clics, MAOI’s, and “second generation” or selective serotonin reuptake inhibitors (421). The tricyclics act by preventing the reabsorbing of catecholamines or serotonin by the presynaptic neuron. Therefore the transmitter will stay in the synaptic cleft longer and stimulate the postsynaptic cell longer. The monoamine oxidase inhibitors (MAOI’s) block the monoamine oxidase enzyme, which metabolizes catecholamines and serotonin into inactive forms. The “second generation” or selective serotonin reuptake inhibitors (SSRI) are similar to the tricyclics. SSRI’s block the reuptake of serotonin, which leads to increased serotonergic activity. For some, the drug may not have had a great effect, if any at all, for this reason psychotherapy has been helpful for these patients and may produce long lasting relief. Before antidepressants and psychotherapy, depression was treated with electro convulsive therapy (ECT). It started out as treatment for schizophrenia and epilepsy. After being tested on other disorders, it seemed to be helpful in many depressed patients and became a common treatment. It became overused and developed a bad reputation, so its use declined. When it seemed that new antidepressants could not help, it made a small come back. It is now used with informed consent, for those in which no antidepressants work and for those with strong suicidal tendencies because it works faster than drugs....
