Written by Kevin Tavolaro
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The term "antidepressant" usually refers to a collective group of medications used for treating depression, anxiety, social phobias, and other psychiatric ailments. However, in recent years the term has also been applied to a number of alternative therapies for these same conditions. These alternative therapies provide a natural counterpart to traditional antidepressant medications, and include herbal, dietary, and vitamin supplements intended to interact with the brain and nervous system in a similar fashion. Because of the highly personalized nature of depression and related disorders, the suitability of traditional vs. alternative antidepressants is open to debate, and often determined by the individual and the situation.

In order to understand the effects of these medications, it is first necessary to understand the basic concept of depression. Depression, simply defined, involves the prolonged and severe experience of a sad, "blue" mood. However, this mood exists independent of, or disproportionate to any legitimate catalyst. That is two say, a person may experience the symptoms of depression due to an event such as the loss of a loved one, but these symptoms are perfectly appropriate in this situation, and are not indicative of the disorder. Depression is defined as when these symptoms occur, yet not as an appropriate response to grief, disappointment, frustration, loneliness, or other melancholy feelings. In addition, in order for the disorder to be present, the symptoms must be present for a prolonged period of time. This period varies between different types of depression disorders, but can be anywhere from two weeks to two years.

While the exact causes of many types of depression are unknown, it is believed to result from a combination of chemical, emotional, hereditary, and psychological factors. Chemically, neurotransmitters in the brain are shown to be responsible for dictating mood and emotion in many circumstances. Medications usually work by interacting with the brain in order to alter the production of some of these chemicals. For example, serotonin, one such neurotransmitter, is a chemical closely associated with the symptoms of mood disorders, including depression. Many of the most popular medications for depression regulate the brain's production of serotonin, thereby balancing the situation and alleviating the effects of depression on the individual.

Development of the Modern Depression Medication

Experiments on animals in the 1940s highlighted the sedative effects of some medications, including lithium. These results were then applied to human beings suffering from manic depressive disorder, which had previously been treated exclusively by therapy. These early medication tests found that lithium promoted relaxation and relieved anxiety in people with manic depression disorders, thereby reducing the overall effects of the condition. This lead to an increased effort through the 1950s and 1960s to study the effects of medications on the brain as well as the body. In the early '50s, a tuberculosis treatment was found to also raise mood levels and promote increased activity among patients. Although this treatment, Ipronazid, was soon found to have many detrimental side effects, its chemical makeup was useful in the development of many new psychiatric drugs.

An important discovery in this field was made in 1971, when it was found that fluoxetine hydrochloride was capable of interacting with the brain and halting the production of serotonin, but allowing all other neurotransmitters to function as normal. This meant that fluoxetine hydrochloride was capable of reducing the effects of depression without creating as many side effects as previous medications. This discovery was eventually used to create the drug Prozac, which is one of the most well known antidepressant medications.

Prescription antidepressants alter the production of neurotransmitters in the body. Depression itself alters the production of these neurotransmitters, which instigates many of the effects and feelings associated with the mood disorder. Depression medications attempt to alter neurotransmitter levels again, until they approximate normal, healthy levels. They largely achieve this by interacting with the production of serotonin, or by inhibiting the output of certain neurons. Neurons are nerve cells that release neurotransmitters into the brain, regulating, among other things, mood and emotion. The presymaptic neuron distributes neurotransmitters into the area between the neuron and its surrounding cells. This space is known as a synapse, and provides a network of routes for the neurotransmitter to reach the neighboring cells. When the neurotransmitters bind with one of the surrounding cells, action and emotion are triggered. Depressive disorders occur when these neurotransmitters are released without appropriate induction, and for a prolonged period.

Antidepressant Functions

Antidepressants usually alter the actions of the neurons and neurotransmitters in one of several key ways. The first way is that they can change the rate at which the body produces or eliminates neurotransmitters. The second is to halt the process that recycles specific neurotransmitters already in use, which is known as the reuptake process. They can also effect the process by preventing the neurotransmitter from binding with the appropriate neighboring cell. The interactions between antidepressants and neurotransmitters may initially cause a number of side effects in a patient as their body grows accustomed to the medication. These side effects can occur for several weeks, the amount of time that it takes for most antidepressants to accumulate in the bloodstream enough to produce a positive effect. That initial period of intense side effects and no recognizable benefits can sometimes sour patients on the value of depression medications. As a result, some patients look to alternative forms of treatment.

Alternatives to prescription medical antidepressants include dietary, herbal, and vitamin supplements. Herbal supplements have gained increasing popularity in recent years, and many appear to exhibit results similar to those of prescription medications. Some of the most popular herbal antidepressant supplements appear to function in a fashion similar to their prescription counterparts, and act as selective serotonin reuptake inhibitors, regulating the production of that depression-related chemical in the brain. These include Kava Kava, St. john's Wort, and Gingko Biloba. These supplements are favored by some people who feel that they provide the same benefits of traditional medical antidepressants, without the debilitating side effects.

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