Decades ago, when people suffered from clinical depression, they were often given a group of antidepressants called tricyclic (TCAs) to help them feel better. These drugs had many and different side effects and weren’t safer than new drugs.
However, things changed when a new type of medication called selective serotonin reuptake inhibitors (SSRIs) came into widespread use. These SSRIs were much safer and easier for people to tolerate.
But even though SSRIs were good news, they still have some limitations. They can sometimes make you feel more worried during the first days of the treatment.
It also takes a while for them to work and make you feel better. Some people taking SSRIs also experience problems with their sex drive, sleep, and the overall effectiveness of the treatment is not always very strong.
SSRIs may not work well for people who have symptoms like a lack of interest in things they used to enjoy and difficulties with thinking.
There are other medications called serotonin and noradrenaline reuptake inhibitors (SNRIs), like venlafaxine, which can work better than SSRIs for some people, but they also come with more side effects.
Scientists have tried to improve SSRIs by improving their therapeutic profile in the brain, but these attempts haven’t been very successful so far. There’s a new medication called vortioxetine that might be better for cognitive problems.
In the future, researchers hope to create medications that work more like the older and more effective TCAs but are still safe and well-tolerated.
There may also be benefits derived from combining SSRIs with other groups like 5-HT4 receptor agonists and 5-HT7 receptor antagonists.
So, while SSRIs have been a big step forward in treating depression, there’s still room for improvement in the world of depression medication.
Source: Cowen PJ. SSRIs in the Treatment of Depression: A Pharmacological CUL-DE-SAC? Curr Top Behav Neurosci. 2023 Nov 4. doi: 10.1007/7854_2023_447. Epub ahead of print. PMID: 37922101.
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