21
Antidepressant agents
Learning objectives
Upon completion of this chapter, you should be able to:
1.
Describe the biogenic theory of depression.
2.
Describe the therapeutic actions, indications, pharmacokinetics, contraindications, most common adverse
reactions and important drug–drug interactions associated with each class of antidepressant.
3.
Discuss the use of antidepressants across the lifespan.
4.
Compare and contrast the prototype drugs for each class of antidepressant with the other drugs in that class
and with drugs in the other classes of antidepressants.
5.
Outline the care considerations and teaching needs for people receiving each class of antidepressant.
Glossary of keys terms
affect:
feeling that a person experiences when they respond emotionally to the environment
biogenic amine:
one of the neurotransmitters noradrenaline, serotonin or dopamine; it is thought that a deficiency of these
substances in key areas of the brain results in depression
depression:
affective disorder in which a person experiences sadness that is much more severe and longer lasting than is warranted by
the event that seems to have precipitated it, with a more intense mood; the condition may not even be traceable to a specific event
or stressor
monoamine oxidase (MAO) inhibitor:
drug that prevents the enzyme monoamine oxidase from breaking down noradrenaline,
leading to increased noradrenaline levels in the synaptic cleft; relieves depression and also causes sympathomimetic effects
selective serotonin reuptake inhibitor (SSRI):
drug that specifically blocks the reuptake of serotonin and increases its concentration
in the synaptic cleft; relieves depression and is not associated with anticholinergic or sympathomimetic adverse effects
tricyclic antidepressant (TCA):
drug that blocks the reuptake of noradrenaline and serotonin; relieves depression and has
anticholinergic and sedative effects
tyramine:
an amine found in food that causes vasoconstriction and raises blood pressure; ingesting foods high in tyramine while
taking an MAO inhibitor poses the risk of a severe hypertensive crisis
Test your current knowledge of antidepressant agents with a PrepU Practice Quiz!
TRICYCLIC ANTIDEPRESSANTS
amitriptyline
clomipramine
dosulepin hydrochloride
dothiepin
doxepin
imipramine
nortriptyline
trimipramine
MONOAMINE OXIDASE
INHIBITORS
phenelzine
tranylcypromine
SELECTIVE SEROTONIN
REUPTAKE INHIBITORS
citalopram
duloxetine
escitalopram
fluoxetine
fluvoxamine
paroxetine
sertraline
OTHER ANTIDEPRESSANTS
agomelatine
bupropion
desvenlafaxine
mianserin
mirtazapine
moclobemide
reboxetine
selegiline
venlafaxine
