In this video we are going to go over the top 5 medications that treat depression that
you can afford.
These are the most common go to medications that your doctor likely will talk to you about
when you are looking for a medication to treat your condition.
Learn about the good and bad of each one to help make your next doctors visit more productive.
Welcome to Family Med, I'm Dr. Richardson and this is your home for practical and accurate
information to help your family make healthy decisions.
This is the channel that focuses on bringing better health to your home.
In this episode we're going to go over the top 5 medications that I use to treat depression
in my clinic.
There are certainly a lot of medications out there so we can't review everyone in one single
video.
But I thought it would be helpful to have more of a broad overview of some of the most
common that we use side by side so you can see which one may better for you.
The great thing about all these medications is that they are all generic and won't break
the bank if you need to be on them.
Ultimately the decision to start a medicine and which one is best is something that you
need to make with your doctor however understanding some of the pros and cons of each can help
you to have that conversation.
I've gone over each one of these medications separately in videos of their own.
So if you want to dive deeper into each one of them, I'll put a link to the video up here
when we talk about it.
So let's get into it.
The first one we are going to talk about is Lexpro or Escitalopram.
This is a great medication that falls in the class of medicine called SSRI or Selective
Serotonin Reuptake Inhibitors.
Lexapro is usually my first go to medication when I have somebody who is coming in with
both depression and anxiety.
It tends to work really well for those two conditions combined.
It's a once a day medication that most patients tend to tolerate really well.
It comes in 5, 10 and 20 mg tablets with the max typical dose of 20mg.
Side Effects tend to be minimal for most people although just like any medication they are
possible.
More common side effects would be some headaches, nausea, tiredness or difficulty sleeping,
some dry mouth, constipation or abdominal pain.
The good news is that most of these side effects tend to go away after a few weeks.
It is possible to have some libido changes and difficulty with intimacy with this medication.
But I tend not to see that complaint as often with this medication.
More concerning side effects would include having worsening symptoms of depression or
anxiety.
It can also put you at risk for certain heart arrhythmias, electrolyte disturbances, allergic
reactions and something called Serotonin syndrome where your body gets too much serotonin.
This is very rare but can present with symptoms like agitation, confusion, rapid heart rate
and high blood pressure, dilated pupils, loss of muscle coordination, muscle rigidity, diarrhea
and heavy sweating.
If you think this is happening to you, get into your doctor or the emergency room right
away.
These possible reactions are not specific to Lexapro and can happen with any of the
medications we are going to discuss.
The other thing that I like about Lexapro is its been generic for some time so it's
pretty affordable.
You can usually find a 30 day supply for around 9-10 dollars either at Walmart or using one
of the discount medication sites like GoodRx.
The 2nd medication we are going to talk about is Zoloft or Sertraline.
This is a mediation that has been around since the early 90's.
It's also an SSRI.
I tend to use this mediation more when someone is strictly suffering from depression or if
they have some OCD tendencies or even some PTSD.
It can help with anxiety but I tend not to see that it works as well as others with this.
It's also a once a day medication that comes in 25, 50 and 100mg pills with the max dose
of around 200mg.
I like this medicine because it gives a little more flexibility with changing the dose.
If somebody is a little more sensitive to medications it makes it a little easier to
increase or decrease the doses.
The Side effects of Zoloft are similar to what we discussed with the Lexapro.
I can't say there is much difference overall between the two other than in the realm of
changes in libido and intimacy.
I definitely see more complaints in regards to this while taking Zoloft.
In fact for those guys out there, we actually use that as a benefit sometimes when you have
a problems with going to fast.
The same kind of more serious side effects apply here.
The only one that is a little different is we do see a slight increased risk of bleeding
with Sertraline.
So if you are on blood thinners it may be something you need to be cautious of.
Zoloft also has the benefit of being generic now so it is usually pretty affordable.
You typically are looking at around $9-10 dollars a month at most of your major pharmacies.
The third medication that I recommend frequently is Wellbutrin or Bupropion.
This medication has been around since the mid 1980's.
It's in a different class of medication than Lexapro or Zoloft.
It belongs to a family of medications called NDRI's or Norepinphhrine Dopamine Reuptake
inhibitors.
It works more on a different area of the brain chemicals to change mood.
Since this does work differently it does have some different effects that the other medications
don't.
Wellbutrin tends to be a little more motivating or elevating type of a medicine.
I like to use this when people's depression really just keeps them down and unmotivated.
When they really have a lack of interest and unable to accomplish much it seems to help
them more.
This medicine also has a few other side benefits.
It's one of the main ingredients of a newer weight loss medication so we can see some
benefit in the realm of weight loss while taking it.
It's also used a lot for smoking cessation.
We also use it to treat ADD/ADHD type symptoms.
So if you are in a depression that has you unmotivated, you are overeating, smoke and
can't concentrate then this may be a good choice.
Side effects are pretty similar to those that have discussed about the others.
The main difference though is that Wellbutrin out of all of them doesn't tend to affect
your intimate relations.
In fact we will sometimes add Wellbutrin when you are on another antidepressant if you are
having those kind of side effects.
It comes in several different formulations from immediate release that you take 3 times
a day, sustained release that is twice a day or extended release that is once a day.
Doses range from 75 to 300mg.
Now not all is good with Wellbutrin though.
There are certain people who don't do well with it.
First of all, Wellbutrin tends to not do very well when you have a lot of anxiety.
Typically when you have bad anxiety Wellbutrin can actually make this worse.
Some people who didn't feel overly anxious upon starting it can start having panic attacks
so I like to steer away from this one for those who are anxious.
The second thing that we are cautions about is that Wellbutrin can decrease what we call
your "seizure threshold".
This means that it can make it more likely that you can have seizures.
So if you have a prior history of seizures then you probably should look elsewhere.
Just like the others, Wellbutrin is now generic and is usually pretty affordable.
A typical 30 day supply is between 9-20 dollars a month.
The 4th medication is one called Cymbalta or Duloxetine.
This is the newest of the medications that we are talking about today.
It's been around since 2004 in the united states.
It belongs to the class of medications called SNRI or Selective Norepinephrine Reuptake
Inhibitors.
These medications work on both hormones Serotonin and Norepinephrine.
Because of that it has some properties that some of the other mediations we have discussed
do not.
Cymbalta works well in treating both depression as well as anxiety.
It also though has some properties that help treat pain.
We will use it to treat fibromyalgia, arthritis and different kind of nerve pains such as
those you can get with diabetes or other nerve injuries.
Interestingly enough we also can use it to treat hot flash symptoms related menopause.
So if you are a woman going through menopause with diabetes and fibromyalgia, bad knees
who also has depression and anxiety, then this is the perfect medication for you.
The possible side effects of Cymbalta would be similar to that of the other medications
that we have discussed.
Its affects on intimacy tend to be less than what you may experience while taking Zoloft
or Prozac but it is still possible.
Cymbalta comes in a capsule of 20, 30 and 60 mg with 60mg being the top dose that you
would take once a day.
This is a great overall medications that can be used for several different symptoms.
It's in the same price category as the others so if you were paying cash for it, you could
expect to pay around 9-20 dollars using a discount coupon like GoodRx.
The 5th medication we are going to discuss is Prozac or Fluoxetine.
This is the original SSRI or Selective Serotonin Reuptake Inhibitor.
It's been on the market since 1987 here in the United States.
This medication works well to treat conditions like Depression, Obessive Compulsive Disorder
and a severe form of PMS.
It can have some effect on anxiety but I don't tend to see this be as successful as some
of the others that we have discussed today.
It's not as commonly used as some of the other newer medications that we have out there but
it definitely still is used and it definitely has its place.
I like using Prozac because it's a little more reliable.
It's not as fast acting as some of the others but on the flip side of that, it also doesn't
get out of your system as fast.
I find this really beneficial in treating people who have a harder time remembering
to take their medications.
You always need to try and take these kind of medications daily but out of all of the
medications that we discuss I see less problems with people who have skipped doses feeling
the withdrawl sypmtoms that commonly happen when you abruptly stop these medications.
Its also a little easier tapering down off of the medication when you decide to stop
it than some of the others.
The possible side effects of this medication would be similar to what we have already discussed.
I don't see that Prozac has any more or less side effects than the other s.
Now, Problems with intimacy are probably the be the most common concern that I see with
this medication.
As with all of them you definitely need to watch for worsening depression or suicidal
symptoms.
Prozac comes in a 10, 20 and 40mg daily pill with a max dose of 80mg or a 90mg once a week
formulation.
Prozac tends to be one of the more affordable ones that you can find.
For a typical 30 day supply you can get it for $4 at Walmart.
So you may have noticed that I didn't really rank them in any specific order as far as
which one is best.
That's because you really can't say that one is better than another.
It is so individual and each one tends to have some benefits over the other.
The best one, is the one that is going to work for you.
Sometimes we have to take a trial and error approach to find the right one and that is
ok.
The good news is, that there are multiple different types of medications that we can
try to find the right one that will fit for you.
If you want to dive deeper into any one of these medications go back and click on the
cards that pop up here throughout the video or I'll place a link in the description below
for each one as well.
Depression/anxiety and other mental health conditions can be very debilitating.
They are as real as any other medical condition out there.
When you have a true clinical depression taking something like Prozac, Lexapro, Wellbutrin,
Zoloft or Cymbalta or any of the other ones out there can be a life altering step.
These medications can make a huge difference in your life.
They certainly are not for everybody and yes there are other nonmedication options out
there that may work for you.
If, however, you and your doctor feel that one of these medications are the best option
for your treatment plan you now have a good foundation of knowledge of what to expect
and what kind of side effects to watch for.
Having that information can be really powerful in your life.
This certainly isn't an all inclusive and indepth discussion of everything that could
be discussied regarding these medicatinos.
That's not what I'm trying to do here.
My purpose in sharing this is to help give information that you can think about and discuss
with your own doctor.
Please don't take this as direct medical advice.
Take everything you learned today and discuss it with your doctor in how it applies to your
own situation.
Now, If you've found this information to be helpful do me a favor, go ahead hit that like
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If you are still wondering whether you are suffering from depression, keep watching right
here to learn about the top 10 signs that you may be suffering from depression.
Review them and see if you need to be seeking help.
Click here to learn about some non-medication options that you can do to help with depression.
So until next tine, this is FamilyMed with Dr. Richardson and remember to take care of
your body because it's the only one you have.