One in five Americans will have a major depressive episode in their lives and many will seek help from a mental health provider, which may include treatment with medication. As with all medication, there is no one-size-fits-all treatment plan when it comes to antidepressants. The terminology alone is confusing. There are SSRIs, tricyclics, and other drugs that have off-label uses.
For those who take antidepressants, it is a challenge to find the right one. Some work better than others for individuals, and family members may not understand why it is difficult to find something that “works.” In Understanding Antidepressants, Wallace B. Mendelson, MD, uses a format understandable to the lay reader to provide a basic overview of the currently available antidepressants.
He starts with an overview of how these medications work before discussing the different classes of antidepressants. Some of this first chapter on how drugs work may go over the heads of some readers who do not have a knack for science. Mendelson identifies the different receptors in our brains and explains how they respond to the chemicals that are in antidepressants. He also includes some history of the different classes of antidepressants for readers who want to dig a little deeper.
Throughout the book, he primarily mentions the generic names for medications, which may be difficult for the lay reader to follow. For example, most people are probably not familiar with fluoxetine, but everyone has heard of Prozac. Although there is a helpful table later in the book that lists the generic name next to the brand name, it would have been useful in the very beginning as a reference for the generic names.
Mendelson provides definitions to better explain how the medications work. For example, the concept of half-life is important for patients to know so they understand why they may still have effects from a medicine they stopped taking days ago. Equally valuable is information on the potential side effects for each class of antidepressant.
The book could have benefited from extra charts like the one listing the chemical name and brand name. Although the book in general is geared toward the lay reader, the description of chemicals in medications and how our brains respond is a complex topic. Tables or charts would help convey that information in conjunction with the text.
Although Understanding Antidepressants is about the medication options, I would have liked to see the section about alternate treatments expanded a bit more. For instance, Mendelson does suggest psychotherapy as an alternative to pharmaceutical treatment. As a licensed therapist, I would argue that psychotherapy works best when it is used with medicine, rather than as an alternative. I hope patients reading the book do not see the solution as either medication or psychotherapy. Both are valuable and both are often necessary.
The end of the book would benefit from an additional resource section. He does briefly mention a selected bibliography, and a condensed guide cannot delve too deep into the complexity of depression and its treatment. References for patients to find more information, such as a credentialed psychiatrist or counselor, would be a nice addition along with reading suggestions to learn more about depression.
Even with these criticisms, the book does meet the original goal of helping people to understand antidepressants. It is a short guide with large print intended for people to get an overview. It is not a resource I would recommend for those studying to become a mental health practitioner, whether a counselor or physician. It is intended for the everyday reader who wants a quick overview and background information on antidepressants and how they work. And the disclaimer at the beginning is important. It is absolutely not a substitute for medical advice from a licensed provider.
Self-published, March 2018
Paperback, 123 pages