Depressed mood, loss of interest and isolation: around 15 percent of people in Germany will be diagnosed with depression at some point in their lives. Many of them are prescribed an antidepressant by their doctor. However, opinions about the preparations differ greatly. While some of those affected swear that the medication improves their lives enormously, other patients report a lack of effect or even side effects that reduce their quality of life.
But how well do the common preparations really work against depression? And what side effects should sufferers expect while taking it? Stiftung Warentest wanted to know more about this and commissioned a team of experts to examine hundreds of antidepressant drugs with a total of 25 different active ingredients. The basis for the analysis was, on the one hand, the proven effectiveness of the preparations and, on the other hand, the risk-benefit ratio.
A distinction is essentially made between three groups: serotonin reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors and tricyclic antidepressants. There are also other medications with other active ingredient compositions. And the list of possible side effects of antidepressants is often long. While the tricyclic drugs sometimes lead to weight gain, dizziness and drowsiness, the serotonin inhibitors are more likely to cause restlessness, nausea and loss of libido.
For this reason, antidepressants are not always the first line of treatment for a depressive episode. If the depression is mild, the National Care Guideline from 2022 recommends online programs or regular discussions with the family doctor as well as healthy self-care. Antidepressants or psychotherapy can help with moderate depression. In the case of severe depression, both should therefore be linked in order to help the patient in the best possible way.
The Stiftung Warentest considers drugs from the group of serotonin and serotonin-norepinephrine reuptake inhibitors to be particularly suitable for the treatment of moderate to severe depression. The corresponding agents include the serotonin reuptake inhibitors “citalopram” and “paroxetine” as well as the serotonin and norepinephrine reuptake inhibitors “duloxetine” and “venlafaxine”. In contrast to other drugs, they hardly make you tired, but rather have an activating effect on the patient.
By the way: The experts also took a close look at the natural antidepressant St. John’s wort. Their conclusion: Suitable for the short-term treatment of mild depression.
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