Antidepressants: Know Your Side Effects - By Gabe Mirkin, M.D.

Drugs to raise brain levels of serotonin are far more effective in treating depression than just psychotherapy and talking, because depression is associated with low brain levels of the neurotransmitter serotonin.
Depression is a condition lasting at least two weeks in which sadness prevents people from functioning up to their capacity. They lose enjoyment and interest in usual activities, are sad and cannot express warm emotions towards other people, sleep all the time or barely at all, are exhausted, lose their ability to concentrate or think clearly, have feelings of worthlessness or inappropriate guilt, feel that life is hopeless, and they eat less or more than usual. Insomnia in young men is associated with a marked increased risk for depression that persists for at least 30 years afterwards.
Doctors treat depression with antidepressants, and the most used and effective antidepressants are Prozac, Paxil and Zoloft. They raise brain levels of a specific chemical called serotonin that helps to make people feel good. A once a week dose of Prozac can often control depression, but high brain levels of serotonin often reduce sexual desire.
On the other hand, Wellbrutin does not raise brain levels of serotonin significantly, does not reduce sexual desire and may even increase desire. Patients who need to stay on the serotonin-uptake-inhibitor antidepressants, but want to maintain interest in making love can take the shorter-acting Paxil or Zoloft safely four days a week from Monday to Thursday and not take them from Friday to Sunday. Taking Prozac intermittently does not prevent loss of libido because it is a long-acting antidepressant.
When a single drug fails to alleviate depression, two or more drugs taken together are far more effective than larger doses of a single drug. Buproprion (brand name Wellbruton) combined with Prozac, Paxil or Zoloft, appears to relieve depression more effectively than the single drugs. However, patients on the combination regimen still have a high incidence of decreased sexual desire, insomnia, tiredness and tremor.
Antidepressants that raise brain serotonin levels are used for other effects. Sibutramine is used to suppress hunger and treat overweight. They may be the drugs of choice to treat premenstrual syndrome or attention deficit disorder. They can be given safely to people with heart disease. Check with your doctor.
Dr. Gabe Mirkin has been a radio talk show host for 25 years and practicing physician for more than 40 years; he is board certified in four specialties, including sports medicine. Read or listen to hundreds of his fitness and health reports at http://www.DrMirkin.com
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