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Created page with "An antidepressant is the name given to a medicine that can help relieve the symptoms of depression, such as low mood, anxiety, and worthlessness. Antidepressants are classifi..."
An antidepressant is the name given to a medicine that can help relieve the symptoms of depression, such as low mood, anxiety, and worthlessness.
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Antidepressants are classified into different types depending on their structure and the way that they work. There are at least seven types of antidepressant:
'''Antidepressants''' are a class of [[psychoactive substances]] that are prescribed to treat psychiatric disorders, most commonly major depressive disorder and some forms of anxiety disorders.
Antidepressants are thought to work by increasing levels of certain [[neurotransmitters]], such as [[dopamine]], [[serotonin]], and/or [[norepinephrine]] in certain regions in the brain.
* [https://en.wikipedia.org/wiki/Norepinephrine Norepinephrine] and dopamine reuptake inhibitors (NDRIs)
* Selective serotonin reuptake inhibitors (SSRIs)
* Serotonin and [https://en.wikipedia.org/wiki/Norepinephrine norepinephrine] reuptake inhibitors (SNRIs)
* Serotonin antagonist and reuptake inhibitors (SARIs)
* Tricyclic antidepressants (TCAs) and tetracyclic antidepressants (TeCAs)
* And the miscellaneous antidepressants.
==History and culture==
{{historyStub}}
[[Monoamine|MAOIs]] and TCAs were among the first antidepressants developed. They have largely been superseded by newer antidepressants (such as the SSRIs) that have fewer side effects, although these older antidepressants may still suit certain people or be effective when other antidepressants have been ineffective.
[[Monoamine|MAOIs]] and TCAs were among the first antidepressants developed. They have largely been superseded by newer antidepressants (such as the SSRIs) that have fewer side effects, although these older antidepressants may still suit certain people or be effective when other antidepressants have been ineffective.
Antidepressants are thought to work by increasing levels of certain neurotransmitters, such as dopamine, serotonin, and/or norepinephrine, in the brain.
==Classes==
== What are antidepressants used for? ==
Antidepressants are classified into different types depending on their structure and mechanism. There are at least seven types of antidepressant:
*[[Monoamine oxidase inhibitors|MAOIs]] (MAOIs)
*[[Norepinephrine]] and [[dopamine]] reuptake inhibitors (NDRIs)
*[[Serotonin]] and [https://en.wikipedia.org/wiki/Norepinephrine norepinephrine] reuptake inhibitors (SNRIs)
*[[Serotonin]] antagonist and reuptake inhibitors (SARIs)
*Tricyclic antidepressants (TCAs) and tetracyclic antidepressants (TeCAs)
*And the miscellaneous antidepressants.
==Uses==
Antidepressants help to relieve the symptoms of depression such as low mood, irritability, feelings of worthlessness, restlessness, anxiety, and difficulty in sleeping.
Antidepressants help to relieve the symptoms of depression such as low mood, irritability, feelings of worthlessness, restlessness, anxiety, and difficulty in sleeping.
In addition to depression, certain antidepressants may also be used to treat a range of other conditions, for example:
In addition to depression, certain antidepressants may also be used to treat a range of other conditions, for example:
* Anxiety
*Anxiety
* Bed-wetting
*Bed-wetting
* Bulimia nervosa
*Bulimia nervosa
* Chronic nerve-related pain
*Chronic nerve-related pain
* Fibromyalgia
*Fibromyalgia
* Hot flashes
*Hot flashes
* Migraine prevention
*Migraine prevention
* Obsessive-compulsive disorder
*Obsessive-compulsive disorder
* Panic disorder
*Panic disorder
* Post-Traumatic Stress Disorder (PTSD)
*Post-Traumatic Stress Disorder (PTSD)
* Premenstrual dysphoric disorder.
*Premenstrual dysphoric disorder
It is important to note that not all antidepressants are used to treat the conditions mentioned above.
It is important to note that not all antidepressants are used to treat the conditions mentioned above.
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Antidepressants generally provide some relief of symptoms within one to two weeks; however, it may take six to eight weeks of treatment before the full effects are seen.
Antidepressants generally provide some relief of symptoms within one to two weeks; however, it may take six to eight weeks of treatment before the full effects are seen.
== What are the differences between antidepressants? ==
==Pharmacology==
There are distinct differences between the different classes of antidepressants available because they all work in a different way. In addition, within each class, there are differences between individual antidepressants with regards to how long they remain in the body, how they are metabolized, and how much they interact with other medications.
There are distinct differences between the different classes of antidepressants available because they all work in a different way. In addition, within each class, there are differences between individual antidepressants with regards to how long they remain in the body, how they are metabolized, and how much they interact with other medications.
=== [[Monoamine]] oxidase inhibitors (MAOIs) ===
===[[Monoamine]] oxidase inhibitors (MAOIs)===
MAOIs block the effects of monoamine oxidase enzymes, thereby increasing the concentration of dopamine, norepinephrine, and serotonin in the brain.
MAOIs block the effects of monoamine oxidase enzymes, thereby increasing the concentration of dopamine, norepinephrine, and serotonin in the brain.
{| class="wikitable"
*[[Isocarboxazid]] (Marplan)
!Generic name
*[[Phenelzine]] (Nardil)
!Brand name examples
*[[Tranylcypromine]] (Parnate)
|-
|isocarboxazid
|Marplan
|-
|phenelzine
|Nardil
|-
|tranylcypromine
|Parnate
|}
=== [https://en.wikipedia.org/wiki/Norepinephrine Norepinephrine] and dopamine reuptake inhibitors (NDRIs) ===
===[https://en.wikipedia.org/wiki/Norepinephrine Norepinephrine] and dopamine reuptake inhibitors (NDRIs)===
NDRIs block the reuptake of norepinephrine and dopamine, increasing the concentration of these two neurotransmitters in the nerve synapse.
NDRIs block the reuptake of norepinephrine and dopamine, increasing the concentration of these two neurotransmitters in the nerve synapse.
SSRIs increase levels of serotonin in the brain by preventing the reuptake of serotonin by nerves.
SSRIs increase levels of serotonin in the brain by preventing the reuptake of serotonin by nerves.
{| class="wikitable"
*[[Citalopram]] (Celexa)
!Generic name
*[[Escitalopram]] (Lexapro)
!Brand name examples
*[[Fluoxetine]] (Prozac)
|-
*[[Fluvoxamine]] (Luvox)
|citalopram
*[[Paroxetine]] (Brisdelle)
|Celexa
*[[Sertraline]] (Zoloft)
|-
*[[Vilazodone]] (Viibrid)
|escitalopram
|Lexapro
|-
|fluoxetine
|Prozac, Sarafem
|-
|fluvoxamine
|Luvox
|-
|paroxetine
|Brisdelle, Paxil
|-
|sertraline
|Zoloft
|-
|vilazodone
|Viibrid
|}
=== Serotonin and norepinephrine reuptake inhibitors (SNRIs) ===
===Serotonin and norepinephrine reuptake inhibitors (SNRIs)===
SNRIs block the reuptake of both serotonin and norepinephrine, increasing the concentration of these two neurotransmitters in the nerve synapse.
SNRIs block the reuptake of both serotonin and norepinephrine, increasing the concentration of these two neurotransmitters in the nerve synapse.
{| class="wikitable"
*[[Duloxetine]] (Cymbalta)
!Generic name
*[[Desvenlafaxine]] (Khedezla)
!Brand name examples
*[[Levomilnacipran]] (Fetzima)
|-
*[[Venlafaxine]] (Effexor)
|duloxetine
|Cymbalta, Irenka
|-
|desvenlafaxine
|Khedezla, Pristiq
|-
|levomilnacipran
|Fetzima
|-
|venlafaxine
|Effexor
|}
=== Serotonin antagonist and reuptake inhibitors (SARIs) ===
===Serotonin antagonist and reuptake inhibitors (SARIs)===
SARIs prevent the reuptake of serotonin and affect the binding of serotonin to certain receptors
SARIs prevent the reuptake of serotonin and affect the binding of serotonin to certain receptors
{| class="wikitable"
*[[Nefazodone]] (Serzone)
!Generic name
*[[Trazodone]] (Desyrel)
!Brand name examples
|-
|nefazodone
|Serzone
|-
|trazodone
|Desyrel, Oleptro
|}
=== Tricyclic antidepressants (TCA) and tetracyclic antidepressants (TeCAs) ===
===Tricyclic antidepressants (TCA) and tetracyclic antidepressants (TeCAs)===
TCAs and TeCAs work by increasing levels of norepinephrine and serotonin. They may also block the actions of other neurotransmitters, such as acetylcholine and histamine.
TCAs and TeCAs work by increasing levels of norepinephrine and serotonin. They may also block the actions of other neurotransmitters, such as acetylcholine and histamine.
Tricyclics
====Tricyclics====
{| class="wikitable"
*[[Amitriptyline]]
!Generic name
*[[Clomipramine]] (Anafranil)
!Brand name examples
*[[Desipramine]] (Norpramin)
|-
*[[Doxepin]] (Sinequan)
|amitriptyline
*[[Imipramine]] (Tofranil)
|Generic only
*[[Nortriptyline]] (Pamelor)
|-
*[[Protriptyline]] (Vivactil)
|clomipramine
*[[Trimipramine]] (Surmontil)
|Anafranil
|-
====Tetracyclics====
|desipramine
*[[Amoxapine]] (Asendin)
|Norpramin
*[[Maprotiline]] (Ludiomil)
|-
*[[Mirtazapine]] (Remeron)
|doxepin
|Sinequan
|-
|imipramine
|Tofranil
|-
|nortriptyline
|Pamelor
|-
|protriptyline
|Vivactil
|-
|trimipramine
|Surmontil
|}
Tetracyclics
{| class="wikitable"
!Generic name
!Brand name examples
|-
|amoxapine
|Asendin
|-
|maprotiline
|Ludiomil
|-
|mirtazapine
|Remeron
|}
=== Miscellaneous antidepressants ===
===Miscellaneous antidepressants===
Increase levels of neurotransmitters by an unknown mechanism of action that is different from other pre-existing classes of antidepressant.
Increase levels of neurotransmitters by an unknown mechanism of action that is different from other pre-existing classes of antidepressant.
{| class="wikitable"
*[[Vortioxetine]] (Trintellix)
!Generic name
!Brand name examples
==Subjective effects==
|-
{{effectStub}}
|vortioxetine
{{Preamble/SubjectiveEffects}}
|Trintellix
|}
*Disorientation or confusion
*Drowsiness, sometimes insomnia
*Excessive sweating
*Gastrointestinal upset (such as constipation, diarrhea, or nausea)
*A headache
*Increased or irregular heartbeat
*Low blood pressure when going from a standing to a sitting position (called [https://en.wikipedia.org/wiki/Orthostatic_hypotension orthostatic hypotension]). In most people, this can be managed by slowly increasing the dosage of the medication, giving split doses, and increasing fluid intake
*Sexual dysfunction (such as reduced desire or erectile dysfunction)
When taken at the recommended dosage, antidepressants are considered safe. However, some have been associated with severe side effects, some potentially fatal, such as:
* An increase in suicidal thoughts and behaviors, particularly in children and young adults under the age of 25 years. This is most likely to occur when starting therapy
<li class="featured list-item">
* An increased risk of seizures in people with a history of seizures
*[[Auditory distortion]]
* Serotonin syndrome – this is caused by excessive levels of serotonin in the body and is more likely to occur with higher dosages of SSRIs or when SSRIs are administered with other medications that also release serotonin. Symptoms include agitation, confusion, sweating, tremors, and a rapid heart rate
*[[Auditory enhancement]]
* The precipitation of a manic episode in people with undiagnosed bipolar disorder
* MAOIs: Very severe drug interactions, very severe food interactions, and rarely, rapid but transient increases in blood pressure within 30 minutes to two hours of MAOI ingestion
* Nefazodone: Life-threatening liver failure, more common two weeks to six months after starting therapy
* SSRIs and vortioxetine: An increase in the risk of bleeding, especially if used with other medications that also increase bleeding risk
* TCAs: An increased risk of arrhythmias, heart attacks, stroke, and other cardiovascular effects, particularly in people with pre-existing heart disease; and the triggering of an angle closure attack in people with angle-closure glaucoma
For a complete list of severe side effects, please refer to the individual drug monographs.
</ul>
</div>
== What are the side effects of antidepressants? ==
</div>
Not everybody experiences significant side effects with antidepressants, and some antidepressants are more likely to cause side effects than others. Some of the more commonly reported side effects include:
</div>
* Blurred vision
==Toxicity and harm potential==
* Disorientation or confusion
When taken at the recommended dosage, antidepressants are considered safe. However, some have been associated with severe side effects, some potentially fatal, such as:
* Dizziness
* Drowsiness, sometimes insomnia
* Dry mouth
* Excessive sweating
* Gastrointestinal upset (such as constipation, diarrhea, or nausea)
* A headache
* Increased or irregular heartbeat
* Low blood pressure when going from a standing to a sitting position (called orthostatic hypotension). In most people, this can be managed by slowly increasing the dosage of the medication, giving split doses, and increasing fluid intake
* Sexual dysfunction (such as reduced desire or erectile dysfunction)
* Tremor
* Urinary retention
* Weight loss or weight gain.
Some antidepressants have been associated with a discontinuation syndrome when they have been stopped suddenly. For this reason, it is best to withdraw all antidepressants slowly.
*An increase in suicidal thoughts and behaviors, particularly in children and young adults under the age of 25 years. This is most likely to occur when starting therapy
*An increased risk of seizures in people with a history of seizures
*Serotonin syndrome – this is caused by excessive levels of serotonin in the body and is more likely to occur with higher dosages of SSRIs or when SSRIs are administered with other medications that also release serotonin. Symptoms include agitation, confusion, sweating, tremors, and a rapid heart rate
*The precipitation of a manic episode in people with undiagnosed bipolar disorder
*Duloxetine: A severe discontinuation syndrome
*MAOIs: Very severe drug interactions, very severe food interactions, and rarely, rapid but transient increases in blood pressure within 30 minutes to two hours of MAOI ingestion
*Nefazodone: Life-threatening liver failure, more common two weeks to six months after starting therapy
*SSRIs and vortioxetine: An increase in the risk of bleeding, especially if used with other medications that also increase bleeding risk
*TCAs: An increased risk of arrhythmias, heart attacks, stroke, and other cardiovascular effects, particularly in people with pre-existing heart disease; and the triggering of an angle closure attack in people with angle-closure glaucoma
For a complete list of side effects, please refer to the individual drug monographs.
For a complete list of severe side effects, please refer to the individual drug monographs.
It may contain incorrect information, particularly with respect to dosage, duration, subjective effects, toxicity and other risks. It may also not meet PW style and grammar standards.
As such, it may contain incomplete or wrong information. You can help by expanding it.
Antidepressants are a class of psychoactive substances that are prescribed to treat psychiatric disorders, most commonly major depressive disorder and some forms of anxiety disorders.
As a result, it may contain incomplete or wrong information. You can help by expanding it.
MAOIs and TCAs were among the first antidepressants developed. They have largely been superseded by newer antidepressants (such as the SSRIs) that have fewer side effects, although these older antidepressants may still suit certain people or be effective when other antidepressants have been ineffective.
Classes
Antidepressants are classified into different types depending on their structure and mechanism. There are at least seven types of antidepressant:
Serotonin antagonist and reuptake inhibitors (SARIs)
Tricyclic antidepressants (TCAs) and tetracyclic antidepressants (TeCAs)
And the miscellaneous antidepressants.
Uses
Antidepressants help to relieve the symptoms of depression such as low mood, irritability, feelings of worthlessness, restlessness, anxiety, and difficulty in sleeping.
In addition to depression, certain antidepressants may also be used to treat a range of other conditions, for example:
Anxiety
Bed-wetting
Bulimia nervosa
Chronic nerve-related pain
Fibromyalgia
Hot flashes
Migraine prevention
Obsessive-compulsive disorder
Panic disorder
Post-Traumatic Stress Disorder (PTSD)
Premenstrual dysphoric disorder
It is important to note that not all antidepressants are used to treat the conditions mentioned above.
Antidepressants generally provide some relief of symptoms within one to two weeks; however, it may take six to eight weeks of treatment before the full effects are seen.
Pharmacology
There are distinct differences between the different classes of antidepressants available because they all work in a different way. In addition, within each class, there are differences between individual antidepressants with regards to how long they remain in the body, how they are metabolized, and how much they interact with other medications.
Tricyclic antidepressants (TCA) and tetracyclic antidepressants (TeCAs)
TCAs and TeCAs work by increasing levels of norepinephrine and serotonin. They may also block the actions of other neurotransmitters, such as acetylcholine and histamine.
Disclaimer: The effects listed below cite the Subjective Effect Index (SEI), an open research literature based on anecdotal user reports and the personal analyses of PsychonautWikicontributors. As a result, they should be viewed with a healthy degree of skepticism.
It is also worth noting that these effects will not necessarily occur in a predictable or reliable manner, although higher doses are more liable to induce the full spectrum of effects. Likewise, adverse effects become increasingly likely with higher doses and may include addiction, severe injury, or death ☠.
Disorientation or confusion
Drowsiness, sometimes insomnia
Excessive sweating
Gastrointestinal upset (such as constipation, diarrhea, or nausea)
A headache
Increased or irregular heartbeat
Low blood pressure when going from a standing to a sitting position (called orthostatic hypotension). In most people, this can be managed by slowly increasing the dosage of the medication, giving split doses, and increasing fluid intake
Sexual dysfunction (such as reduced desire or erectile dysfunction)
Tremor
Urinary retention
Weight loss or weight gain
Disclaimer: The effects listed below cite the Subjective Effect Index (SEI), an open research literature based on anecdotal user reports and the personal analyses of PsychonautWikicontributors. As a result, they should be viewed with a healthy degree of skepticism.
It is also worth noting that these effects will not necessarily occur in a predictable or reliable manner, although higher doses are more liable to induce the full spectrum of effects. Likewise, adverse effects become increasingly likely with higher doses and may include addiction, severe injury, or death ☠.
When taken at the recommended dosage, antidepressants are considered safe. However, some have been associated with severe side effects, some potentially fatal, such as:
An increase in suicidal thoughts and behaviors, particularly in children and young adults under the age of 25 years. This is most likely to occur when starting therapy
An increased risk of seizures in people with a history of seizures
Serotonin syndrome – this is caused by excessive levels of serotonin in the body and is more likely to occur with higher dosages of SSRIs or when SSRIs are administered with other medications that also release serotonin. Symptoms include agitation, confusion, sweating, tremors, and a rapid heart rate
The precipitation of a manic episode in people with undiagnosed bipolar disorder
Duloxetine: A severe discontinuation syndrome
MAOIs: Very severe drug interactions, very severe food interactions, and rarely, rapid but transient increases in blood pressure within 30 minutes to two hours of MAOI ingestion
Nefazodone: Life-threatening liver failure, more common two weeks to six months after starting therapy
SSRIs and vortioxetine: An increase in the risk of bleeding, especially if used with other medications that also increase bleeding risk
TCAs: An increased risk of arrhythmias, heart attacks, stroke, and other cardiovascular effects, particularly in people with pre-existing heart disease; and the triggering of an angle closure attack in people with angle-closure glaucoma
For a complete list of severe side effects, please refer to the individual drug monographs.
