Anti-depressants

The name of the antidepressant medication is shown below. The bold italicized names are the chemical names for the brand names listed under them:

Imipramine
Tofranil
Tofranil-PM
Imavate
Janimine
Pramine
Presamine

Desipramine
Norpramine
Pertofrane
Trimipramine
Surmontil

Amitriptyline
Elavil
Endep
Nortipyline
Aventyl
Pamelor

Trazodone
Desyrel
Doxepin
Adapin
Sinequan

Protripyline
Vivactil
Maprotiline
Ludiomil

Fluoxetine
Prozac
Amozapine
Asendin

Sertraline
Zoloft
Paroxetine
Paxil


Antidepressants must be taken regularly, not just when you feel like you need them. In other words, never stop taking the medications because you feel better and think you no longer need them. Stop them only when I tell you. Your treatment with antidepressants will last a minimum of three months.
Take your medication all in one dose, and take them about four hours before you intend to go to bed. That will put some of your side effects such as drowsiness while you sleep. There are two exceptions’ Trazodone (Desyrel) should be taken right at bedtime with a snack. Fluoxetine (Prozac) should be taken after arising.

Most of the good effects of this medication will not show themselves for about two weeks. Some of the medications will help you sleep right away, but all of the other beneficial effects will be delayed for two weeks or sometimes longer. When the medication does begin to work your headaches or other pain will go away. Your tendencies to cry and feel irritable will go away; in other words, you will feel like you are back to normal.

When you do begin to feel back to normal, do not stop taking the medication. If you do, within three or four days you will feel worse again.

It is extremely important that I see you again after the first two weeks of treatment in order to evaluate whether the diagnosis and treatment is correct. Whatever you do, do not stop taking the medication until you see me.

If anything troublesome happens which you think may be due to the medication, call and let me know what is happening. Many times the problems will have nothing to do with the medication at all. However, it is true that with a few people there may be such reactions as constipation, blurring of vision, delay of urination. or a lot of perspiration. Such side effects are usually temporary and
can be controlled other ways.

You should be able to work, drive, and carry out your usual activities while taking the medicine. When first beginning the antidepressant, you should use some caution about driving or engaging in other hazardous activity until you see how the medicine will affect you. Usually you can do anything you wish, especially after the first two or three days. If you are too sleepy after that, or cannot sleep, it usually means that we need to change the type of antidepressant to one that gives more or less drowsiness, and I can easily do that by phone. Call if there is any problem.

You should be aware that the safety of these medications lies in the fact that you cannot hide from troublesome life situations with them. If, for example, you do not have the true medical disease of depression, but instead are only working too hard, you will receive no “energy” from these pills. If you do not have a depression, but instead are simply unhappy with a life situation that would make anyone unhappy, then the pills will give no happiness. If your headache or stomach ache are due to some other disease, the pills won’t help. They only work when the disease depression is present, and in that situation they usually give dramatic and gratifying relief to all of the symptoms. Thus you can see the basic difference between these medications and such drugs as alcohol, “uppers”, “nerve pills”, sleeping pills and the like. These medications cannot be used as an escape from life’s problems. and are not habit forming. The antidepressants cannot be used in that way, and that is their greatest safety feature.

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