Antidepressant Medicines and Their Uses

1. Phenelzine (Nardil) - antidepressant, monoamine oxidase inhibitor.
-Indicated for use: depression in patients who have failed other modes of therapy (tricyclic antidepressants, SSRIs, SSNRIs, or EC therapy).
-also used in: panic disorder, social anxiety disorder
-Action: inhibits the enzyme monoamine oxidase, resulting in accumulation of various neurotransmitters (dopamine, epinephrine, norepinephrine, and serotonin) in the body.
-Therapeutic effects: improvement in mood for depressed patients
-Contraindicated in: hypersensitivity, liver disease, severe renal disease, cardiovascular disease, uncontrolled hypertension, cerebrovascular disease, CHF, history of severe and frequent headaches, anesthesia, ANY other antidepressant use, narcotics, alcohol, anesthetics, diuretics, tryptophan, antihistamines, excessive caffeine consumption, ingestion of foods high in tyramine, St. John’s Wort.
-Use cautiously in: suicidal patients, history of drug dependency, schizophrenia, bipolar disorder, diabetes mellitus, hyperthyroidism, seizure disorders.
-Side effects: seizures, *dizziness, *headache, anxiety, ataxia, confusion, drowsiness, euphoria, insomnia, restlessness, tremor, weakness, blurred vision, glaucoma, nystagmus, hypertensive crisis, *arrhythmias, edema, orthostatic hypotension, *diarrhea, *weight gain, abdominal pain, anorexia, *constipation, *dry mouth, liver enzyme elevation, nausea, vomiting, dysuria, *sexual dysfunction, urinary incontinence, urinary retention, rashes, pruritis, hypoglycemia
-Nursing implications: assess mental status (orientation, mood, behavior) and anxiety level frequently. Assess for suicidal ideations frequently, especially during early treatment. Monitor blood pressure and pulse before and during therapy. Report significant changes promptly due to disturbances in blood pressure and possible hypertensive crisis. Monitor I&Os and daily weights. Assess for urinary retention. Monitor blood glucose levels in overweight