People with chronic depression may need to take medication indefinitely to avoid relapse.SSRIs are the primary medications prescribed, owing to their relatively mild side-effects, and because they are less toxic in overdose than other antidepressants. People who do not respond to one SSRI can be switched to another antidepressant, and this results in improvement in almost 50% of cases. Another option is to switch to the atypical antidepressant bupropion. Venlafaxine, an antidepressant with a different mechanism of action, may be modestly more effective than SSRIs. However, venlafaxine is not recommended in the UK as a first-line treatment because of evidence suggesting its risks may outweigh benefits, and it is specifically discouraged in children and adolescents as it increases the risk of suicidal thoughts or attempts.For children and adolescents with moderate-to-severe depressive disorder, fluoxetine seems to be the best treatment (either with or without cognitive behavioural therapy) but more research is needed to be certain. Sertraline, escitalopram, duloxetine might also help in reducing symptoms. Some antidepressants have not been shown to be effective. Medications are not recommended in children with mild disease.There is also insufficient evidence to determine effectiveness in those with depression complicated by dementia. Any antidepressant can cause low blood sodium levels; nevertheless, it has been reported more often with SSRIs. It is not uncommon for SSRIs to cause or worsen insomnia; the sedating atypical antidepressant mirtazapine can be used in such cases.Irreversible monoamine oxidase inhibitors, an older class of antidepressants, have been plagued by potentially life-threatening dietary and drug interactions.
Ella may refer to:

Ella (name), most often a feminine given name, but also used as a surname

Places
United States
Ella, Kentucky, an unincorporated community
Ella, Oregon, an unincorporated community
Ella, Pennsylvania, an unincorporated community
Ella, Wisconsin, an unincorporated community
Lake Ella, Tallahassee, Florida

Greenland
Ella Island, an uninhabited island of the Greenland Sea, Greenland

Sri Lanka
Ella, Sri Lanka, a town in Uva, Sri Lanka

Arts and entertainment
Music
Ella (Ella Fitzgerald album), 1969
Ella (Juan Gabriel album), 1980
Ella (Malaysian singer) (born 1966)
"Ella" (Jack de Nijs song), by André Moss, Jack De Nijs, 1973
"Ella", song by Raphael (singer) L. Favio, 1969
"Ella" (José Alfredo Jiménez song)
"Ella", song by The Way (band) J. Hill, R. Hill, 1972
"Ella", song by Bebe from Pafuera Telarañas, 2004
"Ella" (Tan Biónica song), by Argentine group Tan Biónica, 2010

Other
Ella (2016), documentary film about Australian dancer Ella Havelka
Ella Martinez, a protagonist in the Maximum Ride fantasy novel series
Ella (novel), by Uri Geller
the title character of Ella the Elephant, a Canadian animated preschool series

Other uses
ELLA (programming language), hardware design language
435 Ella, a Main belt asteroid
Tropical Storm Ella (disambiguation), several tropical storms
USS Ella, various United States Navy ships
Ella, trade name in the US of ulipristal acetate, an emergency contraceptive

See also
All pages with titles beginning with Ella
"Ella, elle la", a 1987 song by France Gall
Several settlements near Kingston upon Hull, Yorkshire, England, United Kingdom:
East Ella
Kirk Ella
West Ella
Elah (disambiguation)
Aelle (disambiguation)