ABSTRACT
Chapter 7 explores the antidepressant medications and other biological treatments. The vast majority of individuals with clinically significant depression receive no or inadequate treatment due to lack of recognition, unwillingness to seek help or barriers to services. Among those treated most are prescribed antidepressants, with usage in the US and UK doubled in the past 20 years. Most are given a selective serotonin re-uptake inhibitor (SSRI), a class of drugs relatively freer of bothersome side effects compared to earlier formulations. Different medications and side effects are noted. Because of the massive market for such products, new drugs that work on different neurotransmitter processes are constantly being tested. Antidepressant treatment typically involves three phases, acute, continuation and maintenance. Most antidepressants have similar levels of effectiveness (60–70%), although individuals may respond better to some than others. Relatively strong placebo effects and elevated rates of nonresponse suggest the need for further development. Some individuals benefit from non-prescription preparations. For severe forms of depression unresponsive to medications, several effective alternatives such as electroconvulsive therapy and transcranial magnetic stimulation involve electrical stimulation in the brain. Seasonal mood disorders may benefit from light therapy and sleep deprivation therapy may provide temporary benefit. Physical exercise provides mood relief to some people with mild depression.
