Antidepressant Drugs
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Transcript of Antidepressant Drugs
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ANTIDEPRESSANT DRUGS
TRULY SITORUSDepart.Of Pharmacology & Therapy
Faculty Of Medicine – Padjadjaran University
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ANTIDEPRESSANT DRUGSDEPRESSANTIs due to a deficiency of monoamine such as:
NOR EPINEPHRINESEROTONINEDOPAMINE
THE SYMPTOM OF DEPRESSANT:– Intense feelings of sadness– Hopelessness– Despair– Inability ti experience pleasure in usual activities
MANIACaused by an overproduction of MONOAMINE NEUROTRANSMITTERS
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CLASIFICATIONI. TRICYCLIC/ POLYCYCLIC ANTIDEPRESSANT
1ST generation: AMITRIPTYLINE 2ND generation: AMOXAPINE
II. SELECTIVE SEROTONIN REUPTAKE INHIBITORS (SSRI) Fluoxetine
III. MONOAMINE OXIDASE INHIBITORS (MAO INHIBITORS)
Isocarboxazid
Drugs used to treat mania: LITHIUM SALTS
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TCAIncrease the function of monoamine synapses by inhibiting reuptake of the neurotransmitter substances.
Pharmacokinetics
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Relative receptor specificity of antidepressant drugs
Drug
UPTAKE INHIBITION RECEPTOR AFINITIESNorepinephrine Serotonin Muscarinic Histaminergic Adrenergic
Tricyclic antidepressant imipramide
++ +++ ++ - +
Selective serotonin reuptake inhibitor Fluoxetine
0 ++++ 0 0 0
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INDICATION1. SEVERE MAJOR DEPRESSION2. PANIC DISORDERS3. CONTROL BED-WETTING IN CHILDREN (older
than 6 years)
ADVERSE EFFECTS• Antimuscarinic effects• Cardiovascular effects• Orthostatic hypotension• Sedation
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DRUGS INTERACTIONPotentiate effects of biogenic amines drugs by preventing
Their removal from synaptic cleft
Direct actingAdrenergic
drugs
Tricyclicantidepressants
Indirect-actingAdrenergic
drugs
Block effects of Indirect-acting sympathomimetic drugs byPreventing the drugs from reaching their intraceluller sites of action
EthanolOther CNS depressants
Toxicsedation
MAOInhibitors
Mutual enhancement:Hypertension,hyperpyrexia,
convulsions, and coma
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SSRISelectively inhibit serotonin reuptake by nerveEndings
– Antimuscarinic effects– Cardiotoxicity
DRUGS INTERACTION
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INDICATION1. Depression2. Bulimia nervosa3. Obsessive – compulsive4. Anorexia nervosa5. Panic disorder6. PAIN associated with DIABETIC
NEUROPATHY7. Premenstrual syndrome
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MAO INHIBITOR
Inactive the enzyme monoamine neurotransmitter
ISOCARBOXAZID
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INDICATION1. Depressed patient – Unresponsive to TCA2. Allergic to TCA3. Strong anxiety4. Atypical depression CONTRAINDICATION1. Food: aged cheeses, chicken liver, beer, and
red wines (contain TYRAMINE)2. SRRI