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11081506(Ridhi)
11081524(Khushboo)
11081560(shiny)
11081542(Sakshi)


ANTIDEPRESSANTS
Antidepressant is psychiatric medication used to alleviate
mood disorders such as major depression,dysthemia &
anxiety disorders.
Drugs including monoamine oxidase inhibitors,tricyclic
antidepressants, selective serotonin reuptake
inhibitors(SNRIs) are most common drugs used for the
treatment of depression these days & they are commonly
prescribed by the psychiatrists.











































Most antidepressants have a delayed onset of action (2-6 weeks)
& are usually administered for months to years.


Opioids were used until late 1950s & Amphetamines were used
untill mid 1960s.

Despite the name antidepressants have been used controversially
for the treatment of anxiety disorder, obsessive compulsive
disorder, chronic pain & some hormone mediated disorders.

SSRIs have become novel antidepressants along with other
new drugs such as SNRIs.



















Types of Antidepressants
Antidepressants can mainly be classified into 6 main
types:

1)Selective serotonin reuptake inhibitors(SSRIs)
2)Serotonin norepinephrine reuptake
inhibitors(SNRIs)
3)Noradrenergic & specific serotonergic
antidepressants(NaSSAs)
4)Norepinephrine reuptake inhibitors(NRIs)
5)Tricyclic antidepressants(TCAs)
6)Monoamine oxidase inhibitors(MAOIs)
Selective serotonin reuptake inhibitors(SSRIs)
These are the class of antidepressants considered as the current
standard of drug treatment.

SSRIs work by preventing the reuptake of serotonin(also called
5-hydroxytryptamine or 5-HT ) by the presynaptic neuron thus
maintaining higher levels of 5-HT in the synapse.

A possible cause of depression is an inadequate amount of
serotonin, a chemical used in the brain to transmit signals
between the neurons.

These type of antidepressants have fewer adverse effects such as
dry mouth,anxiety,decrease in appetite, long term weight gain.

This type of antidepressants include mainly:
Citalopram(cipramil,celexa)
Escitalopram(lexapro, lexamil)
Setraline(zoloft)
paroxetine

Serotonin Norepinephrine Reuptake
Inhibitors(SNRIs)
These are a newer form of antidepressants that work
on both norepinephrine & 5-HT.
These have typically similar side effects just as SSRIs
though there may be a withdrawal syndrome on
discontinuation of medicine.
This class of antidepressants include:
Desvenlafaxine
Duloxetine
Milnacipram
Venlafaxime
Noradrenergic & Specific Serotonergic
Antidepressants(NaSSAs)
NaSSAs form a newer class of antidepressants which
work to increase norepinephrine (noradrenaline) &
serotonin neurotransmission by blocking presynaptic
alpha-2 adrenergic receptors while at the same time
blocking certain serotonin receptors.
Side effects include drowsiness, increased appetite &
weight gain.
The examples of these type of antidepressants include:
Mianserin
Mirtazapine(Remeron,Zispin, Avanza)

Norepinephrine Reuptake
inhibitors(NRIs)
These type of antidepressants act via norepinephrine
& have a positive effect on concentration & motivation
in a particular person.
These mainly include:
Atomoxetin(strattera)
Mazindol(sanorex)
Reboxitine(edronax)
Tricyclic Antidepressants(TCAs)
Oldest class of antidepressant drugs.
Tricyclics block the reuptake of certain neurotransmitter such as
norepinephrine & serotonin.
Used less commonly now due to development of safer drugs.
Side effects include: increased heart rate,drowsiness,dry mouth
,constipation etc.
Tricyclic antidepressants have been used because of there
effectiveness but they may be often lethal in overdoses.
These include:
Tertiary amine tricyclic antidepressants
Doxepin
Imipramine
Trimipramine


Secondary amine tricyclic antidepressants
Desipramine(Norpramin)
Nortiptyline((Pamelor)
Monoamine oxidase inhibitors(MAOIs)
Work by blocking enzyme monoamine oxidase which
breaks down the neurotransmitter dopamine,
serotonin & norepinephrine.
MAOIs can be as effective as TCAs but now these are
used to a lesser extent because they have a higher
incidence of dangerous side effects.
The MAOI group of medicines include
Phenelzine(Nardil)
Selegiline(Eldepryl)
Isocarboxazid(marplan)

Treatment for Antidepressants
Effective treatment for depression include
Exercise, meditation
Relaxation therapy
Stress management

Side Effects of antidepressants
medication
There are different types of drugs used in the treatment of
depression but they also have a side effect.
Side effects of SSRIs
o Nausea
o Insomnia
o Anxiety
o Restlessness
o Dizziness
o Constipation
o Weight gain or loss
o headache
Side effects of TCAs & MAOIs
TCAs & MAOIs are older classes of antidepressant drugs.
Their side effects are more severe than those of newer antidepressants.
Once started taking up these antidepressants stopping can be tough.
Many people have withdrawal symptoms that makes difficult to get off
the medication.
These withdrawal symptoms include:
1)Anxiety
2)Nausea & vomiting
3)Stomach cramping & pain
4)Dizziness
5)Insomnia , nightmares
Depression & anxiety are also common symptoms when withdrawing
from antidepressants.
Some of the herbal antidepressants include:-
saffron,lavender,tulsi.

Some of the nutritional supplements that can be used
as antidepressants are:-omega 3 fatty acids, folic acid &
vitamin B12.



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