Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Chapter 21: Antidepressant Agents
Copyright © 2017 Wolters Kluwer • All Rights ReservedAffective Disorder vs. DepressionAffective Disorder vs. Depression•Affective Disorder–A person’s mood goes far beyond the usual, normal “ups and downs”•Depression–Severe and long-lasting feelings of sadness lasting beyond period identified with precipitating event
Copyright © 2017 Wolters Kluwer • All Rights ReservedSigns and Symptoms of DepressionSigns and Symptoms of Depression•Low energy level•Sleep disturbances•Lack of appetite•Limited libido•Inability to perform activities of daily living•Overwhelming feelings of sadness, despair, hopelessness, and disorganization
Copyright © 2017 Wolters Kluwer • All Rights ReservedBiogenic Amine Theory of DepressionBiogenic Amine Theory of Depression•Depression results from a deficiency of norepinephrine (NE), dopamine, or serotonin (5HT)–Monoamine oxidase (MAO) may break them down to be recycled or restored in the neuron–Rapid fire of the neurons may lead to their depletion–The number or sensitivity of postsynaptic receptors may increase, depleting neurotransmitter levels
Copyright © 2017 Wolters Kluwer • All Rights ReservedActions of Antidepressant TherapyActions of Antidepressant Therapy•Inhibit the effects of MAO, leading to increased NE or 5HT in the synaptic cleft•Block reuptake by the releasing nerve, leading to increased neurotransmitter levels in the synaptic cleft•Regulate receptor sites and breakdown of neurotransmitters, leading to an accumulation of neurotransmitters in the synaptic cleft
Copyright © 2017 Wolters Kluwer • All Rights ReservedClassifications of AntidepressantsClassifications of Antidepressants•Tricyclic Antidepressants (TCAs)•MAO Inhibitors (MAOIs)•Selective Serotonin Reuptake Inhibitors (SSRIs)
Copyright © 2017 Wolters Kluwer • All Rights ReservedSites of Action for the AntidepressantsSites of Action for the Antidepressants
Copyright © 2017 Wolters Kluwer • All Rights ReservedTricyclic Antidepressants Tricyclic Antidepressants •Actions–Reduce the reuptake of 5HT and NE into nerves•Use–All TCAs are similar–
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