Question: What are the side effects of medicines used to treat depression?
Both Cipramil and Efexor are excellent medications for the treatment of depression, but they come from different classes of drugs, and so have different side effects. If you find that the medication you are taking is helping and has minimal side effects, then follow the old saying of ‘When you are on a good thing, stick to it’. If you are having problems with your medication then discuss the matter with your GP, who may decide to change the dose or try a different medication.
Cipramil is in a class of antidepressants known as SSRI (selective serotonin reuptake inhibitors). The dosage can vary from 10 mg to 60 mg once a day. It should be used with caution in pregnancy, breast feeding and children, heart disease, mania and liver disease. Otherwise it is a very safe drug, but when you decide to stop the drug, you should reduce the dose slowly—do not stop suddenly.
Common side effects include nausea, diarrhea, tiredness, dry mouth, and impotence, but these usually wear off as the medication is continued, so a trial lasting at least two weeks is the minimum. Unusual side effects include sweating, loss of appetite, tremor, agitation, watery nose, and a low libido.
Introduced in 1998 as a further advance within an excellent class of drugs that are very effective in treating depression. It is claimed to have a faster effect and fewer side effects than other SSRI antidepressants. Efexor was introduced in 1997 for the management of more difficult cases of depression. Dosage varies from 37.5 mg to 75 mg twice a day, but the dose must be increased slowly. It must be used with caution in pregnancy, breast feeding and children, epilepsy, other psychiatric conditions, liver, high blood pressure, and kidney diseases. Once again, you should not stop the medication suddenly, but reduce the dose slowly.
Common side effects include dizziness, sleeplessness, nervousness, nausea, diarrhea, and a dry mouth. Unusual side effects are tiredness, vomiting, excess sweating, impotence, and high blood pressure.
Please remember that all antidepressants are slow to work, and it may be two or three weeks before any improvement in mood is felt.

Question: Can depression be caused by an incorrect balance of the hormones ?
Depression is a common problem in women who are passing through the menopause, and can become extremely distressing to both the woman and her family. Hormone replacement therapy is designed to do what its name implies— replace the hormones that are lost during the menopause, and therefore prevent the complications of the menopause.
During menopause women suffer from hot flushes, irregular menstruation, breast tenderness and loss of libido as well as depression. The lack of female hormones after the menopause leads to an increase in the incidence of osteoporosis, heart attacks and strokes.
Every woman’s hormonal balance is different, and sometimes it takes a considerable time, and numerous changes in both the hormone form and dosage to get just the right balance for a particular woman.
If depression is a continuing problem, it may be that the hormone replacement therapy you are taking is not quite the right balance for you, or you may require some specific anti-depressant medication. Write down exactly how you feel regarding your depression, and how the menopause is affecting you, and take the list to your general practitioner to discuss it further. Almost certainly, you will be able to receive furthet assistance with your problems.

Question: I have depression, and it is taking years to clear up. What is this illness, what can be done for them, and what is the long term prognosis?
There are many different types of depression. Some forms are a reaction to stresses in your life such as loss of a job or a death in the family, while others are caused by biochemical imbalances in the brain that occur for no apparent reason. Sometimes it can last for just a few weeks, while in others it may recur, or persist for years. Psychiatrists will attempt to determine the type of depression that is affecting you before starting any treatment, but this is often very difficult, as there are no blood or other tests that can help the doctor, and s/he must depend on his/her clinical skills.
Once the diagnosis is made, the correct treatment will be started. This will usually involve the use of one or more medications, counseling, psychotherapy, and occasionally shock treatment.
There are some cases that can be cured, but others may only have their depression controlled. There are many diseases that cannot be cured, but are effectively controlled, and good examples would be diabetes and high blood pressure, where medication must be used life long.
Provided the patient is prepared to carefully follow a doctor’s advice, the majority of cases of depression can be cured or controlled, so that the patient can lead a normal life with minimal side effects from the treatment. Only in cases where there is poor compliance with treatment, poor family support or other adverse factors does the patient face a life of continued depression and risk suicide.

Question: What is the best treatment for depression? Should I keep taking drugs all the time?
Depression may be due to an imbalance of chemicals that normally occur in the brain to control mood, and it is necessary for doctors to alter this balance, by giving medications that can control the production or activity of the depressing chemicals.
The worst problem with untreated depression is suicide, and this can be seen as a desperate plea for help in many people. The disease may not be detected or treated until a radical attempt to end life has occurred.
Medication and counseling by a general practitioner or psychiatrist will control the vast majority of cases.
The other form of treatment used is shock therapy. This has been surrounded by some controversy in the past, but is a very safe and often very effective method of giving relief to patients with severe chronic depression.

Question: I have heard that there is now an injection that you can have every few months instead of the pill that will stop you falling pregnant. Can you tell me about this please? Is it effective and safe?
Depo-Provera is an injectable contraceptive that has been used for 30 years overseas (including New Zealand and England), and was approved for use in Australia several years ago. It contains a hormone called medroxyprogesterone acetate, which is similar to the natural progesterone produced in the ovaries.
It is given by injection every three months and prevents pregnancy in two ways:
• It prevents the release of the egg from the ovary (ovulation)
• It affects the lining of the womb (uterus) and the type of mucus at the neck of the womb (cervix) to reduce fertility.
Depo-Provera is more than 99% effective in preventing pregnancy, which is comparable to a vasectomy or tubal ligation, and slightly more effective than th contraceptive pill (which can be forgotten at a vital time).
The first injection is given at a time when it is certain that the woman is not pregnant. This is usually during or immediately after a period, or soon after childbirth. The first injection will be fully effective after two weeks, and will last at least three months from the date of injection. Provided they are given regularly every three months, subsequent injections are fully effective immediately.
As with all medications there may be side effects. Many women find that their usual cycle of menstrual periods is altered by Depo-Provera, and periods often stop altogether. Other possibilities include having irregular light periods, or occasionally, constant light bleeding. Heavy bleeding rarely occurs.
Less common side effects include headaches and a prolonged delay in fertility. Rarer side effects include weight gain, anxiety, acne and breast tenderness. Additional medication can be given to counteract these side effects while the injection wears off, but if any significant side effects occur, the injection is not repeated and another form of contraception must be used.
Depo-Provera may be used safely during breast feeding without affecting the baby or the mother’s milk supply.
Women should be aware that the ability to fall pregnant may be delayed after using Depo-Provera by up to six months after the last injection was given.
Occasionally this extends to 15 months, and very rarely up to two years.