I work with a lot of people who struggle with depression. They often come to me questioning why they are still struggling with the feeling of depression and they are on anti-depressant medications.
The anti-depressant medications you list are both of a type called SSRIs (that is, Selective Serotonin Reuptake Inhibitors). In our brains, we use a carefully balanced blend (think of it like a symphony) of neurotransmitters to regulate our thoughts, energy, and emotions throughout a day. Some neurotransmitters are inhibitory (calming) while others are stimulatory (energizing or focusing); the "instruments" are balanced and coordinated finely to yield the "music" the nervous systems want to make in response to our environment. We actually have receptors for various neurotransmitters all throughout the body, so these communication molecules are regulating much more than mood!
Neurotransmitters are used to communicate a message in the brain from neuron to neuron by jumping into the synapse (or space) in between the neurons. Once used, neurotransmitters are then designed to be taken back up (as in, "reuptaken") into the releasing neuron. SSRI medications work by preventing neurons from taking back up on the serotonin they have released. In this way, the drug forces the nervous system to keep serotonin in circulation in the synapses of the brain (and the gut!).
Contrary to popular belief, SSRIs do NOT actually increase the overall amount of serotonin (see other Q&A entries for tips on what does). They essentially "fake" the brain into believing there is more serotonin than there really is and try to increase the action of whatever serotonin is present. However, ongoing use of SSRIs actually depletes the body of serotonin (and dopamine too). Like most systems, the body has override mechanisms in the nervous systems that counter abnormal action!
In this case, the brain naturally secretes enzymes that break down excessive neurotransmitters left in our synapses (in this case, both serotonin and dopamine). Thus, extended use of SSRIs (in some cases, a few weeks, in others a few months) will eventually cause neurotransmitter depletion (thus, a worsening of the situation it was trying to address in the first place!). This will happen at a unique pace for a given person. In most cases, individuals are depressed for reasons that have nothing to do with serotonin (e.g. gut dysbiosis/imbalance, toxicity, food sensitivity, poor methylation, emotional traumas), so they actually have adequate serotonin, despite being prescribed the drug. We are even starting to see this concept promoted in medical journals. Finally!!
Some people who use SSRIs report short-term relief from dark, deep thoughts but also the removal of bright high moods (a bit of a numbing effect - taking away the mood peaks, both high and low). However, clinical research generally does NOT show SSRI medications to be more effective than placebo for alleviating mild-to-moderate depression. Keep in mind that placebo can be very effective! Indeed, the mind is extremely powerful and beyond anything we have ever been taught about the power of our beliefs. If we believe we can (or do) feel better, then indeed we do.
Dr. Mark Hyman has a helpful blog entry on this topic - one I often share with my clients.
Dr. Kelly Brogan is a very passionate psychiatrist and well-spoken on this topic: http://kellybroganmd.com/antidepressants-can-work-but-only-if-you-believe-they-will/ and http://kellybroganmd.com/depression-serotonin/ .
There are actually many factors that can cause feelings of depression. And they have nothing or little to do with neurotransmitters (e.g. Vitamin D, Vitamin B12, Magnesium, Vitamin B6, or Omega-3 fatty acid deficiencies). The of course there is the mind and the spirit alignments that are extremely important to symptoms of depression. If you are constantly beating yourself up as not good enough or out of alignment with your soul desires, you will be feeling the physical symptoms of depression as emotions are our GPS to our soul.
Be sure to thoroughly explore your symptoms to understand their potential root causes and connect to your inner wisdom of what your depression symptoms are trying to tell you.
In health & happiness,