Depression

Sometimes verbal therapy is not enough to treat depressed persons with predominantly physical symptoms. Doctors may also prescribe one or more antidepressant drugs.

Most therapists want to see their patients in therapy sessions so they can monitor their progress while taking antidepressant drugs. If a patient is severely depressed, however, drugs may be used first, before therapy is started. Doctors prescribe several types of antidepressant drugs, including the following:

• Selective serotonin reuptake inhibitors ( SSRI s). These drugs increase the effectiveness of serotonin in the body. Serotonin is a neurotransmitter, which transmits messages from one cell to the next. In depressed people, neurotransmitters do not work as effectively. Prozac and Zoloft are two kinds of selective serotonin reuptake inhibitors.
• Tricyclics. Tricyclics increase the effec tiveness of serotonin and another hormone called norepinephrine, which is also a neurotransmitter. Tricyclics include imipramine, desipramine, amitriptyline, and nortriptyline.
• Monoamine oxidase inhibitors (MAOIs). These antidepressants are rarely used, usually only if SSRIs and tricyclics don't work. People treated with MAOIs have to restrict their diets and cannot eat certain fermented foods, such as cheese and wine. MAOIs are usually quite effective.
• Lithium. This was one of the first anti depressant drugs. Today, it is used mainly for controlling the mood-swing symptoms of manic-depression or bipolar disorder.

There is also electroconvulsive therapy (ECT), commonly called shock treatment. In ECT, the patient is put to sleep with drugs, and an electric shock is sent into the brain. ECT is usually given only to severely depressed people, especially if they are suffering delusions. Because ECT relieves depression more quickly than drugs, it may be lifesaving for people who are suicidal.