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Types of Antidepressants and Their Targets

"Physically you are a human being, but mentally you are incomplete. Given that we have this physical human form, we must safeguard our mental capacity for judgment. For that, we cannot take out insurance; the insurance company is within: self-discipline, self-awareness, and a clear realization of the disadvantages of anger and the positive effects of kindness."

Dalai Lama

This quote is only a small grain in the borderless ocean of human health definitions. It is beyond a question that overall health consists of two components: physical and mental, both having the same potential in making a human being healthy or sick.

For a long history of human civilization, people succeeded greatly in understanding the nature of physical disorders as well as in treating them. In the meantime, mental diseases, like depression for example, have been a kind of a deep dark secret for a long time.

But the amount of these dark secrets is reducing constantly nowadays. Humans have already conquered many diseases; humans revealed the secret mechanisms of mental diseases and humans invented remedies to cure them.

According to the statistics, depression is the most common mental disorder of the modern people. Consequently, drugs, aimed to fight this disease, are called anti-depressants.

For the time being there are three main classes of antidepressants, featuring different modes of action in treating depression: - selective serotonin reuptake inhibitors (SSRIs) - tricyclic antidepressants (tricyclics) - monoamine oxidase inhibitors (MAOIs)

Actually, any antidepressant aims in eliminating depression symptoms and elevating one's mood, improving sleep and appetite, reducing anxiety, sharpening concentration, and restoring energy levels.

In order to understand how they reach this goal, it is necessary to know that modern medicine considers certain chemicals in brain to be responsible for depression symptoms. These chemicals are serotonin, norepinephrine and dopamine. The decrease in their amount or activity usually results in depression symptoms.

Now let me illustrate the difference between SSRIs, tricycles and MAOIs with the following example. Imagine that you have decided to visit the shooting gallery. Your targets are serotonin, norepinephrine and dopamine. But, the task is not so easy, because your targets are encircled with many other objects, which should remain unharmed.

What type of weapon will be your choice in this situation: a sniper rifle, an automatic gun or a bazooka?

It is obvious that the best choice is a rifle, because it allows to strike exactly the necessary object in the crowd, the other two choices are also not bad, though there is a much more greater risk to harm the objects, surrounding the necessary target.

The situation with antidepressants is somewhere close to the above described shooting gallery. SSRIs are drugs, similar to rifles, affecting only serotonin in brain. Consequently, it is more precise in fighting depression and causes fewer side effects.

Paxil, Zoloft, Celexa and Prozac are the most popular SSRIs.

Tricycles are like automatic guns – when a rifle does not help, it is the best choice to strike a target. Their targets are serotonin or norepinephrine in brain. The first drugs of this class appeared about 50 years ago. Now the most popular is Elavil, Asendin, Anafranil, Norpramin, Aventyl, Vivactil and Surmontil.

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Finally MAIOs (Nardil and Marplan) – this medication works by blocking special enzyme, called monoamine oxidase. This enzyme is responsible for metabolizing serotonin and norepinephrine as well as some food components. MAIOs may cause a lot of side effects, because their action is not limited to brain only, yet they can affect liver and intestines. Actually, it is the reason for the fact that bazooka is rarely used in civil shooting galleries.

As you see, every target requires the correct weapon to strike it. Depression, as well as any other mental disease, requires even more care and accuracy in choosing an appropriate treatment option, because all the targets are located in brain - a place, crowded with hundreds of vitally important centers, substances and mechanisms.


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