Alternatives to SSRI
Antidepressants can have serious side effects that require a change. In addition to SSRIs, the class of antidepressants includes the so-called tricyclic antidepressants. Active ingredients in this group include amitriptyline, imipramine, clomipramine and others.
However, due to their numerous side effects, they are no longer considered the first choice in the treatment of depressioanic disorders. Further alternatives are the selective noradrenaline reuptake inhibitors (SNRI, e.g. reboxetine). Dopamine reuptake inhibitors (DRI, amineptin) are no longer on the market today.
Serotonin noradrenaline reuptake inhibitors (SSNRIs, including venlafaxine and duloxetine) are important. Bupropion, a member of the selective noradrenalin/dopamine reuptake inhibitor class, is also considered an alternative to SSRIs.Another large group is the monoaminooxidase inhibitors, MAOI for short. Non-selective MAO inhibitors such as tranylcypromine are important in the treatment of depression. Patients must follow a strict low-tyramine diet, as the consumption of some foods can lead to severe side effects.
Can I take it during pregnancy and breastfeeding?
Women who are taking SSRI and are planning to become pregnant should consult their gynecologist and doctor. There are various claims about the safety of SSRI in pregnancy, but compared to other antidepressants SSRI is considered relatively safe. Stopping the medication should only be done in consultation with a specialist.
The breastfed child is exposed to the active substance of SSRI through the breast milk, but less so than the alternative antidepressants. SSRIs are also generally considered relatively safe for breastfeeding mothers, but this should be decided on a case-by-case basis. In cases of severe depression, the benefits of treatment probably outweigh the disadvantages of the drugs for the mother and the breastfed child.
Because it is the best tested, citalopram is one of the SSRIs of choice in pregnancy and breastfeeding. What medications may be taken during pregnancy or lactation and which should be avoided?
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