Antidepressants for More Than Depression

Other Uses for Antidepressants

Young Woman Taking Medication
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We all know that antidepressants are used to treat depression, but did you know they are often prescribed for other ailments as well? They can also be used to help you sleep, treat anxiety, stop smoking, for irritable bowel syndrome, and some can be used to help relieve certain types of pain.

How Antidepressants Work

Antidepressants appear to act on neurotransmitters in the brain, the chemicals that transmit nerve impulses between brain cells, or neurons.

In most cases, the medications act to either increase the amount of neurotransmitters at the gap between neurons, called the synapse, or to keep these chemicals around longer.

Antidepressant History

The first antidepressant, isoniazid, was originally developed as a treatment for tuberculosis, but it became obvious that patients who were taking it had substantial mood elevation. Because of its antidepressant properties, it was widely prescribed in the late 1950s to treat depression.

Iproniazid, another derivative, belonged to a class of medications known as monoamine oxidase inhibitors (MAOIs).This type of drug revolutionized the treatment of depression, but patients had to follow a strict diet to avoid dangerous side effects. MAOIs are only used for depression when other antidepressants have not worked.

The MAOIs were followed by the tricyclic antidepressants. The first of these drugs, Tofranil (imipramine), was originally developed as a possible treatment for schizophrenia.

It failed as a schizophrenia treatment but succeeded as an antidepressant. Tricyclics elevate mood and increase energy in many depressed patients. 

Selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs) are the most recent class of antidepressants to be developed.

These medications tend to have fewer side effects than the older versions and are the first line of treatment that mental health professionals use for depression and other mental illnesses.

Antidepressants for Sleep

Tricyclic antidepressants tend to be sedating, so tricyclics such as Elavil (amitriptyline) and Oleptro (trazodone) are sometimes used as sleep medications. These medications are prescribed quite often for insomnia since they must be taken at a high dose to alleviate depression, but a low dose tends to cause sleepiness. 

Antidepressants for Anxiety

After depression, antidepressants are probably most commonly used to treat anxiety. An assortment of antidepressants in every category has been approved to treat a variety of anxiety disorders. For instance, Paxil (paroxetine), a SSRI, has been FDA-approved to treat generalized anxiety disorder, obsessive-compulsive disorder (OCD) and social anxiety disorder (SAD). Tofranil, a tricyclic, is used to treat panic disorder, post-traumatic stress disorder (PTSD), and generalized anxiety disorder (GAD).

These all work similarly to how they work for depression, by changing the activity of the brain's neurotransmitters. 

Antidepressants to Stop Smoking

An antidepressant called Wellbutrin (bupropion), also marketed as Zyban, has been approved by the Food and Drug Administration (FDA) to help people stop smoking. Although it is not known exactly how Zyban helps, one factor may be that some people smoke to deal with their anxiety and Zyban will decrease anxiety.  

Antidepressants for Irritable Bowel Syndrome

Tricyclic antidepressants, in particular, have been shown to help relieve symptoms of irritable bowel syndrome (IBS). They work by relieving pain in the abdomen and the gastrointestinal tract.

Antidepressants for Pain

Even when depression isn't a symptom, antidepressants are often used for chronic pain caused by conditions such as arthritis, back pain, fibromyalgia, nerve pain, migraines, tension headaches and pelvic pain. No one knows exactly why antidepressants help, but it seems that by changing the way neurotransmitters work in the brain, this may decrease pain signals. Relief can take several weeks, however. 

Sources:

Chaitra T. Ramachandraih, Narayana Subramanyam, et. al., "Antidepressants: From MAOIs to SSRIs and More." Indian Journal of Psychiatry 53 (2), (2011).

"Medication." Anxiety and Depression Association of America (2016).

"FDA 101: Smoking Cessation Products." U.S. Food and Drug Administration (2015).

Xie C., Tang Y., Wayng Y., et. al., "Efficacy and Safety of Antidepressants for the Treatment of Irritable Bowel Syndrome: A Meta-Analysis." PLOS One (2015).

"Antidepressants: Another weapon against chronic pain." Mayo Clinic (2013).

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