Drugs to relieve depression and anxiety

Currently, drugs that are clinically recognized as effective in relieving depression and anxiety are mainly divided into prescription categories (including SSRIs, SNRIs, tricyclic antidepressants, some atypical antipsychotics, short-term benzodiazepines, etc.) and over-the-counter auxiliary drugs (oryzanol, St. John's wort extract, etc.). However, there is no "magic drug" suitable for everyone. Drug selection, dosage, and dosage periods must be determined after evaluation by a professional psychiatrist. Purchasing and taking drugs by yourself carries great health risks.

A while ago, when I was out with a psychiatrist I knew well, I met a girl who was in her third year of college. The first thing she said when she came in was, "Can I buy Prozac myself?" My roommate took it for half a semester and his anxiety has improved a lot." In fact, this is also the first misunderstanding that most people have about this type of medicine: if it works for others, it will definitely work for you if you take it. Prozac, Sertraline, and Paroxetine that everyone often hears about all belong to the SSRI class, which is a selective serotonin reuptake inhibitor. They are the preferred solution for most doctors now. After all, compared with the old drugs in the early years, its side effects are indeed much lighter. Most people will not feel drowsy after taking them, and their normal work and school will not be affected. But don’t tell me, some people really feel uncomfortable after taking it. I met a patient who was a programmer before. His anxiety was relieved very well by taking paroxetine, but his hands were a little shaking, which affected his writing of code. Later, he changed to sertraline to solve the problem. There are also a few patients who feel nauseated in the first two weeks after taking it, and even said that "the mood has calmed down, and they will not be sad but will not be excited about happy things." These are very individual reactions and there is no unified rule.

What’s interesting is that there has been debate in the academic community about whether to take medication for mild depression and anxiety. Those who do long-term psychological intervention often believe that mild emotional problems are equivalent to "walking with a sprained foot. It is better to slowly recover on your own than to just use a cane." Medication will cover up the real emotional symptoms. ； But the position of clinical psychiatrists is usually that if you have been unable to eat or sleep well for two weeks in a row, and you can't feel energetic about anything, you should first take medication to bring yourself back to your state. Otherwise, you won't even have the energy to sit down and talk to a counselor for an hour. How can you talk about psychological adjustment? Both views are reasonable. The final choice depends on the degree of impact on the life of the person concerned.

If you are not only in a bad mood, but also have inexplicable headaches, backaches, and body tightness. After going to the internal medicine department for a checkup, there are no organic problems. Then the doctor will most likely prescribe SNRI drugs for you, such as venlafaxine and duloxetine. These drugs act on serotonin and norepinephrine at the same time. They are much better than SSRIs for depression and anxiety accompanied by physical symptoms. However, people with high blood pressure should be careful about taking them and monitor their blood pressure during the medication. Many people read on the Internet that old tricyclic antidepressants have serious side effects and should be killed immediately. In fact, drugs such as amitriptyline are cheap and are particularly effective for some refractory depression patients with severe insomnia. However, because there are so many drugs available now, they are not the first choice. They are not "bad drugs that have been eliminated" at all.

There are also many people who buy auxiliary medicines, such as oryzanol, for example. It is really useful to take some when they are anxious and cannot sleep well. The side effects are small. At most, they may have an occasional stomach upset. St. John's wort extract is sold as a health supplement in many places in Europe and the United States, and it also has certain effects on mild anxiety, but here we must sound the alarm: it must not be taken together with SSRI and SNRI prescription drugs, otherwise it can easily cause serotonin syndrome. My doctor friend met a patient before who took paroxetine and purchased St. John's wort gummies as snacks from overseas. He was sent to the emergency room with panic and shaking hands for three days, and almost had an accident.

The most frequently asked question is "Will taking medicine become addictive?" In fact, it is a complete misunderstanding. Except for benzodiazepine anti-anxiety drugs such as lorazepam and alprazolam, doctors generally only let you take them for a few weeks in the short term. Long-term use may indeed lead to dependence. None of the mainstream antidepressant and anti-anxiety prescription drugs mentioned above are addictive. Many people feel uncomfortable after stopping the drug. It is not an addiction at all, but a withdrawal reaction caused by cutting off the drug too quickly. If you reduce the drug slowly and little by little, there will basically be no obvious discomfort.

I have seen people who took half a tablet of sertraline and completely improved and stopped taking it after three months. I have also seen people who changed five or six types of medicines and took more than half a year to find a suitable solution. After all, the human brain is more complex than the most sophisticated instruments. How can there be any unified standard answer? After all, these medicines do not help you "force yourself to be happy", they are more like giving you a cushion for your tense nerves, so that you will not collapse at the slightest thing, or get stuck in a depression and be unable to climb out. You still have to go through the remaining hurdles yourself. Don't blindly search for experience posts and prescribe medicine randomly, and don't feel like the sky is falling when you hear that you need to take medicine. Finding a reliable doctor to communicate with is better than anything else.