Depression

  • Medical Author:
    Roxanne Dryden-Edwards, MD

    Dr. Roxanne Dryden-Edwards is an adult, child, and adolescent psychiatrist. She is a former Chair of the Committee on Developmental Disabilities for the American Psychiatric Association, Assistant Professor of Psychiatry at Johns Hopkins Hospital in Baltimore, Maryland, and Medical Director of the National Center for Children and Families in Bethesda, Maryland.

  • Medical Editor: William C. Shiel Jr., MD, FACP, FACR
    William C. Shiel Jr., MD, FACP, FACR

    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

Understanding Depression Slideshow

Quick GuideDepression Overview Pictures Slideshow: Symptoms, Types, Tests & Treatment

Depression Overview Pictures Slideshow: Symptoms, Types, Tests & Treatment

What about discontinuing antidepressants?

Antidepressants should be gradually tapered and should not be abruptly discontinued. Abruptly stopping an antidepressant in some patients can cause discontinuation syndrome.

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.

Abruptly stopping MAOIs can lead to irritability, agitation, and delirium. Similarly, abruptly stopping a TCA can cause agitation, irritability, and abnormal heart rhythms.

What are complications of depression?

Depression can have a significant impact on the structure and function of many parts of the brain. This can result in many negative consequences. For example, people with severe depression are at higher risk of suffering from anxiety, chronic depression, other emotional issues, or having more medical problems or chronic pain. People with a chronic illness, such as diabetes and heart disease, who also have depression tend to have worse outcome of their medical illness.

What is the prognosis for depression?

Even though clinical depression tends to occur in episodes, most people who experience one such episode will eventually have another one. Also, it seems that any subsequent episodes of depression are more easily triggered than the first one. However, most depression sufferers recover from the episode. In fact, individuals who have mild depression and are treated with medication tend to respond equally as well to sugar pill (placebo). Those with more severe depression seem to be less likely to get better when taking placebo versus taking antidepressant medication. Other encouraging information is that research shows that even people from teenage through adulthood who do not improve when treated with a first medication trial can improve when switched to another medication or given another medication in addition to psychotherapy. For individuals who experience thoughts of suicide, it is thought that preventing access to firearms and other highly lethal means of committing suicide are important ways to improve their safety and that of those around them.

Medically Reviewed by a Doctor on 3/17/2016
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