svrnareens earner segs eeranen' tI HOTT enegengryseszpenyss ree regIn res speaeE ANTIDEPRESSANTS Mildred T, Castitio, RN, RM, RPh, MAN DEPRESSION + mentalstate of law maod = isa mood disorder characterited by persistent symptoms of depressed moad, sadness, and loss of interest in daily activities ta the paint where it alfects their normal functions such as appetite, energy levels, concentration levels & slaw ANTIDEPRESSANTS + ate medications specifically designed to alleviate the symptoms of dapesssion ‘+ low mood (sadness) = anviety = worthiessness + Neurotransmitters taht * Dopamine - regulates mood + Norepinephrine = ~impartant in the regulation of emptions and thought processes Lalactracs ‘goncentration ) =works closely with dopamine and seratonin systems = help mabilize the brain for action, increasing alertness, facus and the retrieval af memory. + Serotonin : ~ ig often referred ta a8 the “leel good hoxneaa” = tt carries messages between brain cells and contributes to well-being. good mood, appetite, social betisvior, helps ta regulate the hady's sleep-wake cyele and internal clack. = When these chemical messengers malfunction, it can contribute to mood disarders such 2s depression and aaaiety = esweally provide some relief within one to two weeks, but i may take six to eight weeks of treatment for full effects to become evident. Uses of, ‘Anjidepressants: + Dépression + mental state of low maad fs amood disorder characterited by persistent symptoms af depressed moad, sadness, and loss of interest in daily activites ta the paint where it alfects their normal functions such as appetite, energy levels, concentration levels & siaup, ae = Anxiety. Fear characterited by behavioral disturbances, ‘+ Primary Nocturnal Enuresis =*Bed-wetting” - isa disorder characterized by the inability ta control frequent urination especially at night. + Bulimia nervosa — { bulimia) Eating disorder characterized by binge eating, followed by methods i to avoid weight gain 1 . Prepared by: Mildred T. Castillo, RN, RM, RPh, MAN a Ni Md i Pmalican liber! uit Hi ce oa 4 i .; Chronic nerverelated pain 4 )e Fibrompaigindikottus that affects muscle and soft tissue characterized by chronic muscle pain, tenderness, fatigue find sleep disturbances, ; «Hot fioshes- A feeling af warmth, sometimes assaciated with flushing tatsptoade over the a houy and sometimes follawed by perspiration. + Migraine prevention - An intense idiapathic, episodic, yqj/bilateral, pulsating {vascular} i headache, often exacerbated by physical activity, linked ta dilation of branches of the caratid : artery. = Panic disorder ‘in an ansiety disorder characterized by regular and sudden panic attacks. It is normal tofeel i ‘anxious and panic in respanse to stressful or dangerous stimuli and situations, but for ' people with panic disorder, the panic attacks occurregularly and at any time, often without : any obvious trigger. ‘© Post-Traumatic Stress Disorder (PTSD) ‘A mentsl health conditian that develops follawing # traumatic event characterized by intrusive et thoughts about the incident, recurrent distress/anxiety, Qashhark and avoidance of similar 2} situations. ae ’ + Premenstrual dysphoric disorder a ©. severe form of premenstrual syndrome {2MS4. This causes depression, mood variations a week - br two before the menses end resales once the period starts. os | + Obsessive compulsive disorder + repetitive behavior a wos : | + A ments| hesith disorder characterized by repetitive actions thet seem impossible to stop. “Pain : 5 fi = Urticaria -A skin rash with red itehy bumps ws asewlt of allergic reactions af the body Types of Antidepressants: + All types of antidepressant drugs may take more than two weeks ta show any benefits, although thei nhatmacolagieal effects are praduced immediately Monoamine oxidase inhibitors [MAOIs] : \ + MOA: tyick the action of manoamine axidase enzymes, leading to increased levels ‘af dopamine, norepinephrine, and serotonin in the brain. 7 — ate typically only used when other antidepressants have proven ineffective, because they have a higher tisk of drug interactions than standard aptidepracsante ean alsa interact with certain types of food such as aged cheeses and cured saute tend to have more side effects than standard antidepeassante may cause a withdrawal syndrame on discontinuation. Medical conditions treated or assaciated w MAGIs ‘= Depression | |g Major depressive disorder ‘= Parkinson's disease Preparedby: Mildred T. Castillo, AN, RM, RPh, MAN ipamine, | i ae Her iris ee } i eal ‘enzymes ~ are responsible for breaking down neurotransmitters such as ihrine, serotonin in the brain ||| ob Isocarboxazid (Marglan) i ! |) sb Phenelzine (Nardil) i > Tranyleypr (Earnate) 4 Selegiline LEmsam/Zelapay/Eldercy)) 2 Not jinephrine and dopamine reuptake inhibitors (NDRIs) MOA: work by inhibiting the reuptake of norepinephrine and dopamine w/c leads to increased neural Concentrations of activating neurotransmitters resulting in increased stimulation of CNS = Commonly utilized to increase cognitive functian dx of ADHD Energy fevels aming individuals ‘with fatigue ‘Toimprove symptoms of depression Some NDRIs have been withdrawn from markets due to abuse potential, many are considered Safe and well-tolerated. i + oe sel (Ritalia/ Concerta, Ui toc rat ‘of ADHD; acts more on dopamine mare an the i ‘ ‘* Bupropion {Welthutria/Zyban) — (also for smaking cessation : best antidepressant for ‘weight loss, but among the worst for anxiety) + DexmethyinhenidatelFocalin)— for ADHD ; “+ Dinkeoyinealing|{02PM) — “designer drug” licits mminar effects as NE-Dopaming_ Seuntake inhibitor; can produce significant euphoria at law doses yhigh doses can still become addictive due to its dopaminergic effects er # + Etubeoisiate LEBH)- psychostimulant similar to Methyiphenidate(Ritalin) + i (MDPV) =*designer drug * that functions as a UEDogsmine reuptake inhibitor; tends to produce auphoria az drug resuttis ‘cocaine & amphetamines “ Methylphenidate [Hala ) for txt of ADHD; acts mor i bcieeaid Concerta, » re on dapamine more + Profintane —" nootropic *- dru 1g OF agent that enha: cognitive function Se ee + Pipradot (Sesgtran) — elicits minor stimulant #ffects ;has potential for abuse ; For ADHD, norcotepsy & inagement of dementio symptoms Dementia ~ A group of symptoms that affects memory, es thinking and j with daily An extreme feeling of pleasure, ‘happiness, and excitement. the "ANIL 8th3. Selective serotonin reuptake inhibitors {SSRIs}: SSRIs + are commonly pesscritied | + MOA+ increase levels of serotonin in the brain by preventing the reuptake of serotonin by nerves I = (Drugs: ‘* Fluoxetine (Prozac) * Paroxetine ( Paxil/Brisdelle) * Sertraline { Zolaft) * Fluvoxamine(Luvox) * Citalopram ( (Celexa} * Escitalopram 4, Serotonin and norepinephrine reuptake inhibitors (SNRIs) = MOA: blocks or delays the reuptake of both serotonin and norepinephrine levels Duloxetine (Cymbalta/irenka) Venlafaxine (Effexor) Desvenlafaxine ( Pristia/ Khedezla) Duloxetine ( Irenka} Milnacipran { Savella) eeeee 5, Serotonin antagonist and reuptake inhibitors (SARIS): = isa class of medication primarily used as an antidepressant, but it also has applications as an arudolytic (anxiety-reducing) and hypnotic (sleep-inducing) agent - These have a dual mechanism of action. = MOA: © blocks the reuptake of neurotransmitters in the brain, | Specifically serotonin, norepinephrine, and/or dopamine. * antagonize certain serotonin receptors, particularly the 5-HT2A receptor. © Inhibits reuptake and enhancing serotonin activity, SARIs help maintain higher levels of active serotonin in the eaaeaT nervous sytem (CNS). = — particularly effective for individuals with depressian accompanied by symptoms of insomnia or psychomotor agitation. - Common side effects include drowsiness, headache, dry mouth, dizziness, and blurred vision. + There is a risk of antidepressant discontinuation syndrome if the medication is stopped suddenly. Ht - SARIs have low potential for abuse, there have been cases af misuse in connection with polysubstance abuse. may have an immediate effect on insomnia and anxiety. impact on depression may take 2-4 weeks to become noticeable. are a specialized class of antidepressants, and their use should always be guided by a healthcare professional. Sk i Prepared by: Mildred T. Castillo, RN. RM. RPh. MAN.7 “Trazodone: Often prescribed for insomnia and anxiety, rathir than as a primary treatment i for deptession, It has a short half-life and can induce sleep without causing daytime drowsiness. : | ae Notasodanol Sereppel \ i i & Tricyatle antidepressants (TCAs) and tetracycli¢ antidepressants (TaCAs): Older antidepressants that oy till be effective far certain individuals. MOA: binek the aetions of ather neurotransmitters, such as acetylcholine and histamine. | Medical conditions treated ar associated with EoAe_ v= Anxiety . - = Chronic Pain : ' ; = Depressian : is ‘trouble Falling or staying asleep an a regulsr Basie a Interstitial Cystitis Bladder See afore (BPS paint SEIS yiedrome (PBS)* == ©) Major Depressive Disorder ss ©. Migraine- epivades of maderste-ta-severe headache, most often unilateral and generally a aisociated with nausea and light and sound sunsitivity = S/f:epnstipation, dry mouth, and sedation. er Dupe: | i —. ‘ & Doxepin ESAnpos/ Sioeavan) , = & Desipramine Ltexprarig) 4 Imipramine {Tefsanil ) = +4 Clamipramine LAnafranil} es ob Trimipramine LSuppeoti) © f + spiniarelian CO Yanotrin) + Nortriptyline {Barnulor/ dept tsb)” & Protrintyline CYivastil 7. Miscellaneous antidepressants if if + includes all antidepressants not classified elsewhere, = Drugs: + Buprepion-t Cartiun(onkarn Budeption / eee + Beearolane Ltakowel ee ‘Miadred T. Castillc, RN, RM, RPh, MAI