternate agent. It is not uncommon that people trial a couple of antidepressants before they find one that is tolerated and effective for them.²

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