This is a part of the Hot Topic podcast series from the Model Systems Knowledge Translation Center on TBI and Depression. Dr. Jesse Fann discusses Antidepressant Medications.

A lot of people have negative images of antidepressants. There’s a lot of negative media out there about antidepressants. A lot of it is not accurate. People can get some side effects from antidepressants, like they can with any medication, but many of those side effects can and usually do go away after one to two weeks as the body and the brain kind of gets used to it.

But I think there is unfortunately still a stigma associated with taking an antidepressant even though in the general population the rates of antidepressant use are increasing over time.

Antidepressants are not addictive, and they do often take several weeks to get their full effect. So, it’s very important that people take the medication every day, and once they do start to feel better, often in a few weeks, they should continue to take the medication even if they are feeling better.

And what antidepressants do is they help to rebalance those natural chemicals in the brain called neurotransmitters to a more natural state. And by doing so can help their mood get back to normal.

What we usually do in people with a brain injury or any other kind of injuries to the brain like a stroke or other injuries is that we usually try to start at relatively lower doses and go up at a slightly slower pace than what we would do with people without a brain injury. And when you do that, what we would call “start low, go slow,” people generally do tend to tolerate the medications pretty well.

There are a number of patients who would prefer not to take an antidepressant, partly because they’re already on a lot of medications. Sometimes people who have had a brain injury are on pain medications, sometimes even seizure medications. So, it’s understandable that some people might not want to take another medication and would prefer counseling, for example.

And so again it’s very important that patients — and their families — really be a close partner in the decision-making process of what are the best options, the best approaches for them in dealing with their depression.

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