Nearly 280 million people around the world experience depression, one of the most common mental health conditions.
Depression can negatively affect your mood and how you feel, and lead to emotional and physical issues.
Impacting how you function daily, it can cause feelings of sadness, depression, helplessness, and loss of interest in previously enjoyable activities.
While it’s normal to feel low occasionally, if those symptoms of depression last longer than a couple of weeks, you may have depression.
It can be difficult to talk about depression, but it’s important to remember that millions of people may be experiencing similar difficulties.
Without treatment, symptoms may worsen or last longer. While depression is serious, its symptoms can be treated. One of the common treatments are antidepressants.
But despite being a popular way to treat symptoms of depression, it may not be clear how to access the medications.
In this article, I’ll discuss what antidepressants are and the different types (or classes) of antidepressants.
I’ll also explain whether you can get antidepressants over the counter and who can prescribe antidepressants.
Finally, I’ll talk about how to ask a doctor for antidepressants.
What Are Antidepressants?
Antidepressants are medications used to treat symptoms of depression.
Depression can affect brain chemistry by lowering levels of serotonin, norepinephrine, and dopamine—neurotransmitters that help facilitate communication between brain cells.
Antidepressants work by balancing chemicals in your brain, helping to regulate your overall well-being.
There are potential side effects from taking antidepressants, including nausea, insomnia, weight gain, vomiting, dizziness, agitation, fever, fainting, hallucinations, changes in blood pressure, rapid heartbeat, tremors, and seizures.
Types of Antidepressants
There are various classes of antidepressants, which help adjust levels of serotonin, norepinephrine, and dopamine. Each of the following medications works differently to affect these neurotransmitters.
Selective serotonin reuptake inhibitors (SSRIs)
Medical professionals typically prescribe SSRIs before any other class of antidepressants since they’re known to cause fewer side effects.
They block the removal (or reuptake) of serotonin from the brain, resulting in an increase of serotonin.
The right amount of serotonin is important, as the hormone helps stabilize our mood and feelings. It can also help with sleeping and digestion. Common SSRIs include:
- Celexa (citalopram)
- Lexapro (escitalopram oxalate)
- Paxil (paroxetine)
- Prozac (fluoxetine)
- Zoloft (sertraline)
Serotonin and norepinephrine reuptake inhibitors (SNRIs)
SNRIs work in a similar way to SSRIs: they block the removal of neurotransmitters.
But in addition to boosting serotonin levels, SNRIs also increase norepinephrine, which facilitates communication between nerve cells and acts like a stress hormone.
The following are brands of SNRIs:
Tricyclic Antidepressants (TCAs)
An older type of antidepressant, TCAs help with depression by blocking the removal of norepinephrine serotonin.
They get their name from the three rings that make up their chemical structure.
They’re not as commonly prescribed as SSRIs and SNRIs because they can cause more severe side effects.
Common TCAs include:
- Elavil (amitriptyline)
- Norpramin (desipramine)
- Pamelor (nortriptyline)
- Tofranil (imipramine)
Monoamine oxidase inhibitors (MAOIs)
The first antidepressants developed, MAOIs are less commonly prescribed today.
While they’re effective, they can cause serious side effects, such as high blood pressure when taken with certain medications or foods.
They work by preventing an enzyme called monoamine oxidase from removing norepinephrine, serotonin, and dopamine from the brain, increasing their levels.
Your doctor may prescribe one of the following MAOIs:
- Marplan (isocarboxazid)
- Nardil (phenelzine)
- Parnate (tranylcypromine)
In certain cases, a doctor may prescribe an atypical antidepressant, such as Wellbutrin.
As its name suggests, this type of antidepressant doesn’t quite fit into any other class of antidepressants.
However, similar to other antidepressants, it helps treat depressive symptoms by affecting brain chemistry.
Can I Get Antidepressants Over the Counter?
No Food And Drug Administration (FDA)-approved antidepressants are available over the counter; antidepressants need to be prescribed by a medical professional.
Antidepressants affect people differently, so in order to find what works best for you, it’s important to discuss your depression symptoms, medical conditions, and any medications you’re currently taking with your doctor.
Who Can Prescribe Antidepressants?
Antidepressants can only be prescribed by the following medical health professionals:
- A nurse practitioner
- A physician
- A psychiatrist, a medical doctor who specializes in mental health
How to Ask a Doctor for Antidepressants
Discussing depression can be difficult.
Remember that your doctor is there to help you get the treatment you need to treat with symptoms of depression.
It may be helpful to come prepared with questions to ask.
Questions to ask your doctor
Some questions you may want to ask your doctor include:
- Is depression what’s causing my symptoms?
- Are there other potential causes for my symptoms?
- How can we determine what’s causing my symptoms?
- What treatment do you think will work best for me?
- Are there any alternative treatments that may also work?
- What main side effects may occur from the treatment you’re prescribing?
- Are there any serious side effects that may occur from the treatment you’re prescribing?
- These are some health conditions I have. How can I manage them with the antidepressant?
- Does the antidepressant have any restrictions?
- Do you have any materials or can you suggest some websites that have more info about the antidepressant you’re prescribing?
If you’re experiencing symptoms of depression and think antidepressants can help, you can discuss it with your doctor.
However, studies show that patients who made brand-specific requests or no request at all for antidepressants are less likely to be thoroughly evaluated for depression than those who opened a general discussion regarding a need for antidepressants.
So while it can help to know why you think antidepressants could help treat your depression, it’s also important to keep an open mind about which medication may work best for you.
How doctors make a diagnosis
Doctors may make a diagnosis of depression based on the following:
- Lab tests: Blood and thyroid tests can be used to help determine whether a medical condition is contributing to your symptoms. However, labs are not typically needed to diagnose depression.
- Physical exams: Physical exams can help determine if depression may be caused by an underlying physical health problem.
- Psychiatric evaluation: A medical professional can ask you questions about your thoughts, feelings, behaviors and symptoms.
- DSM-5: Published by the American Psychiatric Association, the Diagnostic and Statistical Manual of Mental Disorders features criteria for depression.
Can Online Doctors Prescribe Antidepressants?
Yes, online doctors are able to prescribe antidepressants.
They can virtually perform mental health assessments to determine if antidepressants would be right for you.
K Health offers holistic care to help manage depression and anxiety. After taking a 5-minute assessment, you text with a doctor to get the care you need, and then receive a treatment plan based on your doctor’s discretion.
When to See a Doctor for Depression
Experiencing sadness from time to time is normal. But when symptoms of depression last longer than two weeks and start to affect your day-to-day life, speak with a medical professional about your symptoms.
It may be difficult to talk about depression, but remember it’s a common condition that affects many people.
Speaking with your doctor about how you’re feeling, is the first step to getting treatment that can help with depression symptoms.
If you’re having thoughts of self-harm or suicided, seek medical attention right away.
You can also reach the National Suicide Prevention Hotline 24 hours every day at 988.
How K Health Can Help
You can get help managing symptoms of depression from K Health.
Did you know you can get affordable primary care with the K Health app? Download K Health to check your symptoms, explore conditions and treatments, and if needed text with a provider in minutes. K Health’s AI-powered app is based on 20 years of clinical data.
Frequently Asked Questions
K Health has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references.
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Antidepressants: Selecting one that's right for you. (2019).
Monoamine oxidase inhibitors (MAOIs). (2019).
Patients' requests for antidepressants can influence physician evaluation of depression. (2006).
Depression: FDA-Approved Medications May Help. (2017).
Depression (major depressive disorder). (2018).
Should you use an antidepressant to get through a difficult time? (2020).