Depression Symptoms Treatment

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Definition of Depression

A diagnosis of major depressive disorder is made if an individual has five or more of the following symptoms during the same two-week period. The symptoms may vary from person to person but often include:

• a persistent sad mood
• loss of interest or pleasure in activities that were once enjoyed
• significant change in appetite or body weight
• difficulty sleeping or oversleeping
• physical slowing or agitation
• loss of energy
• feelings of worthlessness or inappropriate guilt
• difficulty thinking or concentrating
• recurrent thoughts of death or suicide

Pharmacological Treatment for Depression

In the past, people with depression were commonly treated with medications called tricyclic antidepressants (TCAs) or monoamine oxidase inhibitors (MAOIs). These treatments, although effective, cause various side effects that can force many patients to discontinue therapy. Today, more treatment options are available to people with depression. Depending on the severity, patients may benefit from newer medications, psychotherapy, and, in severe cases, electroconvulsive therapy (ECT).

SSRIs and How They Work

In the last decade, there have been great improvements in the use of medication to treat depression. One of those advances has been the introduction of a class of antidepressants called selective serotonin reuptake inhibitors (SSRIs) that target specific neurotransmitters — chemicals used by nerve cells to communicate — in the brain. Researchers believe that depression may be the result of a serotonin imbalance in the brain. Mood, hunger, and sleep are all regulated to a large extent by serotonin. SSRIs work to block the reabsorption or reuptake of serotonin so that there is more of the chemical available in the brain.

Since the early 1990s, SSRIs have been the most widely used treatment for depression. These drugs, however, can have side effects, such as upset stomach, headache, insomnia, lower libido and difficulty reaching orgasm. While not serious, some patients find these side effects troublesome and may discontinue therapy.

New SSRI in Development

New technology in drug development continues to offer hope to patients and physicians in search of medications that will yield the most effective treatment with the least amount of side effects. Recently, researchers have focused on creating single-isomer drugs from existing compounds that contain two “mirror- image” halves called an S- and R- enantiomer. Using this technology, Forest Laboratories has isolated the S-enantiomer of Celexa™ (citalopram HBr) called Lexapro™ (escitalopram oxalate). When separated, each enantiomer affects serotonin levels in significantly different ways. The S-enantiomer demonstrates a unilateral ability to increase brain serotonin levels, thereby providing effective relief of depression symptoms. By contrast, the R-enantiomer has no or minimal effect and possesses no therapeutic activity as an antidepressant.