Antidepressant medications work by increasing the transmission along serotonin and noradrenaline nerve fibres in the brain. Medications are chosen based on the type of depression and the side effect profile.
Once a drug has started to work, the patient is expected to improve with continued intake of antidepressant medication. By about two months, most symptoms would have disappeared. The medications should be continued for 9-12 months after remission of symptoms. Premature discontinuation of treatment even in the absence of symptoms may lead to relapses several months later.
Electroconvulsive Therapy (ECT)
ECT is the most effective treatment for depression where rapid reduction of symptoms is required. Thus it could be life-saving for those who are suicidal, with depressive stupor or who cannot tolerate the side effects of medication.
Psychological treatments require the patient to talk about their problems, also referred to as ‘ventilation’. Psychological approaches work best for persons who are able and willing to describe their thoughts and feelings. Types of therapy that may be used for depression include Interpersonal Psychotherapy, Cognitive Behavioural Therapy or Psychodynamic Psychotherapy. What sort of therapy will be administered depends on the skills and expertise available.