Multiple sclerosis (MS) symptoms vary from person to person, and can last for days to months without periods of remission. Symptoms of MS include sexual problems and problems with the bowel, bladder, eyes, muscles, speech, swallowing, brain, and nervous system. The early symptoms and signs of multiple sclerosis usually start between age 20 and 40. MS in children, teens, and those over age 40 is rare. Treatment options for multiple sclerosis vary depending on the type and severity of symptoms. Medications may be prescribed to manage MS symptoms.
Antidepressants can have central and peripheral anticholinergic effects, as well as sedative effects, and can block the active reuptake of norepinephrine (NE), serotonin (5-HT), and dopamine. SSRIs are metabolized via the cytochrome P-450 system and may have drug interactions on that basis. The degree of enzyme inhibition varies among SSRIs. Effects on blood levels and bioavailability of coadministered drugs, as well as pharmacodynamic interactions, account for most clinically significant SSRI-drug interactions.
Some people with milder forms of depression get better after treatment with therapy. People with moderate to severe depression might need a type of medicine called an antidepressant in addition to therapy. Antidepressants change the levels of certain chemicals in your brain. It may take a few weeks or months before you begin to feel a change in your mood. There are different types of antidepressant medicines, and some work better than others for certain people. Some people get better only with both treatments — therapy and antidepressants.
Medication. Many people with depression find that taking prescribed medications called antidepressants can help improve their mood and coping skills. Talk to your doctor about whether they are right for you. If your doctor writes you a prescription for an antidepressant‚ ask exactly how you should take the medication. If you are already using nicotine replacement therapy or another medication to help you quit smoking, be sure to let your doctor know. Several antidepressant medications are available‚ so you and your doctor have options to choose from. Sometimes it takes several tries to find the best medication and the right dose for you, so be patient. Also be aware of the following important information:
For example, abruptly stopping an SSRI such as paroxetine can cause dizziness, nausea, flu-like symptoms, body aches, anxiety, irritability, fatigue, and vivid dreams. These symptoms typically occur within days of abrupt cessation, and can last one to two weeks (up to 21 days). Among the SSRIs, paroxetine and fluvoxamine cause more pronounced discontinuation symptoms than fluoxetine, sertraline, citalopram, escitalopram, vortioxetine, and vilazodone. Some patients experience discontinuation symptoms despite gradual tapering of the SSRI. Abrupt cessation of venlafaxine, duloxetine, desvenlafaxine, or levomilnacipran can cause discontinuation symptoms similar to those of SSRIs.
Educate Yourself. Depression is a type of illness, and illnesses tend to make people feel out of control. One way to regain a sense of control is to educate yourself about your illness. You can do this by talking with your doctors and therapists, by listening to what other people who have had depression have to say about it, and by reading as much as you can. The more you know about what depression is and how it may be treated, the better chance you have of figuring out the combination of treatments and techniques that will help you feel better. There are literally thousands of self-help books out there for depression. Some of them are even worth reading. We provide a list of such books we consider worthwhile at the end of this document.
Rebecca, age 57, struggled with depression and had a few wake-up calls as a smoker. She felt depressed and smoked cigarettes to help her cope with her feelings. The more Rebecca smoked, the harder it seemed to quit. Rebecca finally quit smoking after getting care for her depression and realizing that she had to take care of her own health. She now leads a new, smokefree life.
Atypical antidepressants include bupropion (Wellbutrin, Wellbutrin SR), mirtazapine (Remeron), and trazodone (Desyrel). These agents are effective in treating major depression and may be effective in combination therapy in major depressive disorder. This group also shows low toxicity in overdose. Wellbutrin SR may have an advantage over the SSRIs by causing less sexual dysfunction and weight gain.
Daniela McVicker is an editor for Top Writers Review. She is also an experienced writer with a degree in social psychology from Durham University. Daniela is primarily focused on writing about self-improvement. She has authored a number of insightful and motivating articles like “Making The Right Choices Every Day” and “7 Steps To Open Yourself To New Opportunities  & Possibilities.”
Selective serotonin reuptake inhibitors (SSRIs) are medications that increase the amount of the neurochemical serotonin in the brain. (Remember that brain serotonin levels often are low in depression.) As their name implies, the SSRIs work by selectively inhibiting (blocking) serotonin reuptake in the brain. This block occurs at the synapse, the place where brain cells (neurons) connect to each other. Serotonin is one of the chemicals in the brain that carries messages across these connections (synapses) from one neuron to another.

While some illnesses have a specific medical cause, making treatment straightforward, depression is more complicated. Depression is not just the result of a chemical imbalance in the brain that can be simply cured with medication. It’s caused by a combination of biological, psychological, and social factors. In other words, your lifestyle choices, relationships, and coping skills matter just as much—if not more so—than genetics.
People who are depressed may reject your help because they feel they should be able to help themselves, and feel worthless when they can’t. Instead, they may withdraw or start an argument in an effort to resolve their difficulties. In addition, people with depression may have negative thoughts and feel so hopeless that they do not see recovery as a reality.
Family and friends can help! Since depression can make the affected person feel exhausted and helpless, he or she will want and probably need help from others. However, people who have never had a depressive disorder may not fully understand its effects. Although unintentional, friends and loved ones may unknowingly say and do things that may be hurtful to the depressed person. If you are struggling with depression, it may help to share the information in this article with those you most care about so they can better understand and help you.
Regardless of the medication that treats depression, practitioners have become more aware that both genders, each age group, and different ethnic groups may have different responses and have different risks for medication side effects than others. Also, while there are certainly treatment methods that have been determined to be effective across populations, given the individual variability of response to treatment, there should not be a one-size-fits-all approach to treatment.
Patience is required because the treatment of depression takes time. Sometimes, the doctor will need to try a variety of antidepressants before finding the medication or combination of medications that is most effective for the patient. Sometimes, it's necessary to increase the dosage to be effective or decrease the dosage to alleviate medication side effects.

Trial of sildenafil (Viagra) or other sexual-enhancement medication. Studies in men whose depression has responded to SSRI but have developed sexual dysfunction showed improvement in sexual function with Viagra. Men taking Viagra reported significant improvements in arousal, erection, ejaculation, and orgasm as compared to men who were taking placebo, although Viagra generally does not increase one's libido.


Getting support plays an essential role in overcoming depression. On your own, it can be difficult to maintain a healthy perspective and sustain the effort required to beat depression. At the same time, the very nature of depression makes it difficult to reach out for help. When you’re depressed, the tendency is to withdraw and isolate so that connecting to even close family members and friends can be tough.
The aim of a cognitive approach is to help people identify and correct their distorted and negatively biased thoughts. This approach identifies and challenges underlying assumptions and beliefs. With encouragement to reframe the way they think about life, people are able to recover from failures more effectively and to recognise and take credit for the good things in their lives. People learn that they have some control over what happens to them. As with behavioural strategies, having these skills reduces relapse and recurrence of depression.
Stay Socially Engaged. The core symptoms of depression push people to stop participating with others socially and emotionally and motivate them to isolate. It is important to work to resist these urges to isolate as best you can. Let your family, friends and associates help you. Accept invitations to social events and maintain your typical social schedule as best you can even if you are not enjoying your participation as much as you used to. Staying socially engaged provides you with social support, offers you a distraction from the repetitive negative ruminations you are otherwise going to be prone to experiencing, may offer some pleasure even if that feeling is fleeting for a while, and can provide you with opportunities for reality testing (so that you don't take your depressive ideas about how worthless you are too seriously).
Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Occasional anxiety is a normal part of life. It’s common for people to feel anxious if there’s conflict in a relationship, a problem at work, a big test looming or a major decision dead ahead. But anxiety disorders involve more than temporary worry or fear. For people with an anxiety disorder, the anxiety does not go away. It often gets worse over time to the point where feelings interfere with their daily functions.3
A person whose primary problem is depression, rather than anxiety, generally doesn't show the same fear and uncertainty that people do with anxiety disorders. Depressed people are not so preoccupied with worrying about what might happen to them in the future. They think they already know what will happen, and they believe it will be bad, the same bad stuff that's happening to them now. The key symptoms of depression include:
Another possible cause of depression that should not be overlooked is physical illness or medications. Glandular fever, influenza, hepatitis, thyroid hormones, anaemia, diabetes, birth control pills, alcohol and other substances of abuse, or other medications such as those for heart or blood pressure conditions, may all cause symptoms of depression.
Major depression, also often referred to as unipolar depression, is characterized by a combination of symptoms that lasts for at least two weeks in a row, including depressed and/or irritable mood (see symptom list), that interferes with the ability to work, sleep, eat, and enjoy once-pleasurable activities. Difficulties in sleeping or eating can take the form of excessive or insufficient of either behavior. Disabling episodes of depression can occur once, twice, or several times in a lifetime.
Some of the newer antidepressant drugs, however, appear to have particularly robust effects on both the norepinephrine and serotonin systems. These medications seem to be very promising, especially for the more severe and chronic cases of depression. (Psychiatrists and other mental health professionals, rather than family practitioners, see such cases most frequently.) Venlafaxine (Effexor), duloxetine (Cymbalta), desvenlafaxine (Pristiq), and levomilnacipran (Fetzima) are four of these dual-action compounds. Effexor is a serotonin reuptake inhibitor that, at lower doses, shares many of the safety and low side-effect characteristics of the SSRIs. At higher doses, this drug appears to block the reuptake of norepinephrine. Thus, venlafaxine is an SNRI, a serotonin and norepinephrine reuptake inhibitor. Cymbalta and Pristiq tend to act as equally powerful serotonin reuptake inhibitors and norepinephrine reuptake inhibitors regardless of the dose, Fetzima even more so. They are, therefore, also SNRIs.

Sadness that lasts a long time and a loss of enjoyment in almost all activities are the central features of depression. Sadness is a symptom, but not the same thing as depression. Everyone is sad sometimes. The type of sadness that occurs in depression lasts all day or most of the day, every day for a long time (at least two weeks). Other symptoms include feelings of worthlessness or guilt, suicidal thoughts, loss of concentration, decreased energy, slowed thinking and movement, appetite loss and sleep problems.
Patients with generalized anxiety disorder can’t control their constant worry. They worry about life events that may never even happen. They are “worry warts” who often expect the worst possible outcome of every situation. Physical symptoms such as fatigue, trouble concentrating, and having tense muscles are common in these patients. Phobias are fears of specific objects or places, such as an intense fear of social interactions that causes the patient to avoid most social situations (social phobia). Physicians and mental health professionals assess these symptoms through interviews, surveys, and observing patient behavior.
Recovery from a depressive episode takes time as well as a desire and willingness for change. You can start by talking to someone — anyone — about your feelings, and finding some immediate emotional support through the sharing. Many people start their journey of recovery off by going to see their family physician for an initial diagnosis. Such a professional can also help connect you with referrals or encouragement to continue your treatment with a mental health specialist.
Encourage the person to get a clinical evaluation. You can start by helping them to fill out our Depression and Bipolar Test. When finished, you can print the results so that the person can bring them to a clinician for further evaluation. Mention that depression and bipolar disorder are both treatable medical conditions. Often, people feel relieved to learn that they are suffering from a medical condition. Ask the person to see a medical professional, offer to make an appointment, and go with the person or call the doctor in advance to state the person’s symptoms.
If the patient is taking MAOIs, he or she must avoid certain aged, fermented, or pickled foods, like many wines, processed meats, and cheeses. The patient should obtain a complete list of prohibited foods from the doctor and keep it available at all times. The other types of antidepressants require no food restrictions. It is also important to note that some over-the-counter cold and cough medicines can also cause problems when taken with MAOIs.
This information is not designed to replace a physician's independent judgment about the appropriateness or risks of a procedure for a given patient. Always consult your doctor about your medical conditions. Vertical Health & PsyCom do not provide medical advice, diagnosis or treatment. Use of this website is conditional upon your acceptance of our User Agreement.
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