Drugs that are effective in relieving depression are

Currently, the first-line clinically effective drugs for relieving depression are selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs) as the core. Traditional drugs such as tricyclic antidepressants (TCAs) and monoamine oxidase inhibitors (MAOIs), as well as new preparations such as esketamine nasal spray and brenoperidone that have been approved in recent years, are selected according to the patient's individual characteristics.

I have been working hard in psychiatric clinics for 7 years. The most common thing I am asked by patients is "Doctor, please prescribe the best medicine for me. I want to get better soon." Every time I hear this, I have to smile bitterly - there is no "best" antidepressant. The only one that can adapt to your situation is effective. A while ago, I treated a girl who was just entering her junior year in college. She was suffering from moderate depression and severe test anxiety. She had kept her eyes open until dawn for a week, and she had a utility knife in her pocket and scratched her wrist several times. She was prescribed the lowest dose of sertraline (a commonly used drug in SSRIs), combined with short-term sleep aids. Two weeks later, she came for a follow-up consultation. The first thing she said when she came in was, "I was able to sit down and watch a variety show for half an hour last week. I didn't even want to touch my phone before." You said that sertraline was a miracle drug for her, but that was not the case with the 42-year-old male patient I treated last month. He tried three SSRIs and one SNRIs, and after taking it for three consecutive months, his mood was still at rock bottom, and he could not even attend work. He was finally diagnosed with refractory depression, and was switched to esketamine combination therapy. After the third treatment, he told me, "I can finally sleep through the night. When I woke up in the morning, I actually thought the trees outside the window were pretty."

Of course, the controversy over antidepressants has never stopped, and even practitioners from different directions in the industry have different opinions. Most scholars who do basic neurological research agree with the hypothesis of "neurotransmitter imbalance" and believe that symptoms can be relieved as long as the concentrations of serotonin and norepinephrine are returned to normal levels. ； However, many clinical psychologists will emphasize that drugs are just the rope that pulls you out of the emotional quagmire. If the conflicts in your family of origin, the pressure in the workplace, and the unsolved trauma are not resolved, even if you take drugs and you are temporarily cured, you may still fall back next time. I personally think both are reasonable. After the junior girl took medicine to eliminate her suicidal thoughts, she was still afraid of failing the course and graduating. She had to undergo 8 times of cognitive behavioral therapy before she dared to go back to school. Taking medicine alone would definitely not make it this far.

There are also many people who are afraid of becoming "addicted" or "stupid" by taking medicines. Such rumors are really flying all over the Internet. I have seen many patients who have just received a prescription, searched Xiaohongshu for half an hour, and then came back to ask for a refund, saying they were afraid they would become a fool after taking it. To be honest, I have seen too many patients who couldn't even get out of bed and didn't even want to eat before taking medicine. After taking it for a month, they were able to go downstairs to buy ice cream and go to the park with friends. How can this be called stupid? Of course, there are indeed a few patients who will experience some unresponsiveness, nausea, and headache in the early stage of taking the medicine. Most of them are side effects that disappear within a week or two. If they really can't bear it, they can just ask the doctor to adjust the dose and change the medicine. They don't have to bear it by themselves or stop taking the medicine without authorization. Oh, by the way, the "feeling you feel when you stop taking the medicine" that many people say is not addiction at all, but a withdrawal reaction caused by cutting off the medicine too quickly without permission. If you follow the doctor's advice and cut off the medicine slowly, you won't have this problem at all.

Many patients also ask me whether they can take traditional Chinese medicine. I generally won’t kill them in one go. Current evidence-based evidence supports that Chinese patent medicines that soothe the liver and relieve depression can be used as auxiliary medicines for mild to moderate depression. For example, some patients always have chest tightness, rib pain, and cannot eat. Taking some Chinese patent medicines that relieve depression can indeed relieve physical symptoms. Many Chinese medicine colleagues have also reported cases of mild to moderate depression treated with Chinese medicine alone. But if you have moderate to severe depression with suicidal thoughts, sudden weight loss, and complete loss of social functions, I still recommend giving priority to first-line western medicine. This is the current global clinical consensus. Don’t gamble with your own life.

In fact, in the final analysis, antidepressants are like the umbrella you hold on a rainy day. They can help you avoid getting soaked in the rain, but you still have to use your own legs to get where you want to go. I have seen people who have completely recovered after taking the medicine for half a year and have never relapsed, and I have also seen people who have been taking the medicine for three or four years and are still adjusting their prescriptions intermittently. Everyone's situation is different, and there is really no unified standard answer. Don't randomly search for and buy medicines on your own, and don't just follow what others say is good. Find a reliable doctor and tell him all the little things like whether you have stomach problems, whether you want to prepare for pregnancy, and whether you forget to take medicine. This is better than anything else. Oh, by the way, a follow-up patient told me yesterday that she was willing to go out for a walk for the first time after taking medicine. The wind felt sweet on her face. You see, as long as you are willing to move forward, you will always encounter good things, right?