-An antidepressant is a psychiatric medication used to alleviate mood disorders, such as major depression and dysthymia and anxiety disorders such as social anxiety disorder. - They can improve your mood, sleep, appetite and concentration. It may take several weeks for them to help. - Antidepressant agents act by increasing the levels of excitatory neurostransmitters. Excitatory neurotransmitters are not necessarily exciting – they are what stimulate the brain. Those that calm the brain and help create balance are called inhibitory. Inhibitory neurotransmitters balance mood and are easily depleted when the excitatory neurotransmitters are overactive.
The main types of antidepressant drugs in use today are:
Tricyclic antidepressants (TCAs) - are the oldest class of antidepressant drugs - block the reuptake of certain neurotransmitters such as norepinephrine (noradrenaline) and serotonin -tricyclic antidepressants have been used to treat mental depression. Like other antidepressant drugs, they reduce symptoms such as extreme sadness, hopelessness, and lack of energy. Some tricyclic antidepressants are also used to treat bulimia, cocaine withdrawal, panic disorder, obsessive-compulsive disorders, certain types of chronic pain, and bed-wetting in children. 2.
selective serotonin reuptake inhibitors (SSRIs or serotonin boosters) – are said to work by preventing the reuptake of serotonin -they help reduce the extreme sadness, hopelessness, and lack of interest in life that are typical in people with depression. Selective serotonin reuptake inhibitors also are used to treat panic disorder, obsessive compulsive disorder (OCD), and have shown promise for treating a variety of other conditions, such as premenstrual syndrome, eating disorders, obesity, self-mutilation, and migraine headache. 3.
monoamine oxidase inhibitors (MAO inhibitors) - may be used if other antidepressant medications are ineffective - work by blocking the enzyme monoamine oxidase which breaks down the neurotransmitters dopamine, serotonin, and norepinephrine (noradrenaline). -help reduce the extreme sadness, hopelessness, and lack of interest in life that are typical in people with depression. MAO inhibitors are especially useful in treating people whose depression is combined with other problems such as anxiety, panic attacks, phobias, or the desire to sleep too much. 4.
tetracyclic compounds and atypical antidepressants - ay be prescribed when SSRIs or TCAs have not worked.
MECHANISM OF ACTION
SIDE EFFECTS /ADVERSE EFFECTS
USUAL DOSE TCAs
-For the relief of symptoms of depression.
-temporary adjunctive therapy in reducing enuresis (bedwetting or involuntary urination) in children aged 5 years and older
-Imipramine works by inhibiting the neuronal re-uptake of the neurotransmitters norepinephrine and serotonin
-convulsive disorders or glaucoma -acute recovery phase following a myocardial infarction
-hypersensitivity to the drug
-hepatic or renal damage, and those with a history of blood dyscrasias -should not be given in conjunction with, or within 14 days of treatment with a MAO inhibitor (Combined therapy of this type could lead to the appearance of serious interactions such as hypertensive crises, hyperactivity, hyperpyrexia, spasticity, severe convulsions or coma and death may occur.)
-Dizziness, drowsiness, confusion, seizures, headache, anxiety, tremors, stimulation, weakness, insomnia, nightmares -Orthostatic hypotension, EKG changes, tachycardia, hypertension, palpitations, dysrhythmias -Blurred vision, tinnitus, mydriasis
-Diarrhea, Dry mouth, nausea, vomiting, paralytic ileus, increased appetite, cramps, epigastric distress, jaundice, hepatitis, stomatitis, constipation, taste change -Urinary retention, acute renal failure
Hospitalized patients: starting with 3 times 25 mg, increasing to 125 mg
Ambulatory patients: starting with 25 to...
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