depression from coronavirus - wellrx blog image

By Rosanna Sutherby, PharmD

The current COVID-19 pandemic has affected the physical health and the mental health of millions worldwide. Nearly half of American adults report in a recent poll that their mental health has been negatively affected by stressors related to COVID-19, and the use of support hotlines and other mental health resources has drastically increased compared to a year ago.

If you are experiencing new or resurgent symptoms of anxiety or depression due to the current global crisis, you are not alone. Reaching out to a healthcare provider can help you obtain the care and support needed during these difficult times.

A conversation with your provider will help you determine if you need medication to help relieve your symptoms. The following are some common medicines used to treat anxiety and depression.

Medications That Treat Anxiety

The American Psychological Association defines anxiety as “an emotion characterized by feelings of tension, worried thoughts, and physical changes, like increased blood pressure.” If you need medication to treat your anxiety, your doctor may prescribe any of the following:

  • antidepressants
  • buspirone (Buspar)
  • benzodiazepines

Antidepressants

Antidepressants are the first line of treatment for anxiety disorder. Two types of antidepressants used to treat anxiety are selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs). SSRIs and SNRIs work by increasing the amount of chemicals in your brain that help regulate your mood. SSRIs increase the amount of serotonin in your brain, and SNRIs increase both serotonin and norepinephrine.

SSRIs used to treat anxiety include the following:

SNRIs used for anxiety include the following:

There are some common side effects seen with antidepressants, including:

  • nausea
  • dizziness
  • dry mouth
  • headache
  • restlessness
  • changes in appetite
  • problems with sleep
  • problems with orgasms or decreased interest in sex

If you are taking antidepressants to treat your anxiety, let your healthcare provider know if your symptoms worsen or if you do not feel better. It may take a few weeks before you feel the effects of SSRIs or SNRIs. Call your doctor if you suddenly feel agitated, anxious, or aggressive while taking your medication.

You should avoid drinking alcohol while taking antidepressants because it can interfere it the action of the medication.

Buspirone

Buspirone (Buspar) is an antianxiety medication that your doctor may prescribe for long-term treatment of anxiety. The most common side effects reported by those taking buspirone include:

  • dizziness
  • nausea
  • headache
  • nervousness
  • lightheadedness

Be sure to maintain your regular appointments with your healthcare provider to evaluate your progress while taking this medication.

Benzodiazepines

Benzodiazepines are generally used for short-term treatment of anxiety symptoms. They work quickly at reducing anxiety but should not be used regularly or long-term since they can be habit-forming.

Benzodiazepines used to treat anxiety include:

Side effects related to benzodiazepines include the following:

  • drowsiness
  • blurred vision
  • headache
  • dizziness
  • nausea or vomiting
  • confusion

You should not drive or engage in activities that require alertness while you are taking benzodiazepines. Do not drink alcohol or take other medications that cause drowsiness if you are taking benzodiazepines.

Medications That Treat Depression

According to the World Health Organization (WHO), depression is a leading cause of disability around the world. Over 264 million people worldwide, including 16 million Americans, are living with depression.

Depression is a condition that causes prolonged feelings of sadness, hopelessness, and loss of interest. Treatment for depression includes several modalities of psychotherapy and, in some cases, medication.

Medicines that your doctor may prescribe to treat depression include the following:

  • SSRIs
  • SNRIs
  • Atypical antidepressants
  • Tricyclic antidepressants
  • Monoamine oxidase inhibitors (MAOIs)

SSRIs

Healthcare providers usually begin medication treatment of depression with SSRIs. These newer medications have fewer side effects than older drugs and are generally safer to use.

Drugs in the class of SSRIs include the following:

SNRIs

SNRIs are similar to SSRIs; they work by increasing the amount of norepinephrine as well as serotonin in your brain. Examples of SNRIs include:

  • venlafaxine (Effexor)
  • duloxetine (Cymbalta)

SSRIs and SNRIs have similar side effects, which include the following:

  • nausea
  • dizziness
  • dry mouth
  • headache
  • restlessness
  • changes in appetite
  • problems with sleep
  • problems with orgasms or decreased interest in sex

You may not feel the effects of SSRIs or SNRIs during the first few weeks of treatment. This is normal. It generally takes at least two weeks before the medication starts working. Seek immediate help if your depressive symptoms worsen or if you have feelings or thoughts of hurting yourself.

Atypical Antidepressants

Other antidepressants work by different pathways and are sometimes added to treatment with SSRIs or SNRIs. Some atypical antidepressants include:

Tricyclic Antidepressants

Tricyclic antidepressants include medications such as:

  • imipramine (Tofranil)
  • nortriptyline (Pamelor)
  • protriptyline (Vivactil)

These are older antidepressants that have been largely replaced by SSRIs.  Due to the high incidence of severe side effects, these medications are generally used only if treatment with SSRIs was unsuccessful.

MAOIs

MAOI antidepressants, such as phenelzine (Nardil), tranylcypromine (Parnate), and isocarboxazid (Marplan), are used rarely because they have dangerous interactions with foods and other medications. MAOIs cannot be combined with SSRIs or SNRIs.

How to Get the Lowest Prescription Price for Your Anxiety and Depression Medication

Whether you are taking one prescription or several to treat your symptoms of anxiety or depression, always compare prescription prices before heading to a pharmacy near you. You can use your prescription savings card to obtain the best price for your medication.

Rosanna Sutherby is a freelance medical writer who has been a practicing pharmacist in her community for close to 20 years. She obtained her Doctor of Pharmacy from Nova Southeastern University in Ft. Lauderdale, FL. She utilizes her clinical training in the pharmacy, where she helps patients manage disease states such as asthma, diabetes, heart disease, hypertension, and many others. Dr. Sutherby reviews and recommends drug regimens based on patients’ concurrent conditions and potential drug interactions.

References:

https://www.kff.org/coronavirus-covid-19/issue-brief/the-implications-of-covid-19-for-mental-health-and-substance-use/

https://news.wellrx.com/2020/05/18/may-is-mental-health-awareness-month/

https://www.apa.org/topics/anxiety/

https://www.wellrx.com/escitalopram%20oxalate/drug-information/

https://www.wellrx.com/paroxetine%20hcl/drug-information/

https://www.wellrx.com/duloxetine%20hcl/drug-information/

https://www.wellrx.com/venlafaxine%20hcl%20er/drug-information/

https://www.wellrx.com/buspirone%20hcl/drug-information/

https://www.wellrx.com/alprazolam/drug-information/

https://www.wellrx.com/clonazepam/drug-information/

https://www.wellrx.com/lorazepam/drug-information/

https://www.who.int/news-room/fact-sheets/detail/depression

https://www.nami.org/nami/media/nami-media/infographics/generalmhfacts.pdf

https://www.wellrx.com/hn/us/assets/health-condition/depression/~default/

https://www.mayoclinic.org/diseases-conditions/depression/diagnosis-treatment/drc-20356013

https://www.wellrx.com/fluoxetine%20hcl/drug-information/

https://www.wellrx.com/citalopram%20hbr/drug-information/

https://www.wellrx.com/sertraline%20hcl/drug-information/

https://www.wellrx.com/bupropion%20xl/drug-information/

https://www.wellrx.com/mirtazapine/drug-information/

https://www.wellrx.com/nefazodone%20hcl/drug-information/

https://www.wellrx.com/trazodone%20hcl/drug-information/

https://www.wellrx.com/prescriptions/

https://www.wellrx.com/rx-discount-card/enroll/

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Treatment for Depression and Anxiety: The Fight to End Suicide

by Cherokie Dyer, PharmD candidate class of 2020,
University of Florida

Alarming Suicide Statistics

Over the past 17 years, rates for death by suicide has dramatically risen here in the United States. From 1999 to 2016, 25 states had over a 30% increase in their suicide rates. There’s rarely any one reason for someone to commit suicide. However, most suicides are attributed to life stressors, loss of a relationship, and a recent or approaching crisis. Another huge contributor is the presence of a mental health disorder such as depression or anxiety.

In the year of 2017, the CDC states that there were:

  • 44,965 suicide deaths
  • 13.9 suicide deaths per every 100,000 people
  • 39% of adults 18 and older had serious psychological distress in the past 30 days
  • 56.8 million physician visits resulted in mental, behavioral, and neurodevelopmental disorders as a diagnosis
  • 5.5 million emergency room visits were due to mental health disorders

The Good News

The amount of people being treated for depression and anxiety disorders is also rising. In 2012, the World Health Organization stated that 350 million people across the globe were affected by depressive disorder. This is followed with an increase in diagnosis and treatment of these disorders.

Common Anti-Depressant and Antianxiety medications include:

Brand Name Generic Name Drug Class
Zoloft Sertraline Selective Serotonin Reuptake Inhibitor
Lexapro Escitalopram Selective Serotonin Reuptake Inhibitor
Prozac Fluoxetine Selective Serotonin Reuptake Inhibitor
Wellbutrin Bupropion Dopamine/Norepinephrine Reuptake Inhibitor
Cymbalta Duloxetine Serotonin/Norepinephrine Reuptake Inhibitor
Effexor Venlafaxine Serotonin/Norepinephrine Reuptake Inhibitor
Pristiq Desvenlafaxine Serotonin/Norepinephrine Reuptake Inhibitor
Remeron Mirtazapine Alpha-2 Antagonist
  Amitriptyline Tricyclic Antidepressant

It’s great that more people are getting help for their mental health conditions. The increase in people getting treatment will help to decrease the number of people wanting to harm themselves. If you have sought treatment for anxiety or depression or know someone who sought treatment, I am so happy! Everyone’s life is valuable. If you or someone you know suffers from anxiety or depression and hasn’t yet felt comfortable seeking treatment, don’t hesitate. The awareness of these conditions and options for treatment are expanding; set up an appointment to talk about what you are experiencing.

Things to Remember about your Antidepressants or Antianxiety Meds

These medications take time to work. In many cases, you won’t see an effect until after about 1 month. Taking your medications as prescribed can help strengthen their effectiveness and prevent side effects like dizziness, fatigue and nausea. If significant time passes and you still don’t feel any better, ask your doctor to try you on another medicine. Never quit these medicines abruptly as this can result in bothersome, and sometimes serious withdrawal symptoms. Be sure to follow your doctor’s instruction to taper these medications if it’s determined that they need to be stopped.

Outside of Medicine

Outside of prescription medication, these are 3 valuable ways to improve mental health. Incorporating these changes along with your medication can also increase their effectiveness.

Nutrition: Your body makes all your brain chemicals from the food you eat daily. That’s your protein, complex carbohydrates (fruits, veggies, whole grains), and good fats. If you don’t eat this kind of balanced diet, you may consider taking a daily multivitamin.

Sleep: Getting close to 8 hours of sleep each day gives your body the time to make more brain chemicals. It’s the best opportunity for your body to fix and replace other cells like the nerves and muscles.

Exercise:  Daily exercise improves your brain activity and increases the release of brain chemicals. A great example would be going for a brisk walk outside. The movement, along with getting at least 10 minutes of sun each day, is another great way to both exercise and get your daily vitamin D allowance. Not to mention exercise is a good way to relieve anxiety and avoid personal stressors! 

Suicide Lifeline

If you or someone you know are thinking about harming themselves in any way, call the National Suicide Prevention Lifeline at 1-800-273-8255. You can also text HOME to 741741 to receive texts from the Crisis Text Line. If you feel there is an emergency, you should always call 911 or go to the nearest hospital.


Cherokie Dyer is a PharmD candidate of 2020 who is also pursuing a career in nutrition and holistic wellness. She founded Healthy La Vie, a wellness platform aimed to help people live healthier lives through health education, nutrition and holistic wellness tips. She’s written many articles bringing the world of medicine and nutrition together on the Healthy La Vie blog.


References:

Suicide Prevention websites:

https://www.crisistextline.org/

https://suicidepreventionlifeline.org/

Statistics:

https://www.grandviewresearch.com/industry-analysis/anxiety-disorders-and-depression-treatment-market

https://www.cdc.gov/nchs/fastats/mental-health.htm

https://www.cdc.gov/mmwr/volumes/67/wr/mm6722a1.htm?s_cid=mm6722a1_w

Medication and Nutrition information:

https://www.fda.gov/consumers/free-publications-women/depression-medicines-help-you

http://www.martiefankhauser.com/


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