Antidepressants are psychotropic drugs, mainly used since the 1960s, in the treatment of depression. They are also used in the treatment of anxiety disorders, chronic pain, and depressive phases in bipolar disorder.

What is a psychoactive drug?

Nerve cells (neurons) synthesize substances called neuromediators (or neurotransmitters), mainly: dopamine, serotonin and norepinephrine. These neuromediators intervene in the functioning of neurons.

There is a disturbance of these neuromediators in certain disorders, such as depressive disorders, bipolar disorders, anxiety disorders or schizophrenic disorders. Psychotropic drugs acting on these neuromediators are used to fight against mental disorders. They also have effects other than psychic, which also explains some of their undesirable effects.The other option that can be useful is the local talk therapy.

Antidepressants: who is concerned?

In 2010, 6% of 18-75 year olds report taking an antidepressant. Between 2000 and 2015, antidepressant consumption increased by around 20% in France, and more than doubled in Germany and the United Kingdom. In 2015, France ranks 18th among OECD countries for antidepressant use (Source: OECD Health Statistics 2017).

What effects? What precautions?

The goal of psychotropic drug therapy is not to normalize thinking or change personality. The first objective is to relieve the suffering of the person and to reduce the psychic disorders, in order to have the best possible life.

The goal of the treatment of depression is to relieve suffering and sadness, to reduce the physical, psychological and relational consequences, as well as the suicidal risk.

Regardless of the level of depression, care is primarily based on psychological support that can be conducted by the attending physician, a psychologist or a psychiatrist for complex and / or severe cases. It is sometimes enough to overcome a mild or moderate depressive episode.

Antidepressant drugs should be considered in cases of severe or prolonged depression.

In anxiety disorders, non-medical treatments (cognitive-behavioral therapies (CBT), relaxation, etc.) are preferred. Antidepressants should be considered when these therapies are not enough or are not available.

All antidepressants can cause side effects . Most are uncomfortable and often appear at the beginning of treatment. Some side effects are serious, but they are rare. Some are common to all antidepressants, but each group of antidepressants also has specific side effects. Detecting them often makes it possible to limit their consequences, hence the importance of an open dialogue between patients and caregivers. Some precautions can avoid a lot of side effects, especially by limiting the associations with other drugs.

Special precautions

Pregnant women (or likely to become pregnant), breastfeeding women: it is prudent to check with a health professional the absence of possible harmful effects for the pregnancy or the unborn child. Other options may be to consider.

Elderly: The dosages of the drugs are often to adapt to the cardiovascular, cognitive, renal and hepatic state. Seniors are particularly sensitive to adverse drug reactions, which often warrant lower dosages than those used in adults.

Medications do not summarize the treatment

The doctor, psychiatrist or generalist, after having identified the symptoms of a psychic disorder, can prescribe, if necessary, a psychotropic treatment. It offers psychological and medical support during the course of treatment (evaluation of beneficial effects and monitoring of adverse effects).