Of the 14 genes that showed increased activity in the paroxetine-treated cells, the gene that expresses ITGB3 showed the greatest increase in activity. Intriguingly, none of the 14 genes are related to serotonin signaling or metabolism, and, ITGB3 has never before been implicated in depression or an SSRI mode of action.
But, the bigger picture lies in the fact that in order to make up for the lull in SERT, more ITGB3 is produced, which then goes to work in bolstering synaptogenesis and neurogenesis, the true culprits behind depression. The research is weakened by its reliance on observations of cells in culture rather than in actual patients.
The study turned up additional drug targets for treating depression—two microRNA molecules, miR and miR Essentially, microRNAs are small molecules that can turn a gene off by binding to it. The microarray results showed a significant decrease in the expression of miR and miR, both of which are predicted to target ITGB3 , when cells were exposed to paroxetine.
So, a drug that could prevent those molecules from inhibiting the production of the ITGB3 protein would arguably enable the growth of more new neurons and synapses. And, if the neurogenesis and synaptogenesis hypothesis holds, a drug that specifically targeted miR or miR could bring sunnier days to those suffering from depression.
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About OCD. OCD section contents. Introduction to OCD. The history of OCD. The language of OCD. The Impact of OCD. Diagnosing OCD. Related Disorders. Introduction to BDD. More about OCD. Section contents. OCD Book Club. Supporting Someone with OCD. OCD Support Groups. Inspirational Quotes. OCD Forums. More contents. Overcoming OCD. Overcoming OCD section contents. When they're prescribed, you'll start on the lowest possible dose thought necessary to improve your symptoms.
SSRIs usually need to be taken for 2 to 4 weeks before the benefit is felt. You may experience mild side effects early on, but it's important that you don't stop taking the medication. These effects will usually wear off quickly. They may recommend increasing your dose or trying an alternative antidepressant. A course of treatment usually lasts for at least 6 months, although longer courses are sometimes recommended and some people with recurrent problems may be advised to take them indefinitely.
SSRIs aren't suitable for everyone. They're not usually recommended if you're pregnant, breastfeeding or under 18, because there's an increased risk of serious side effects. SSRIs are generally safe for most people. However, in some circumstances they can cause problems. For example, high doses of citalopram may cause dangerous abnormal heart rhythms, so doses over 40 milligrams mg a day should be avoided according to the FDA and the manufacturer.
They also recommend a maximum daily dose of 20 mg of citalopram for people over age Issues to discuss with your doctor before you take an SSRI include:.
Drug interactions. When taking an antidepressant, tell your doctor about any other prescription or over-the-counter medications, herbs or other supplements you're taking. Some antidepressants can interfere with the effectiveness of other medications, and some can cause dangerous reactions when combined with certain medications or herbal supplements.
For example, SSRIs may increase your risk of bleeding, especially when you're taking other medications that increase the risk of bleeding, such as nonsteroidal anti-inflammatory drugs NSAIDs , aspirin, warfarin Coumadin, Jantoven and other blood thinners. Serotonin syndrome. Rarely, an antidepressant can cause high levels of serotonin to accumulate in your body. Serotonin syndrome most often occurs when two medications that raise the level of serotonin are combined.
These include, for example, other antidepressants, certain pain or headache medications, and the herbal supplement St. John's wort. Signs and symptoms of serotonin syndrome include anxiety, agitation, high fever, sweating, confusion, tremors, restlessness, lack of coordination, major changes in blood pressure and a rapid heart rate. Seek immediate medical attention if you have any of these signs or symptoms. Most antidepressants are generally safe, but the FDA requires that all antidepressants carry black box warnings, the strictest warnings for prescriptions.
In some cases, children, teenagers and young adults under 25 may have an increase in suicidal thoughts or behavior when taking antidepressants, especially in the first few weeks after starting or when the dose is changed. Anyone taking an antidepressant should be watched closely for worsening depression or unusual behavior.
If you or someone you know has suicidal thoughts when taking an antidepressant, immediately contact your doctor or get emergency help. Keep in mind that antidepressants are more likely to reduce suicide risk in the long run by improving mood. SSRIs aren't addictive.
However, stopping antidepressant treatment abruptly or missing several doses can cause withdrawal-like symptoms. This is sometimes called discontinuation syndrome.
Work with your doctor to gradually and safely decrease your dose. People may react differently to the same antidepressant. For example, a particular drug may work better — or not as well — for you than for another person. Or you may have more, or fewer, side effects from taking a specific antidepressant than someone else does. Inherited traits play a role in how antidepressants affect you.
If you have a close relative who responded to a particular antidepressant, tell your doctor, because this could be a good drug choice to start. In some cases, results of special blood tests, where available, may offer clues about how your body may respond to a particular antidepressant.
However, other variables can affect your response to medication. When choosing an antidepressant, your doctor takes into account your symptoms, any health problems, other medications you take and what has worked for you in the past. Typically, it may take several weeks or longer before an antidepressant is fully effective and for initial side effects to ease up. Your doctor may recommend some dose adjustments or different antidepressants, but with patience, you and your doctor can find a medication that works well for you.
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