332
P A R T 4
Drugs acting on the central and peripheral nervous systems
CHAPTER SUMMARY
■■
Depression is a very common affective disorder; it is
associated with many physical manifestations and
is often misdiagnosed. It could be that depression
is caused by a series of events that are not yet
understood.
■■
Antidepressant drugs—TCAs, MAO inhibitors and
SSRIs—increase the concentrations of the biogenic
amines in the brain.
■■
Selection of an antidepressant depends on individual
drug response and tolerance of associated adverse
effects. The adverse effects of TCAs are sedating and
anticholinergic; those of MAO inhibitors are CNS
related and sympathomimetic. The adverse effects of
SSRIs are fewer, but they do cause CNS changes.
■■
Other antidepressants with unknown mechanisms of
action are also effective in treating depression.
Knowing your strengths and weaknesses helps you to
study more effectively. Take a PrepU Practice Quiz
to find out how you measure up!
ONLINE RESOURCES
An extensive range of additional resources to enhance teaching
and learning and to facilitate understanding of this chapter may
be found online at the text’s accompanying website, located on
thePoint at
These include Watch and
Learn videos, Concepts in Action animations, journal articles,
review questions, case studies, discussion topics and quizzes.
WEB LINKS
Healthcare providers and students may want to consult
the following Internet sources:
Australian Institute of Health and Welfare, National
Priority Area—Mental Health.
Home page of Beyond Blue—The National Depression
Initiative.
Australian Government National Drug Strategy.
BIBLIOGRAPHY
Anderson C. & Roy, T. (2013). Patient experiences of taking
antidepressants for depression: A secondary qualitative analysis.
Research in Social & Administrative Pharmacy, 9,
884–902.
Australian Institute of Health and Welfare (AIHW). (2013). Mental
health,
Buist, A. (2008). Treatment of perinatal depression.
Australian
Prescriber, 31,
36–39.
Casey, G. (2013). Antidepressants: Their role in treating depression.
Kai Tiaki Nursing New Zealand, 19(8)
, 20–24.
Goodman, L. S., Brunton, L. L., Chabner, B. & Knollmann, B. C.
(2011).
Goodman and Gilman’s Pharmacological Basis of
Therapeutics
(12th edn). New York: McGraw-Hill.
Lampe, L. (2005). Antidepressants: Not just for depression
.
Australian Prescriber, 28
, 91–93.
McKenna, L. (2012).
Pharmacology Made Incredibly Easy
(1st Australian and New Zealand edn). Sydney: Lippincott
Williams & Wilkins.
McKenna, L. & Mirkov, S. (2014).
McKenna’s Drug Handbook for
Nursing & Midwifery
(7th edn). Sydney: Lippincott Williams &
Wilkins.
Porth, C. M. (2011).
Essentials of Pathophysiology: Concepts
of Altered Health States
(3rd edn). Philadelphia: Lippincott
Williams & Wilkins.
Porth, C. M. (2009).
Pathophysiology: Concepts of Altered Health
States
(8th edn). Philadelphia: Lippincott Williams & Wilkins.
Rahman, S. Z., Basilakis, J., Rahmadi, A., Lujic, S., Musgrave, I.,
Jorm, L., Hau, P. & Munch, G. (2013). Use of serotonergic
antidepressants and St John’s wort in older Australians:
A population-based cohort study.
Australasian Psychiatry, 21(3)
,
262–266.
Williams, A. V. (2007). Antidepressants in pregnancy and
breastfeeding.
Australian Prescriber, 30,
125–127.
C H E C K Y O U R U N D E R S T A N D I N G
Answers to the questions in this chapter can be found in
Appendix A at the back of this book.
MULTIPLE CHOICE
Select the best answer to the following.
1.
The biogenic amine theory of depression states that
depression is a result of:
a.
an unpleasant childhood.
b.
GABA inhibition.
c.
deficiency of noradrenaline, dopamine or 5HT in
key areas of the brain.
d.
blockages within the limbic system, which
controls emotions and affect.
2.
When teaching a person receiving tricyclic
antidepressants (TCAs), it is important to remember
that TCAs are associated with many anticholinergic
adverse effects. Teaching about these drugs should
include anticipation of:
a.
increased libido and increased appetite.
b.
polyuria and polydipsia.
c.
urinary retention, arrhythmias and constipation.
d.
hearing changes, cataracts and nightmares.
