Atypical Antidepressants An Alternative Treatment

Atypical Antidepressants: An Alternative Treatment

Depression is a common mental disorder that affects millions of people worldwide. It’s a condition that affects how you feel, think, and behave, and if left untreated, it can lead to severe consequences. While traditional antidepressants are effective, they may not work for everyone and, in some cases, may cause unwanted side effects.

What Are Antidepressants?

Antidepressants are mental health medications used to treat depression and other mood disorders like bipolar disorder. They work by altering the levels of certain neurotransmitters in the brain, which influence our mood, emotions, and behavior. Traditional antidepressants, known as selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs), have been the go-to treatment for depression for decades. However, they are not always effective, and some people may experience unwanted side effects, such as sexual dysfunction, weight gain, and persistent nausea.

Atypical antidepressants, also known as second-generation antidepressants, are a newer class of medications that work in different ways than traditional antidepressants. These medications may be an alternative treatment for people who have not responded well to traditional antidepressants. However, as much as they have unique benefits, they also come with their own risks, and it is essential to speak to your healthcare provider about which medication may be right for you.

 

What Are Atypical Antidepressants?

Atypical antidepressants are more than just a newer class of medication. They have a different mechanism of action than traditional antidepressants. While SSRIs and SNRIs work by the reuptake of serotonin and norepinephrine in the brain, atypical antidepressants work by affecting the levels of other neurotransmitters, often without the common undesirable side effects. For example, bupropion affects the levels of dopamine and norepinephrine, while vilazodone and vortioxetine work by increasing the levels of serotonin without causing sexual problems or weight gain.

 

Common Side Effects and Safety Concerns with Atypical Antidepressants

Side effects range from common to rare with antidepressants, including atypical antidepressants, though some people may not experience any. Some side effects are more common in the initial phase of starting the medication and may go away after a time, while others may cause you to try a different medication.

Antidepressants and atypical antidepressants all work differently, which means that each medication has its own unique characteristics and varying possible side effects.

For example:

  • Most atypical antidepressants list possible side effects like dry mouth, dizziness, or lightheadedness.
  • Some antidepressants improve sleep and should be taken at night, while others should be taken as early as possible as they may cause sleep deprivation.
  • Some antidepressants are known to cause constipation, while others increase the opposite issue, diarrhea.
  • Some antidepressants affect your appetite and may cause weight gain or weight loss, while others may cause nausea.
  • Traditional antidepressants are more likely to cause sexual side effects than atypical antidepressants.

 

Antidepressants and Pregnancy

It is important to discuss the advantages and disadvantages of taking certain antidepressants with your doctor. If you are pregnant or breastfeeding, some antidepressants may be harmful to your baby, so it’s crucial to consult with your doctor or mental health professional if you are thinking of becoming pregnant. It is not recommended to stop taking your medication without first consulting your doctor, as doing so may pose potential risks for you.

 

Examples of Atypical Antidepressants

Below are five atypical antidepressants in a bit more detail, along with a rundown of each of their potential benefits and side effects.

 

Bupropion (Wellbutrin SR, Wellbutrin XL, others)

Bupropion is an atypical antidepressant that works by affecting the levels of dopamine and norepinephrine in the brain. It is commonly used to treat depression and seasonal affective disorder. It can also help with the treatment of attention deficit hyperactivity disorder (ADHD) and help people quit smoking. Unlike traditional antidepressants, bupropion does not cause sexual side effects and may even improve sexual function.

Additionally, it may help with weight loss and has a low risk of causing weight gain. However, it may cause anxiety, dry mouth, and insomnia. Bupropion should not be used by people who experience seizures or have issues with an eating disorder such as bulimia or anorexia.

 

Mirtazapine (Remeron)

Mirtazapine is another atypical antidepressant. It’s a second-generation SNRI that works by increasing the levels of serotonin and norepinephrine in the brain. It is commonly used to treat depression and anxiety disorders, and it may also help with sleep.

Mirtazapine has a low risk of causing sexual side effects and may even improve sexual function. Additionally, it has a low risk of causing chronic nausea. However, it may cause drowsiness and increased appetite and may affect weight gain. In some cases, mirtazapine has also been linked to an increase in cholesterol.

 

Trazodone

Trazodone is another second-generation SNRI. It is commonly used to treat depression and insomnia. It has a low risk of causing weight gain. However, it does affect awareness and may cause some people to become drowsy or less alert than they are normally.

Dizziness, lightheadedness, or fainting may occur, especially when you get up suddenly from a lying or sitting position. This medicine will also increase the effects of alcohol and other central nervous system depressants. Make sure you know how you react to this medicine before you drive, use machines, or do anything else that could be dangerous if you are not alert.

Unlike traditional antidepressants, trazodone does not cause sexual issues like low libido and erectile dysfunction. On the contrary, it is known to be used for treating difficulties with getting and maintaining an erection and may even improve sexual function. However, in rare cases, it has caused orgasmic inhibition in males. Trazodone has also been associated with rare cases of priapism, which is a persistent, usually painful erection not caused by or associated with sexual arousal. In other rare cases, trazodone has also been linked to problems with heart rhythm.

Vilazodone (Viibryd)

Vilazodone is a newer atypical antidepressant that falls in the second-generation SSRI category and works by increasing the levels of serotonin in the brain. It is commonly used to treat depression and may also help with anxiety. Because of its postsynaptic receptor actions, vilazodone has a lower risk of causing sexual side effects. Another potential benefit is the lower likelihood of vilazodone causing weight gain and cardiac toxicity.

Some products like antiplatelet drugs, nonsteroidal anti-inflammatory drugs, and blood thinners may interact with this drug and can cause bleeding/bruising. Older people are more sensitive to these side effects. Additionally, it may cause nausea, diarrhea, and insomnia.

 

Vortioxetine (Trintellix)

Vortioxetine is an atypical selective serotonin reuptake inhibitor antidepressant that works by increasing the levels of serotonin in the brain. It is commonly used for the treatment of major depressive disorder. Vortioxetine is different than other SSRIs because it also works by directly modulating various serotonin receptors. Unlike traditional antidepressants, vortioxetine does not cause sexual dysfunction. Additionally, it has a low risk of causing weight gain. However, it may cause nausea, vomiting, and constipation. Vortioxetine may also increase the risk of bleeding, especially when interacting with other medications that cause blood thinning.

In rare cases, this medication may cause a serious condition called serotonin syndrome. The risk of this happening increases if you are also taking other drugs that increase serotonin. These could include other SSRIs, certain pain medications, herbal supplements like St. John’s wort, or street drugs like MDMA. Vortioxetine has also been associated with the activation of mania/ hypomania in other rare cases.

 

Always Follow Medical Supervision

Atypical antidepressants are a newer class of medications that can be very effective for people who have not responded to other antidepressants or who have experienced unwanted side effects. They may be a valuable alternative treatment as they have unique benefits. However, it’s important to note that these medications may not work for everyone and that it may take several weeks to see results.

Additionally, some atypical antidepressants may interact with other medications or supplements, so it is important to inform your healthcare provider of all medications you are taking. As with any medication, it is important to be aware of the potential risks and side effects associated with atypical antidepressants. It’s essential to discuss medications with your healthcare provider when deciding which may be right for you. They can also monitor your progress and adjust your treatment plan as necessary.

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