Antidepressants

Antidepressants

• 1.
  AFFECTIVE DISORDERS Anxiety----uneasiness fromapprehension and worry about possible events. Try psychotherpay first. Anti-anxiety agents: xanax/aplrazolam valium/diazepam avitan/lorazepam equanil/meprobamate Adverse reactions: drug dependance, sedation, depression, possible birth defect, muscle relaxation
• 2.
  Anti-anxiety agents:  Benzodiazepines  Mechanism ofAction • Benzodiazepines bind to benzodiazepine receptors in the CNS and act as agonists. • They enhance the action of the inhibitory neurotransmitter gamma-aminobutyric acid (GABA). • Reduce anxiety and panic. • Cause sedation. • Skeletal muscle relaxation Uses •The short-term treatment of anxiety, panic attacks, insomnia, and •alcohol withdrawal. •Some benzodiazepines are used to treat seizure disorders.
• 3.
  Anti-anxiety agents:  Barbiturates       These drugsare the original sedative-hypnotics. They have been associated with a high rate of abuse and complete respiratory and cardiovascular depression. They are lethal in an overdose. Benzodiazepines have pretty much replaced barbiturates in treating anxiety, insomnia and panic because of their more acceptable safety profile. Barbiturates are used to treat seizure disorders and to induce general anesthesia. like benzodiazepine but also help block glutamate, the principal excitatory CNS neurotransmitter.
• 4.
  Depression  feelings of pessimism,worry, sadness, reduced eating and sleeping, concentration.  Types of antidepressants---- SSRI  Tricyclic  MAOI
• 5.
  Anti-depressant---SSRI     SSRI--selective seratonin reuptakeinhibitor moa---blocks reuptake of seratonin(brain neurotransmitter. reduced seratonin may affect mood. indications---major depression,obsessivecompulsion adverse effect---takes 2-3weeks to work, insomia, nervousness, diarrhea, weight loss, reduced libido
• 6.
  SSRI antidepressants  celexa  cymbalta prozac  paxil  zoloft  effexor
• 7.
  Tricyclic antidepressant (TCA) 10 11 9 8 1 B C 5 N moa--block reuptakeof seratonin or norepinephrine(hormone and neurotransmitter most responsible for alertness ) indications--depression, bedwetting children adverse reactions---cardiotoxic in high dose, drowsiness, several weeks to work 7 2 A 3 6 N R2 R1
• 8.
  Tricyclic antidepressant (TCA)  Examples amytriptyline  doxepin  imipramine  desipramine
• 9.
  MAOI antidepressant      monoamine oxidaseinhibitor catecholamines are monoamine---mostly epinephrine (adrenaline), norepinephrine (noradrenaline) and dopamine MAOIs act by inhibiting the activity of monoamine oxidase, thus preventing the breakdown of monoamine neurotransmitters and thereby increasing their availability. indications--atypical depression adverse effect---hypertension, avoid certain wines,yeast,cheese. avoid ephedrine,levopoda
• 10.
  MAOI examples  phenelzine---Nardil  tranylcypromine---Parnate selegiline-----Eldepryl
• 11.
  Bipolar disorder  swings betweenmania and depression  lithium moa unknown….has sodium properties to generate action potentials, also enhance seratonin.watch salt diet.  use carbamezepine more severe cases but interferes with many many drugs  adverse reactions--bloating, abnomral fetus, increased weight, acne
• 12.
  Psychosis  not living inreality,hallucinations, bizarre behavior  dose varies drug to drug  moa--affects neurotransmitters  adverse reactions---sedation, bone marrow suppression, pseudoparkinson’s  allow 6-12 weeks for improvement
• 13.
  Anti-psychotics  haldol  abilify  compazine risperdal  geodon  prolixin