How do antidepressants work?

No one knows for certain how antidepressants work. While we have many pieces of the puzzle, we still do not know how they all fit. What complicates our understanding how antidepressants work is not just the intricacies of brain functioning but also our limited understanding of what causes depression. Researchers still struggle with whether depression is just brain chemicals gone awry or a far more complicated story involving biological, psychological, relationship and even spiritual issues.

The first antidepressants were developed for different medical conditions but doctors observed they had a useful side effect of improving mood in depressed patients. They figured out that these drugs affected chemicals in the brain (neurotransmitters) that regulate mood. The brain is made of over 100 billion neurons that communicate to one another through these neurotransmitters. The three neurotransmitters most affected by these early antidepressants are serotonin, norepinephrine and dopamine. We now know that antidepressants also affect the part of the neuron that the neurotransmitters work on, called the receptor.

Most of the commonly used antidepressants used today alter either one or more of these neurotransmitter levels and/or their receptor site. This has been a remarkably safe and effective way to treat depression but not everyone does well with these types of medications. Scientists have recently discovered the role of other neurotransmitters and receptors in depression and are developing new antidepressants that modify them. One example is the neurotransmitter glutamate, which many drug companies are looking at as a promising target for better treating depression.
As good as our current antidepressants are and as exciting as the new ones in development appear, medications alone are unlikely to be a “depression cure.” Fixing the physical and chemical changes in the brain seen in depression is just one important part of an effective treatment program.

Antidepressants reduce and reverse depression. They are believed to increase mood-boosting neurochemicals, such as serotonin, norepinephrine and dopamine, says Tarique Perera, MD, a psychiatrist with Contemporary Care of Connecticut.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.