MSAA: Publications - The Motivator: Winter/Spring 2009 - SECTION 8: DEPRESSION
Multiple Sclerosis Association of America Logo
Link to FaceBook Link to Twitter Link to YouTube Link to Pinterest
Register Why Register Contact MSAA Site Preferences Print Page Home
Improving Lives Today!
Donate Button
The Motivator iconMSAA's MAGAZINE
The Motivator
Booklets and Brochures iconBooklets & Brochures
MS Research Update 2015
MS Research Update 2014
About MS
Improving Lives Today! A Guide
to MSAA's Programs and Services
Ways to Give
Medicare Planning
and Multiple Sclerosis
The Affordable Care Act
and Multiple Sclerosis
Aquatic Exercise and Multiple Sclerosis:
A Guide for Patients
How to S.E.A.R.C.H.™ for the Right
MS Therapy for You!
Understanding and Treating
MS Relapses
Mommy's Story
Daddy's Story
Understanding and Treating
Depression in Multiple Sclerosis
MSAA Monograph: The Confusing
World of Clinical Trials
Primary Progressive Multiple
Sclerosis: What You Need to Know
Order Publications iconOrder Publications
Individual Order
Group Orders

Home > MSAA Publications > The Motivator > The Motivator: Winter/Spring 2009 > Cover Story - Symptom Management Update > SECTION 8: DEPRESSION
Share this Page:
submit to reddit



Depression is common in MS. It can be the result of difficult life situations or stresses, but may also occur from the MS disease process, because of damage to areas of the brain that are involved in emotional expression and control. Additionally, depression can also be a side effect of various medications used in the management of other MS symptoms.


Because of the wide-ranging issues that affect people with MS and can also contribute to depression, the effective results are usually obtained with a combination of "talk therapy," (through some type of counseling or therapy), pharmacologic agents, and exercise.


A wide variety of antidepressant medications are useful in managing depression associated with MS. Most of them appear to work by slowing the removal of specific neurotransmitters, thus increasing their activity because they stay in the system longer. This means that the chemicals that make us feel good remain in the body longer, and this positively affects mood. The two main neurotransmitters affected by antidepressant medications are serotonin and norepinephrine. These medications belong to a variety of subcategories, depending on the neurotransmitter they affect.

SSRI antidepressants (Selective Serotonin Reuptake Inhibitors)
including Prozac® (fluoxetine), Zoloft® (sertraline), Paxil® (paroxetine), Celexa® (citalopram), and Lexapro®(escitalopram)

This group of antidepressants was developed to treat general mental depression and panic disorders, and has proved effective in treating depression and anxiety, as well as several other symptoms of MS. SSRIs inhibit the reuptake of serotonin (a chemical produced within the body, which is known to elevate mood), allowing it to remain in the body 's system longer.

Side effects of this class of drugs include decreased sexual drive or ability, drowsiness, dry mouth, headache, and weakness, as well as psychological symptoms that may include agitation and nervousness.

SRNI antidepressants (selective Serotonin and Norepinephrine Reuptake Inhibitors)
including Cymbalta® (duloxetine hydrochloride), Serzone® (nefazodone), Wellbutrin® (bupropion), and Remeron®(mirtazapine)

These are oral medications in tablet form. With Side effects similar to the SSRIs, SSRNIs are a newer type of antidepressant and provide additional treatment options.

Side effects vary with the specific drug, but may include gastrointestinal problems, fatigue, sleepiness, drowsiness, and dizziness. Contact your healthcare provider if you experience any sudden emotional or behavioral changes while taking this medication.

Tricyclic Antidepressants
including Elavil® (amitriptyline), Tofranil®(imipramine), Pamelor (nortriptyline)

These are oral medications in tablet form. The dose normally ranges from 10 to 150 mg per day (amitriptyline), 75 to 150 mg per day (imipramine), and 10 to 175 mg per day (nortriptyline).

Side effects include dry mouth, constipation, sexual problems, dizziness, and drowsiness.


Last Updated on Friday, 10 May 2013 10:27