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According to the National Institute of Mental Health, depression affects
more than 17 million Americans in any one-year period. Although
depression can be exacerbated by a variety of life situations, medical
experts attribute the disease to an imbalance of the brain
neurotransmitters, serotonin and norepinenephrine, which affect mood,
eating, sleeping, pain and thinking.
Treatment for the disease--which annually costs the federal government
$12.4 billion in medical, psychiatric and drug costs, and $23.8 million
in work absenteeism and lost productivity--depends on the severity of
the illness. Adults with severe depression are often treated with
antidepressant medication, including selective serotonin reuptake
inhibitors (SSRIs), which act on serotonin only, and tricyclics, which
act on both serotonin and norepinenephrine. Monoamine oxidase inhibitors
(MAOIs), another antidepressant, is less frequently used. SSRIs and
tricyclics have fewer side effects than MAOIs, but tricyclics are used
to treat depression for longer periods.
Newly introduced treatments for depression include the use of "booster
drugs" that help the primary antidepressant drug work more effectively,
including Cytomel (a thyroid stimulator), lithium and Ritalin.
Vagal-nerve stimulation (VNS), initially used by researchers to prevent
or lessen seizures in epileptics, was proven effective in a recent study
of treatment-resistant patients at the University of Texas Southwestern.
The process involves implanting a small pacemaker into the vagal nerves
(which connects the brain stem with the upper body), thereby affecting
changes in serotonin and norepinephrine levels. Transcranial magnetic
stimulation (TMS), which stimulates the nerve cells in the brain, has
also been used to treat depression and has been shown to relieve
depression when applied once daily for two or more weeks. Psychological
treatments (often preferred for children and adolescents) may be
combined with medical treatments.
Some side
effects of antidepressants include nausea, dry mouth, diarrhea or
constipation, dizziness, sleeping problems, weight changes, sweating and
irritability.
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