Antidepressants Elavil and Relatives

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The word antidepressant sounds attractive. It suggests a drug that lifts mood and makes you feel good, something like a stimulant. The antidepressant drugs used in psychiatry today, however, do not give the good feelings of stimulants. Instead, they often cause sedation and a variety of uncomfortable physical effects.

These drugs date from 1958, when the parent compound, imip-ramine (Tofranil), was invented. It is still in wide use today, along with a close relative, amitriptyline (Elavil), and a number of other similar drugs. Some depressed patients respond very well to these medications but not until after at least two weeks of regular use. On the other hand, the toxic effects begin right away: sedation, dry mouth, blurred vision, constipation, difficulty in urinating. Normal people are likely to notice only these "side effects'' without any positive mood changes. A newer antidepressant drug is fluoxetine (Prozac), unrelated to the older members of this group. It is currently very popular in psychiatric medicine. Fluoxetine is an effective antidepressant, but some patients cannot tolerate it, because it makes them very anxious.

Like the major tranquilizers, the antidepressants do not lend themselves to recreational use because no one likes their effects. Often, even depressed patients who are helped by them like to cut dosage to a minimum and do without them altogether when they can. Do not be misled by their name: antidepressants will not make you high.

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