Finding the right medication is often a matter of trial and error. Be sure your doctor understands this, and works with you in finding the right medication. One doctor specializing in mental illness says it takes an average of nine months to get his patients on the right medication. If your doctor doesn't take the time to carefully evaluate your progress, ask for a referral to a psychiatrist.

For severe major depressive disorder, antidepressants must be taken for a minimum of one year after a person is symptom-free. If the depression has been severe and untreated for a lengthy period of time, you may require life-long medication, as cell damage may be irreparable.

At present there are more than 25 antidepressant medications. The most popular medications are categorized as follows:

SSRIs – serotonin re-uptake inhibitors:
These include medications such as Prozac, Zoloft, and Lexapro.

SNRIs – serotonin norepinephrine re-uptake inhibitors:
Effexor, Cymbalta and Pristique (Effexor also targets dopamine at high dosages).

DNRIs – Dopamine norepinephrine re-uptake inhibitors:  
Wellbutin and Aplenzin.

My first medication was an SSRI, which targets serotonin alone. After a few weeks, it restored thought control, which was a wonderful gift. It also slowed the speed of my thoughts, which had been racing uncontrollably for years. My mind could finally rest!

It also normalized my sleep patterns and balanced my metabolism (I was about 20 pounds underweight despite eating several high calorie meals and numerous high fat snacks every day for several years in an attempt to stop the slide).

But the medication didn’t help with many other symptoms. After a few months on this medication (during which time I was also conducting my own research on depression), I realized I likely needed a different anti-depressant. I went to my doctor with my own recommendation of a medication, one that targets serotonin and norepinephrine.

Within weeks, I was a different person. Actually -- I was transformed into the "real me" - the person I was before depression invaded my brain and masked my personality. I felt like I was born again physically, emotionally and mentally. I had not felt so healthy in 30 years. It was a shock to realize how many years I had lost to depressive illness.

Over the subsequent four years, I continued to see more improvements in mental cognition. I also started seeing a new doctor who is very knowledgeable about depression. She has been fantastic in helping me in my treatment journey.

Now, four years later, for the first time I have been able to reduce my dose of medication. (Conventional medical wisdom is that I would need to take medication for the rest of my life, due to the severity and the number of years I was untreated). As of this writing, my dosage is half of what it was only a few months ago.

Doesn’t medication turn you into a zombie?

If you feel tranquilized or emotionally flat on an anti-depressant, you are likely on the wrong medication, or you don’t need medication, or your doctor is intentionally slowing down your brain prior to adding a second medication to deal with other symptoms.

Many doctors don’t have the time or training to match medication to the symptoms a person is having, relying on the most popular and commonly prescribed medications. I recommend you take a detailed list of your symptoms to your doctor.

If your symptoms persist after several weeks, learn all you can about different medications and take that information to your next appointment with your doctor. If your doctor is not willing to work with you on this, you may want to request a referral to a psychiatrist.

Unfortunately there are no blood tests that can show which part of your brain is affected and what medication will work best for you. Hopefully that will change over the next few years. Calgary's Foothills hospital and the University of Calgary are currently conducting a pilot project to see if they can find biomarkers that would help narrow down the medications most likely to help individuals cases of depression. Read more

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