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15 Cards in this Set
- Front
- Back
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Action of Antidepressants
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Target Serotonin and NE levels
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Amine Hypothesis
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Decreased levels of important monoamines in brain is responsible for depression (ie. Serotonin & NE)
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Problems with Amine Hypothesis
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5-HT or NE depletion in healthy people doesn't result in depression
-efficacy in tx takes weeks |
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Effects of prolonged tx wth antidepressants
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-Repeated exposure to ADs may lead to a decrease in the number of autoreceptors for 5-HT & Serotonin
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Classes of Antidepressants
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+Tricyclics
+MAO Inhibators +SSRIs (most commonly used) +Atypical |
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Mechanism for Tricyclics
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-All block reuptake of NE
-Some block reuptake of 5-HT |
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Mechanism for SSRIs
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-Selectively block serotonin uptake
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Mechanism for MAO Inhibitors
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-Prevents metabolism of monoamines
-MAO A metabolizes 5-HT & NE |
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Mechanism for Atypical
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Blocks uptake of NE, 5-HT, and dopamine
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Tx of Major Depression
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All antidepressants are equally effective
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Tx of Bipolar
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Most ADs result in induction of manic phase
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Adverse Effects
Tricyclics, MAO Inhibitors, SSRIs, Atypical |
Tricyclics have varied sites of action -->more likely to produce side effects
(sedation, weight gain, hypotension, constipation) MAO Inhibitors = sleep disturbances, weight gain, postural hypotension SSRIs-nausea, vomitting, headache, sexual dysfunction, and insomnia (BEST TOLERATED) |
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Overdose Tricyclic/MAO Inhibitors
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Coma, Respiratory Depression, agitation or delirium, seizures, cardiac manifestations
Can be FATAL! |
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Treatment Duration
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-If pt. responds to treatment, medication should be continuted for 6-12 months.
-Up to 50% of pts. do not experience full therapeutic effects though... -If resistant, try increasing dose, increasing duration or switch compounds |
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Tx of Bipolar
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-Lithium--evens out mood swings
-Antipsychotic/benzos -Antidepressants -Anticonvulsants (Valproic Acid) ++Must closely monitor liver function when taking lithium or valproic acid++ |
