Anti-Depressant Medication: Many doctors link phobias with depression
and, accordingly, prescribe anti-depressant medication. Of course, sometimes
the patient might also be depressed but the depression might actually be
secondary to the emetophobia - ie the emetophobe feels very depressed due to
being unable to lead a 'normal' life. Some anti-depressants have a sedative
effect, others act at the parts of the brain linked to both anxiety and
depression and some are specifically indicated as suitable for treating
phobic states (e.g. clomipramine). 
All anti-depressants can cause nausea and vomiting as a potential side-effect. It is important to gradually increase the dosage over a period of a few weeks in order to minimise such effects. Similarly, anti-depressants should not suddenly be withdrawn as this can lead to an unpleasant withdrawal syndrome with possible symptoms including: nausea, vomiting, anorexia, headache, giddiness, chills, insomnia, panic-anxiety and restlessness. If anti-depressants have been taken regularly for 8 weeks or longer, then dosages should be reduced over about 4 weeks, tapering the dose gradually.
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There are several different types of anti-depressant drugs available including (drug names - not brand names): |
 | Tri-Cyclic anti-depressants (TCA's) - amitriptyline, clomipramine, dothiepin, imipramine, lofepramine, nortriptyline, protriptyline, trimipramine…. |
| Flupenthixol (Fluanxol) is a thioxanthene with anti-depressant properties. Its advantages include a lack of stomach-related side effects, but it should only be used for short-term treatment. |
| Tryptophan (Optimax) is used by hospital specialists treating patients with severe and disabling depression lasting for more than 2 years and only after standard anti-depressants have been tried and, even then, as an adjunct to other anti-depressant medication. Tryptophan anti-depressants were withdrawn after they were linked with eosinophilia-myalgia but Optimax has been re-introduced but only for patients for whom other anti-depressants are unsuitable. |
| Mono Amine Oxidase Inhibitors (MAOI's) - phenelzine, isocarboxazid, tranylcypromine |
| Selective Serotonin Re-uptake Inhibitors (SSRI's) seem to be the amongst the most commonly prescribed anti-depressants of the early 21st century. They include: fluoxetine (Prozac), citalopram (Cipramil), fluvoaxmine (Faverin), paroxetine (Seroxat, Paxil), sertraline (Lustral, Zoloft). Related drugs include - nefazodone (Dutonin, Serzone) and venlafaxine (Efexor). Low levels of serotonin are linked to depression while raised levels are linked to anxiety states. For more information about serotonin, see serotonin link. |
| Nor-Adrenaline Re-uptake Inhibitors (NARI's) - reboxetine (Edronax) |
| The most commonly prescribed medication for anxiety disorders (including emetophobia) include : clomipramine, dothiepin and paroxetine which are felt to be the most beneficial for anxiety and panic attacks. |
| Paroxetine (brand name Seroxat in UK, Paxil in USA) is a popular drug of choice amongst many General Practitioners, however, like the other SSRI drugs, it can cause nausea (and vomiting) as a side-effect. The nausea side-effect usually subsides within 3 weeks but can be minimised by taking a reduced dosage and gradually increasing this from 10mg daily to 40mg daily. Although it is usually prescribed to be taken in the morning, users often find it is best taken with the evening meal for fewer side-effects. Of all the SSRI's, paroxetine has the highest incidence of a withdrawal syndrome which has received much publicity (autumn 2002). For more information about serotonin, go to : serotonin |
The Depression Alliance has produced a new booklet to help sufferers of depression, which lists a number of self-help approaches. For a copy (UK ONLY), please send postage stamps to the value of 50 pence to Depression Alliance, 35 Westminster Bridge Road, London, SE1 7JB
06/07/04