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a more serious depression that usually requires psychotherapy and drug treatment
Exogenous, or reactive, depression
depression caused by external factors; not as serious as endogenous depression
Drugs that can increase
the level of nor epinephrine or serotonin in the brain are useful in the treatment of mental depression, while high levels of nor epinephrine and/or serotonin may be involved in mania. This concept involving nor epinephrine and serotonin (referred to chemically as monoamines) is known as MONOAMINE THEORY OF MENTAL DEPRESSION.
They are referred to as
antidepressant, or mood elevator. Major antidepressant drug classes include the MAOIs, TCAs, and SSRIs. These drugs take about 2 or 4 weeks to work fully in the body.
1.How do MAOIs work?
Is an enzyme found in most body cell but particularly in the adrenergic nerve endings. The normal functions of MAO is to break down nor epinephrine and serotonin into metabolites that are then excreted by the kidneys.
2.One of the disadvantages of MAO inhibitor therapy is the dietary restrictions.
A pt on monoamine oxidase inhibitor (MAOI) must include avoid foods that contain tyramine. Why? Tyramine may produce a massive release of nor epinephrine , which can result in serious consequences, such as hypertensive crisis or cerebral stroke. Which foods must one avoid? Wine, beer, herring, certain cheese, and chocolate.
3.The Mao inhibitors may produce central nervous system (CNS) stimulation resulting in
Insomnia, tremors, or convulsions.
phenylzine (Nardil)In addition MAOIs, they can produce a type of liver damage that may be fatal
Tricyclic Antidepressants of (TCAs)-
no food restriction
1.How do Tricyclic work?
Is to block the reuptake of nor epinephrine and serotonin back into the neuronal nerve ending.
2. Some of the side effects are?
Sedation and anticholinergic effects.
List anticholinergic sx:
Dry mouth, constipation, urinary retention, rapid heart beat, postural hypotension, blurred vision, wt gain and drowsiness.
Tricyclics may produce toxic in
effects in the heart and liver.
4. Compare to MAOIs, the Tyricyclic
- nortriptyline (Aventyl)
- amitriptyline (Elvail)
- doxepin (Sinequan)
1.How do selective Serotonin Reuptake Inhibitors (SSRIs) work
The SSRIs are a group of drugs that have a very selective action to block the reuptake and inactivation of serotonin in the brain.
2. Consequently, SSRIs produce fewer side and adverse effects, and currently have become the most widely
used antidepressant drug.
SSRIs adverse effects
- 1.Wt loss
- sertrline (Zoloft)
- fluoxetine (Prozac) 20 to 40mg a day
Atypical Antidepressants Medication
- bupropion (Wellbutrin)- high incidence of seizure
- venlafaxin (Effexor)- pharmacological effects are most similar to those of SSRIs