Effect of Antidepressant Medication on Patients - Essay Example

Abstract

Although antidepressants generally produce desired results among patients, their side effects have often been overlooked. There are many types of antidepressants in the market, and each poses risks to the users. Although the data on the prevalence and frequency of these side effects is relatively limited, there is some evidence to show that sexual dysfunction, sleep disorders, weight gain and suicidality are linked to the use of these drugs. In addition, pregnant women are also exposed to a wide variety of risks when using antidepressants. Users and medical practitioners need to understand the effects of these drugs to enhance their effective use. Future studies need to explore how individual antidepressants from the various categories affect users.

Introduction

Since the discovery of antidepressants in the 1950s, these drugs have become some of the most common prescribed in the world. This is as a result of the high number of patients suffering from depression or related disorders. Most of these drugs provide the required benefits to the users. However, the use of antidepressants has significant side effects. This paper is thus concerned with the effects of these drugs on patients, and the possible preventive or curative measures of these effects.

History and Use of Antidepressants

The history of antidepressants dates back to 1952 when an antimycobacterial agent known as iproniazid was found to have psychoactive properties (Lieberman, 2003). It was realized that patients are given this drug became active, cheerful and optimistic. However, the use of this drug as an antidepressant was not immediate until the 1960s (Lieberman, 2003). Although the use of these drugs was at first limited due to safety and toxicity concerns, advances in medicine led to modifications of existing drugs that provided better antidepressants. Since then, the use of antidepressants has been on the rise. In most cases, antidepressants are used in the treatment of depression. Heath care providers often prescribe these drugs to depressed patients, and this has led to a high number of users. Also, antidepressants are now used to treat anxiety, and in some cases, relieve chronic pains. Some of the common groups of antidepressants in the market today include Selective serotonin reuptake inhibitors (SSRIs), Serotonin and norepinephrine reuptake inhibitors (SNRIs), Vilazodone, Bupropion and Monoamine oxidase inhibitors (MAOIs). Under these classes, there are many different types of antidepressant drugs (Lieberman, 2003). However, the continued use of these drugs has been found to cause certain effects on the patients.

Prevalence

Although there are no clear figures that show the prevalence of these effects, the literature shows that between 30 and 70% of adult patients may be experiencing sexual dysfunctions after using antidepressants (Bahrick & Harris, 2003). Research, shows that all types of antidepressants are likely to affect sleep patterns in one way or the other.However, children and young adults are at a greater risk, with studies showing that the risk of suicidal thought is increased by 2 to 4 % (Turnipseed & Magid, 2008). Most of the antidepressants in the SSRI category are the ones that have been cited to cause this problem. For example, in 2003, UK Committee on Safety of Medicines advised that paroxetine, which is one of the drugs in the SSRI family, should not be used to treat teenagers under the age of 18 (Turnipseed & Magid, 2008). This was based on trial studies that demonstrated that patients who used this drug experienced worsening of depression.

It is estimated that up to 20% of pregnant women do suffer depression (Moret, & Isaac, 2007). Although there are no exact figures on the percentage of women affected by antidepressants, research shows that a good fraction of these is affected. However, prevalence is dependent on factors such as the type of antidepressant, age and the duration of usage.

Finally, the use of antidepressants is associated with certain risks during pregnancy (Turnipseed & Magid, 2008). It is common that a significant percentage of pregnant women suffer depression, and this makes it necessary to provide the necessary medications to treat depression.

Signs and Symptoms

Generally, symptoms vary with the type of antidepressants. For men, the most common symptoms include decreased morning erections, difficulty in achieving an erection, delay in ejaculation and reduced libido. When it comes to women, effects such as delayed orgasm, lubrication difficulties, difficulty with arousal and reduced libido are also noted (Ferguson, 2001). The case of these sexual problems is linked to the fact that these medications decrease the overall sensitivity of genitals (Bahrick & Harris, 2003). This is because they interfere with the functioning of nitric oxide which helps in penile and clitoral sensitivity.

Sleep problems have also been associated with the use of antidepressants. Research has shown that all antidepressants have an effect on the sleep architecture and sleep-wakefulness (Winokur & Demartinis, 2012). This is because the use of antidepressants causes the chemicals in these drugs to have a direct effect on neurotransmitters. This then has a direct effect on the sleeping behavior and sleeping patterns. Other common signs and symptoms include dizziness, headaches, loss of appetite, insomnia, diarrhoea, constitpation, feeling of sickness, anxiety, stomachaches, fits, muscle pain, weightgain, dry mouth, drowsiness, excessive sweating, shivering, confusion etc. (Winokur & Demartinis, 2012).

Treatment

Management of these side effects may require the patient to reduce the dose of the antidepressant, changing to a different brand and using of medications that improve sexual functioning such as Viagra. It is recommended that patients who experience weight gain when using antidepressants should consider changing their medications (Moret, & Isaac, 2007). Also, regular exercising and healthier meals could help address this problem. It is advised that patients using these drugs should be constantly observed by immediate family members and the healthcare professionals. In addition, patients are encouraged to stick to the prescribed dosages. Support from family is also an important factor. More importantly, seeking professional counseling is the best alternative. The treatment for pregnancy-related side effects is not clear, and hence, it is recommended that these medications should be avoided during pregnancy unless it is necessary.

Side effects

Antidepressants have been found to result in sexual side effects. Research has shown that sexual side effects of antidepressants may persist in individuals for as long as they continue to use them. However, in some cases, the effects may persist for years after the patient stops using the antidepressants (Bahrick & Harris, 2003). The use of antidepressants has also been associated with weight gain. It is estimated that 10-20% of people that use antidepressants are likely to experience a weight gain of 1-3kg on average (Nihalani et al., 2011). Some studies have shown that the use of certain SSRIs, for instance, can cause weight gains of more than 9kg (Ranjbar et al., 2008). Tricyclic antidepressants (TCAs), MAOIs and mirtazapine, are among the common antidepressants associated with weight gain (Ranjbar et al., 2008). Although the direct link between weight gain and antidepressant use is not very clear, there is evidence to show that the weight gain could be as a result of gaining an appetite. Since the loss of appetite is one of the indicators of depression, it means that curing of this problem could lead the individual to overeat.

The use of antidepressants drugs has significant side effects on both the woman and the unborn child. SSRIs, in particular, have been found to cross the placenta freely, and thus ends up being transferred to the fetus and newborn through breastfeeding. Specifically, SSRIs have been found to increase the chances of congenital malformations in the offspring. Although these risks are rare, studies have shown that paroxetine and sertraline are the common SSRIs that could result in such malformations (Moret, & Isaac, 2007). Also, the use of SSRIs is associated with the increased pulmonary hypertension in newborns. Furthermore, in some cases, antidepressants have been found to cause Neonatal withdrawal syndrome whereby newborns exhibit symptoms such as fever, tremors, jitteriness, mottling and poor feeding (Moret, & Isaac, 2007). Studies reveal that up to 30% of children exposed to SSRIs end up with this condition.

Prognosis

The period of use of the antidepressants is an important factor. If the use of antidepressants is stopped, the prognosis looks good. The patient will not experience sexual problems after ceasing the use of antidepressants. Factors such as age and the type of antidepressant use may affect the prognosis. When these medications are used for a long time, patients tend to gain more weight compared to when they are used for a short time (Ranjbar et al., 2008). Age is also a factor whereby research shows that older patients are likely to gain weight as a result of using antidepressants compared to their younger counterparts.

Conclusion

Depression is a common disorder that requires treatment. The use of antidepressants in the treatment of this disorder has been on the rise. However, it is important to consider the effects of these medications on the users. Although most of these medications provide the desired results in treating depression and related disorders, there are long term affects associated with them. Although by no means exhaustive, this paper has attempted to highlight some of these effects. When taking antidepressants, it is important for the patients to understand some of these effects in order to make better choices. Sexual dysfunction, sleep problems, weight gain and problems related to pregnancies are major effects discussed in the paper. There are limited studies that demonstrate the effects of specific antidepressants on patients, and this provides room for future studies to focus on this subject.