Taking antidepressant medications is not the complete answer to depression. A comprehensive treatment program customized to your particular needs may yield better results.
What Should You Do Next?
- Counseling may be recommended.
- Antidepressant medications is the most common conventional medical treatment. Antidepressants are grouped based on which chemicals in the brain they affect. There are many different kinds of antidepressants, including:
- Selective serotonin reuptake inhibitors (SSRIs)
- citalopram (brand name: Celexa)
- escitalopram (brand name: Lexapro)
- fluoxetine (brand name: Prozac)
- paroxetine (brand names: Paxil, Pexeva)
- sertraline (brand name: Zoloft)
- These medicines tend to have fewer side effects than other antidepressants. Some of the side effects that can be caused by SSRIs include dry mouth, nausea, nervousness, insomnia, sexual problems and headache.
- Tricyclic Antidepressants
- amitriptyline (brand name: Elavil)
- desipramine (brand name: Norpramin)
- imipramine (brand name: Tofranil)
- nortriptyline (brand name: Aventyl, Pamelor)
- Common side effects caused by these medicines include dry mouth, blurred vision, constipation, difficulty urinating, worsening of glaucoma, impaired thinking and tiredness. These antidepressants can also affect a person's blood pressure and heart rate.
- Serotonin and norepinephrine reuptake inhibitors (SNRIs)
- venlafaxine (brand name: Effexor)
- duloxetine (brand name: Cymbalta)
- Some common side effects caused by these medicines include nausea and loss of appetite, anxiety and nervousness, headache, insomnia and tiredness. Dry mouth, constipation, weight loss, sexual problems, increased heart rate and increased cholesterol levels can also occur.
- Norepinephrine and dopamine reuptake inhibitors (NDRIs)
- bupropion (brand name: Wellbutrin)
- Some of the common side effects in people taking NDRIs include agitation, nausea, headache, loss of appetite and insomnia. It can also cause increase blood pressure in some people.
- Combined reuptake inhibitors and receptor blockers
- trazodone (brand name: Desyrel)
- nefazodone (brand name: Serzone)
- mirtazpine (brand name: Remeron)
- Common side effects of these medicines are drowsiness, dry mouth, nausea and dizziness. If you have liver problems, you should not take nefazodone. If you have seizures, you should not take maprotiline.
- Monamine oxidase inhibitors (MAOIs)
- isocarboxazid (brand name: Marplan)
- phenelzine (brand name: Nardil)
- tranlcypromine (brand name: Parnate)
- MAOIs are used less commonly than the other antidepressants. They can have serious side effects, including weakness, dizziness, headaches and trembling. MAOI antidepressants can dangerously interact with over-the-counter medicines and certain foods and alcoholic beverages.
- Selective serotonin reuptake inhibitors (SSRIs)
Note: Many of the following supplements should not be taken along with antidepressant medication or should not be taken with each other, and should only be taken under supervision of a physician who is trained in alternative medicine, such as a licensed naturopathic physician.
- Get regular exercise for at least 30 minutes per day 6 days per week.
- Stop smoking.
- Seek counseling for emotional support and learning new coping strategies.
- Utilize relaxation/stress reduction for 10-15 minutes daily.
- Get fresh air and sunshine daily.
- Drink plenty of water.
- Identify and eliminate food allergies.
- Increase vegetables, whole grains, fruits, legumes, nuts, seeds, and lean protein.
- Increase consumption of cold water fish to twice weekly. Seek out nontoxic forms of fish.
- Consume foods high in nutrients necessary for normal brain function and growth and repair of nervous tissue
- Omega-3 fatty acids: nuts, seeds, and nut, seed, and vegetable oils (safflower, canola, walnut, sunflower, flax seed).
- Vitamin B6: Brewer’s yeast, bok choy, spinach, banana, potato
- Tryptophan (precursor to neurotransmitter serotonin): white turkey meat, milk, nuts, eggs, fish
- Liver cleansing foods - proper liver function helps to regulate blood sugar: bitters, beets, carrots, artichokes, lemons, parsnips, dandelion greens, watercress, burdock root
- Magnesium rich foods: seeds, legumes, dark green leafy vegetables, soy products, almonds, pecans, cashews, wheat bran
- Balance blood sugar, for depression due to hypoglycemia (see your physician).
- Avoid caffeine, other stimulants, and alcohol.
- Avoid refined sugar.
- Vitamin B12: Vitamin B12 deficiency can manifest as depression. In depressed patients with documented vitamin B12 deficiency, Vitamin B12 in high doses improved symptoms rapidly.
- Folic Acid. Depressed patients had significantly lower serum folate concentrations than non-depressed patients. Vitamin B12 should always be taken with folic acid.
- Vitamin B-6: Vitamin B6, or pyridoxine, is the cofactor (works along with) for enzymes that convert L-tryptophan (an amino acid) to serotonin and L-tyrosine (another amino acid) to norepinephrine. Adequate B6 levels are necessary for optimal brain neurotransmitters.
- L-Tryptophan. This amino acid is converted in the body to serotonin, one of the body’s “anti-depressant” neurotransmitters, or brain chemicals (as well as other neurotransmitters). See your doctor before taking this supplement if you are taking any medications.
- 5-Hydroxytryptophan (5-HTP). This form of tryptophan is one step closer to serotonin and it can only be used to make serotonin in the body. See your doctor before taking this supplement if you are taking any medications.
- L-Tyrosine. This amino acid is the precursor to the neurotransmitter norepinephrine . Some people with depression fail to respond to all medications except amphetamines. Such people often have a deficiency of brain chemical norepinephrine and their depression improves when taking it. See your doctor before taking this supplement if you are taking any medications.
- D- or D,L-phenylalanine has been used in patients with depression with significant improvement in some cases. See your doctor before taking this supplement if you are taking any medications.
- S-Adenosylmethionine (SAM-e). SAMe is often of benefit in depression. Higher doses are used with more sever depression. People with bipolar depression or hyperhomocystinemia should not take SAM-e.
- Essential fatty acids. Supplementation can dramatically increase mood, especially in people whose levels are low.
- Zinc. People with depression who have low Zinc levels tend to be resistant to treatment.
- Magnesium. Magnesium deficiency may be a factor in some cases of depression. Magnesium intake is deficient for many Americans. Supplemental magnesium may therefore improve mood in some patients with depression.
- Chromium. In one small study, chromium supplementation led to remission of dysthymic symptoms. Improvement was typically seen within several days to 3 weeks after the start of chromium therapy. It is possible that dysthymic disorder is, in some cases, a manifestation of glucose and insulin dysregulation.
- Vitamin D. Supplement only if deficient. It is particularly effective in seasonal depression.
- DHEA-S. . DHEA supplementation resulted in significant improvements in mood, energy, and motivation.
- Vitamin C is a cofactor for the conversion of tryptophan to serotonin. Vitamin C may therefore be valuable for patients with depression associated with low levels of serotonin. In one study, significant improvements were seen in depressive, manic and paranoid symptom complexes, as well as in overall functioning.
Botanical (Herbal) Medicine
- Hypericum (St. Johns Wort). This herb is effective in the treatment of mild to moderate depression. See your doctor before taking this herb if you are taking any medications.
- Other herbs may be used to treat the underlying causes of depression such as thyroid problems, hypoglycemia, or adrenal dysfunction.
A detailed history is taken and a remedy is selected that is customized to the individual.
Supplement Quality Is Important
Nutritional and botanical supplements used in these treatments are intended to have a physiological effect and clinical benefit, i.e., they are effective and your health improves.
The quality of nutritional supplements in the general marketplace is suspect. In order to get the maximum benefit to your health, be sure you purchase the highest quality nutritional supplements.
The doctors at The Connecticut Center for Health are experienced in how to treat depression holistically.
If you would like to learn more about natural medicine approaches to depression, contact one of our clinics for a free consultation or an appointment.