Escitalopram
Escitalopram belongs to the SSRI group. It has a very similar chemical structure to citalopram. The mode of action is the same: it inhibits the reuptake of serotonin in the synaptic cleft of the nerve cells.
This counteracts the serotonin deficiency present in depression, more serotonin is available in the tissue fluid of the brain. The side effect profile is similar to that of other drugs in the SSRI group. The most common are nausea, vomiting, diarrhea, insomnia, dizziness and increased sweating.
Appetite reduction also occurs. Both citalopram and escitalopram may cause ECG changes (QT time prolongation) which can lead to cardiac arrhythmia. Citalopram and sertraline from the group of SSRIs are better suited as antidepressants that can be taken during pregnancy and lactation because there are sufficient studies on these drugs.
However, there is no evidence that escitalopram has a teratogenic effect. If escitalopram was already taken before pregnancy for antidepressant therapy, it can be considered whether the therapy should be continued. Especially to avoid the risk of psychological crises that can arise from a change of medication.
Fluoxetine
Fluoxetine also belongs to the SSRI group.It is used to treat depression, obsessive-compulsive disorder, anxiety disorders and occasionally bulimia (commonly known as bulimia). The side effects are similar to those of Setralin. Fluoxetine is currently not recommended for use during pregnancy or while breast-feeding as there is evidence of an increased risk of heart defects in the unborn child if fluoxetine is taken in the first trimester. This topic may also be of interest to you: Fluoxetine
Amitriptyline
Amitriptyline is an antidepressant from the group of tricyclic antidepressants. This group belongs to the older antidepressant drugs. It has therefore been in use for a relatively long time.
Amitriptyline has been on the market since the early 1960s and for many years was the most prescribed antidepressant in the world. The group of tricyclic antidepressants works by a relatively unselective reabsorption of certain messenger substances into the nerve cells in the brain. In depression, among other things, there is a deficiency of messenger substances such as norepinephrine and serotonin.
By taking amitriptyline, these are made available again in greater amounts. In addition to its use in depression, amitriptyline is also used for the preventive treatment of certain types of headache such as tension headache and migraine, and for chronic neuropathic (nerve-related) pain. Several studies in recent years have shown better tolerability of another antidepressant group, the SSRIs.
Therefore, in recent years, SSRIs have slowly begun to replace tricyclic antidepressants such as amitriptyline in their sovereign status in the treatment of depression. This is particularly related to the range of side effects of tricyclic antidepressants. Due to the relatively unspecific reuptake inhibition of various messenger substances in the brain, the rate of side effects is higher with amitriptyline than with the newer antidepressants.
Typical side effects include headache, trembling of the hands (tremor), dizziness and drowsiness. Weight gain is also described relatively frequently. Furthermore, increased sweating, visual disturbances (accommodation disorders, i.e. difficulties in focusing at short distances), nausea and dry mouth can occur.
Tachycardia and heart stumbling are also relatively common. Overdosage can lead to dangerous cardiac arrhythmia. Other – less frequent – side effects include difficulty concentrating, tiredness or insomnia, manic conditions, tingling sensations (paresthesia) and confusion. Amitriptyline is one of the rather few antidepressants that, according to current studies, can be taken explicitly during pregnancy and lactation.
