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Encyclopedia > Antidepressant
Prozac, a selective serotonin reuptake inhibitor (SSRI)
Prozac, a selective serotonin reuptake inhibitor (SSRI)
Serotonin-norepinephrine reuptake inhibitor, Venlafaxine
Serotonin-norepinephrine reuptake inhibitor, Venlafaxine

An antidepressant is a psychiatric medication or other substance (nutrient or herb) used for alleviating depression or dysthymia ('milder' depression). Drug groups known as MAOIs, tricyclics and SSRIs are particularly associated with the term. These medications are now amongst the drugs most commonly prescribed by medical psychologists, psychiatrists and general practitioners, and their effectiveness and adverse effects are the subject of many studies and competing claims. Nutrients for which there are claims of antidepressant activity include phenylalanine, tyrosine, tryptophan, 5-Hydroxytryptophan, and choline[citation needed]. Image File history File linksMetadata Download high-resolution version (1165x909, 696 KB) La bildo estas kopiita de wikipedia:nl. ... Image File history File linksMetadata Download high-resolution version (1165x909, 696 KB) La bildo estas kopiita de wikipedia:nl. ... SSRI is an acronym that stands for several things: It is a class of antidepressants called selective serotonin reuptake inhibitor SSRI also is used as the stock symbol for Silver Standard Resources Inc. ... Image File history File links Download high-resolution version (1083x1190, 176 KB) File links The following pages on the English Wikipedia link to this file (pages on other projects are not listed): Venlafaxine ... Image File history File links Download high-resolution version (1083x1190, 176 KB) File links The following pages on the English Wikipedia link to this file (pages on other projects are not listed): Venlafaxine ... Psychopharmacology is the study of the effects of any psychoactive drug that acts upon the mind by affecting brain chemistry. ... On the Threshold of Eternity. ... Dysthymia is a mood disorder that falls within the depression spectrum. ... Monoamine oxidase inhibitors (MAOIs) are a class of antidepressant drugs prescribed for the treatment of depression. ... Chemical structure of the tricyclic antidepressant amitriptyline Tricyclic antidepressants are a class of antidepressant drugs first used in the 1950s. ... SSRI is an acronym that stands for several things: It is a class of antidepressants called selective serotonin reuptake inhibitor SSRI also is used as the stock symbol for Silver Standard Resources Inc. ... Zoloft, an antidepressant and antianxiety medication A prescription drug is a licensed medicine that is regulated by legislation to require a prescription before it can be obtained. ... For other uses, see Psychiatrist (disambiguation). ... A general practitioner (GP) or family physician (FP) is a physician/medical doctor who provides primary care. ... Effectiveness means the capability of producing an effect. ... ... Phenyl alanine is an α-amino acid with the formula HO2CCH(NH2)CH2C6H5. ... Tyrosine (from the Greek tyros, meaning cheese, as it was first discovered in 1846 by German chemist Justus von Liebig in the protein casein from cheese[1][2]), 4-hydroxyphenylalanine, or 2-amino-3(4-hydroxyphenyl)-propanoic acid, is one of the 20 amino acids that are used by cells... Tryptophan (abbreviated as Trp or W)[1] is one of the 20 standard amino acids, which are the building blocks of proteins, and an essential amino acid in the human diet. ... 5-Hydroxytryptophan or 5-HTP is a naturally-occurring amino acid, a precursor to the neurotransmitter serotonin and an intermediate in tryptophan metabolism. ... Choline is an organic compound, classified as an essential nutrient and usually grouped within the Vitamin B complex. ...


Most antidepressants have a delayed onset of action and are usually taken over the course of weeks, months or years. They are generally considered distinct from stimulants, and drugs used for an immediate euphoric effect only are not generally considered antidepressants. Despite the name, antidepressants are often used in the treatment of other conditions, including anxiety disorders, bipolar disorder, obsessive compulsive disorder, eating disorders and chronic pain. Some have also become known as lifestyle drugs or "mood brighteners". Other medications not known as antidepressants, including antipsychotics in low doses[1] and benzodiazepines,[2] are also widely used to manage depression. A stimulant is a drug which increases the activity of the sympathetic nervous system and produces a sense of euphoria or awakeness. ... For other uses, see Happiness (disambiguation). ... Anxiety disorder is a blanket term covering several different forms of fear, phobia and nervous condition, that come on suddenly and prevent pursuing normal daily routines including: general anxiety disorder social anxiety, sometimes known as social phobia or social anxiety disorder (SAD) specific phobias agoraphobia claustrophobia panic disorder separation anxiety... For other uses, see Bipolar. ... For other things named OCD, see OCD (disambiguation). ... Eating disorders are a group of mental disorders that interfere with normal food consumption. ... Chronic pain was originally defined as pain that has lasted 6 months or longer. ... Lifestyle drugs are drugs created to improve the patients quality of life by addressing relatively minor non-life threatening conditions such as head colds, headaches, baldness, impotence, wrinkles, and obesity. ... The term antipsychotic is applied to a group of drugs used to treat psychosis. ... Benzodiazepine tablets The benzodiazepines are a class of drugs with hypnotic, anxiolytic, anticonvulsant, amnestic and muscle relaxant properties. ...


The term antidepressant is sometimes applied to any therapy (e.g. psychotherapy, electro-convulsive therapy, acupuncture) or process (e.g. sleep disruption, increased light levels, regular exercise) found to improve clinically depressed mood. An inert placebo tends to have a significant antidepressant effect, so establishing something as an antidepressant in a clinical trial involves demonstrating a significant additional effect. Psychotherapy is an interpersonal, relational intervention used by trained psychotherapists to aid clients in problems of living. ... Electroconvulsive therapy, also known as electroshock or ECT, is a type of psychiatric shock therapy involving the induction of an artificial seizure in a patient by passing electricity through the brain. ... Acupuncture chart from Hua Shou (fl. ... For other uses, see Placebo (disambiguation). ... In health care, including medicine, a clinical trial (synonyms: clinical studies, research protocols, medical research) is a process in which a medicine or other medical treatment is tested for its safety and effectiveness, often in comparison to existing treatments. ...

Contents

History

Saint John's Wort
Saint John's Wort

Opium[3] and St John's Wort[4] (as a "nerve tonic") had long been used to alleviate depression, but the contemporary history of antidepressant medications begins with isoniazid. Image File history File links Download high resolution version (1600x1067, 264 KB) St. ... Image File history File links Download high resolution version (1600x1067, 264 KB) St. ... This article is about the drug. ... Binomial name Hypericum perforatum L. St Johns wort (IPA pronunciation: , rhyming with hurt, or ) used alone refers to the species Hypericum perforatum, also known as Klamath weed or Goat weed, but, with qualifiers, is used to refer to any species of the genus Hypericum. ... Isoniazid (also called isonicotinyl hydrazine or isonicotinic acid hydrazide); abbreviated INH or just H. Isoniazid is a first-line antituberculous medication used in the prevention and treatment of tuberculosis. ...


Isoniazid and iproniazid

In 1951, two physicians from the Sea View Hospital on Staten Island, Irving Selikoff and Edward Robitzek, began clinical trials to evaluate two new anti-tuberculosis agents from Hoffman-LaRoche, isoniazid and iproniazid. Only the patients with poor prognosis were initially treated; nevertheless, their condition improved dramatically. In addition, Selikoff and Robitzek noted "a subtle general stimulation... The patients exhibited renewed vigor and indeed this occasionally served to introduce disciplinary problems."[5] The promise of the cure for tuberculosis brought by the results of the Sea View Hospital trials was also excitedly discussed in the mainstream press. In 1952, learning of the stimulant-like side effects of the isoniazid, the Cincinnati psychiatrist Max Lurie decided to try it on his patients. In the following year, he and Harry Salzer reported that isoniazid improved the depression in two thirds of their patients and also coined the term antidepressant to describe its action.[6] A similar story happened in Paris, where Jean Delay, the head of psychiatry at Sainte-Anne Hospital, found out from his pulmonology colleagues from Cochin Hospital about the side effects of isoniazid. In 1952, that is even earlier than Lurie and Salzer, Delay with the resident Jean-Francois Buisson also reported the positive action of isoniazid on depressed patients.[7] For the reasons unrelated to the efficacy, isoniazid as antidepressant was soon overshadowed by more toxic iproniazid,[6] although it remains one of the mainstays of the tuberculosis treatment. The mode of antidepressant action of isoniazid is still unclear. It is speculated that its effect is due to the inhibition of diamine oxidase coupled with a weak inhibition of monoamine oxidase A.[8] Tuberculosis (abbreviated as TB for tubercle bacillus or Tuberculosis) is a common and deadly infectious disease caused by mycobacteria, mainly Mycobacterium tuberculosis. ... Isoniazid (also called isonicotinyl hydrazine or isonicotinic acid hydrazide); abbreviated INH or just H. Isoniazid is a first-line antituberculous medication used in the prevention and treatment of tuberculosis. ... Iproniazid is a monamine oxidase inhibitor (MAOI) that was developed as the first anti-depressant (Also first psychiatric drug). ... In medicine, pulmonology (aka pneumology) is the specialty that deals with diseases of the lungs and the respiratory tract. ... The standard short course treatment for tuberculosis (TB) is isoniazid, rifampicin, pyrazinamide and ethambutol for two months, then isoniazid and rifampicin alone for a further four months. ... Amine oxidase is an enzyme involved in the metabolism of histamine. ... Monoamine oxidase A is an isozyme of monoamine oxidase. ...


Another anti-tuberculosis drug tried at the same time by Selikoff and Robitzek, iproniazid, was observed to have a greater "psychostimulant" effect, albeit at the cost of a greater toxicity.[9] Subsequently to the publications on isoniazid, papers by Jackson Smith, Gordon Kamman, George Crane and Frank Ayd describing the psychiatric applications of iproniazid also appeared, and Ernst Zeller found iproniazid to be a potent monoamine oxidase inhibitor.[10] Nevertheless, iproniazid had remained relatively obscure until Nathan Kline, the influential and flamboyant head of research at Rockland State Hospital, began its popularization both in medical and popular press as a "psychic energizer".[11][10] While isoniazid was not patentable,[6] Roche put a significant marketing effort behind iproniazid, including promoting its off-label use for depression.[10] Its sales grew massively in the following years, until it was recalled from the market in 1961 due to the cases of lethal hepatotoxicity.[10] Iproniazid is a monamine oxidase inhibitor (MAOI) that was developed as the first anti-depressant (Also first psychiatric drug). ... MAOI redirects here. ... The term off-label refers to the use of a drug for a medical condition other than for which it was officially approved and marketed. ... Hepatotoxicity (from hepatic toxicity) implies chemical-driven liver damage. ...


Imipramine

The discovery that a tricyclic ("three ringed") compound had a significant antidepressant effect was also first made in the early 1950s, by Roland Kuhn in a Swiss psychiatric hospital. By that time antihistamine derivatives were coming in to use to treat surgical shock and then as psychiatric neuroleptics. Although, in 1955, reserpine was indicated to be more effective than placebo in alleviating anxious depression, neuroleptics (literally "to seize the neuron") were developing for use as sedatives and antipsychotics. Chemical structure of the tricyclic antidepressant amitriptyline. ... An H1 antihistamine is a histamine antagonist which serves to reduce or eliminate effects mediated by histamine, an endogenous chemical mediator released during allergic reactions, through action at the H1 receptor. ... Reserpine is an indole alkaloid antipsychotic and antihypertensive drug that has been used for the control of high blood pressure and for the relief of psychotic behaviors, although because of the development of better drugs for these purposes and because of its numerous side-effects, it is rarely used today. ... A sedative is a drug that depresses the central nervous system (CNS), which causes calmness, relaxation, reduction of anxiety, sleepiness, slowed breathing, slurred speech, staggering gait, poor judgment, and slow, uncertain reflexes. ... The term antipsychotic is applied to a group of drugs used to treat psychosis. ...


In attempting to improve the effectiveness of one of them, chlorpromazine, in conjunction with the Geigy pharmaceutical company, Kuhn discovered that compound "G 22355" (manufactured and patented in the US in 1951 by Häfliger and Schinder) had a beneficial effect in patients with depression with mental and motor retardation.[12] He first reported his findings on what he called a "thymoleptic" (literally "taking hold of the emotions", by contrast with neuroleptics, "taking hold of the nerves") in 1955/56 and they gradually became established, resulting in the marketing of the first tricyclic antidepressant, imipramine, soon followed by variants. Chlorpromazine was the first antipsychotic drug, used during the 1950s and 1960s. ... Novartis Suffern Yes plant is the Swiss companys sole pharmaceutical production facility in the U.S. Novartis International AG is a multinational pharmaceutical company based in Basel, Switzerland that manufactures mainstream products such as Benefiber (a fiber supplement) and Lamisil (a foot fungus medicine). ... A pharmaceutical company, or drug company, is a commercial business whose focus is to research, develop, market and/or distribute drugs, most commonly in the context of healthcare. ... This article does not cite any references or sources. ...


Later history

These new drug therapies became prescription-only medications in the 1950s. It was estimated that no more than 50 to 100 people per million suffered from the kind of depression that these new drugs would treat and pharmaceutical companies were not enthusiastic.[citation needed] Sales through the 1960s remained poor compared to the major tranquilizers (neuroleptics/antipsychotics) and minor tranquilizers (such as benzodiazepines), which were being marketed for different uses. Look up prescription in Wiktionary, the free dictionary. ... The term antipsychotic is applied to a group of drugs used to treat psychosis. ... Alprazolam 2mg tablets The benzodiazepines (pronounced , or benzo for short) are considered minor tranquilizers that are a class of drugs with sedative, hypnotic, anxiolytic, anticonvulsant, amnestic and muscle relaxant properties. ...


The term antidepressant is reported to have been coined by Lurie and to not have been widely adopted until at least the 1960s.[13] Imipramine remained in common use and numerous successors were introduced. The field of MAO inhibitors remained quiet for many years until "reversible" forms affecting only the MAO-A subtype were introduced, avoiding some of the adverse effects.[14][15][16]


Most pharmacologists by the 1960s thought the main therapeutic action of tricyclics was to inhibit norepinephrine reuptake, but it was gradually observed that this action was associated with energizing and motor stimulating effects whilst some antidepressant compounds appeared to have differing effects through action on serotonin systems (notably proposed by Carlsson and Lindqvist (1969) and Lapin and Oxenkrug (1969)). Norepinephrine (INN)(abbr. ... For the professional wrestling stable, see Ravens Nest#Serotonin. ...


Researchers began a process of rational drug design to isolate antihistamine-derived compounds that would 'selectively' (specifically) target these systems. The first such compound to be patented, in 1971, was zimelidine, whilst the first released clinically was indalpine. Fluoxetine (Prozac), FDA approved for commercial use in 1988, became the first blockbuster SSRI. Fluoxetine was developed at Eli Lilly in the early 1970s by Bryan Molloy, David Wong and others.[17][18] Drug design is the approach of finding drugs by design, based on what the drug is targeting. ... // General Remars and History Zimelidine is a pyridylallylamine and has a structure different from other antidepressants. ... Indalpine is a serotonin uptake inhibitor. ... Prozac redirects here. ... A blockbuster drug is a drug generating more than $1 billion of revenue for its owner each year. ... SSRI is an acronym that stands for several things: It is a class of antidepressants called selective serotonin reuptake inhibitor SSRI also is used as the stock symbol for Silver Standard Resources Inc. ... One of the worlds largest corporations, Eli Lilly and Company (NYSE: LLY) is a global pharmaceutical company with headquarters in Indianapolis,Indiana, USA. A Fortune 500 corporation, the company had revenues of $12. ...


While it had fallen out of favor in most countries through the 19th and 20th centuries, the herb St John's Wort had become increasingly popular in Germany where Hypericum extracts eventually became licensed, packaged and prescribed by doctors. Small-scale efficacy trials were carried out from the 1970s and 1980s, and attention grew in the 1990s following a meta-analysis of these.[19] It remained an over-the-counter drug (OTC) or supplement in most countries and research continued to investigate its neurotransmitter effects and active components, particularly hyperforin[20][21] Binomial name Hypericum perforatum L. St Johns wort (IPA pronunciation: , rhyming with hurt, or ) used alone refers to the species Hypericum perforatum, also known as Klamath weed or Goat weed, but, with qualifiers, is used to refer to any species of the genus Hypericum. ... Species See text Hypericum is a genus of about 400 species of flowering plants in the family Clusiaceae, formerly often treated separately in their own family the Hypericaceae. ... A meta-analysis is a statistical practice of combining the results of a number of studies. ... Over-the-counter (OTC) drugs are medicines that may be sold without a prescription, in contrast to prescription drugs. ... Hyperforin is one of the principal constituents identified in St Johns wort. ...


SSRIs became known as "novel antidepressants" along with other newer drugs such as SNRIs and NRIs with various different selective effects, such as venlafaxine, duloxetine, nefazodone and mirtazapine[22] Serotonin norepinephrine reuptake inhibitors (SNRIs) are a class of antidepressant used in the treatment of clinical depression and other affective disorders. ... Norepinephrine reuptake inhibitors (NRIs) are compounds that increase amounts of the neurotransmitter norepinephrine in the brain by inhibiting its reuptake at synapses. ... Venlafaxine (Effexor) is an antidepressant of the serotonin-norepinephrine reuptake inhibitor (SNRI) class first introduced by Wyeth in 1993. ... Duloxetine (brand names Cymbalta, Yentreve, and in parts of Europe, Xeristar or Ariclaim) is a drug which primarily targets major depressive disorder (MDD), generalized anxiety disorder (GAD), pain related to diabetic peripheral neuropathy and in some countries stress urinary incontinence (SUI). ... Nefazodone hydrochloride (trade name Serzone) is an antidepressant drug marketed by Bristol-Myers Squibb. ... Mirtazapine is an antidepressant introduced by Organon International in 1996 used for the treatment of mild to severe depression. ...


Types of Antidepressants

Selective serotonin reuptake inhibitors (SSRIs)

Selective serotonin reuptake inhibitors (SSRIs) are a family of antidepressants considered to be the current standard of drug treatment. It is thought that one cause of depression is an inadequate amount of serotonin, a chemical used in the brain to transmit signals between neurons. SSRIs are said to work by preventing the reuptake of serotonin by the presynaptic neuron, thus maintaining higher levels of 5-HT in the synapse. Recently, however, work by two researchers has called into question the link between serotonin deficiency and symptoms of depression, noting that the efficacy of SSRIs as treatment does not in itself prove the link.[23] Recent research indicates that these drugs may interact with transcription factors known as "clock genes",[24] which may be important for the addictive properties of drugs of abuse, and possibly in obesity.[25][26] SSRI redirects here; for other uses, see SSRI (disambiguation). ... For the professional wrestling stable, see Ravens Nest#Serotonin. ...


Recent randomized controlled trials in Archives of General Psychiatry showed that up to one-third of effects of SSRI Treatment can be seen in first week. Early effects also shown to have secondary effect of reducing absolute reduction in HDRS score by 50%. Even more recent studies, published by the Archives of General Psychiatry note that 25% of so-called clinical depression does not meet a disease criteria and should be considered to be ordinary sadness and adjustment to the difficulties in life. A randomized controlled trial (RCT) is a form of clinical trial, or scientific procedure used in the testing of the efficacy of medicine, used because of its record of reliability. ...


This family of drugs includes fluoxetine (Prozac), paroxetine (Paxil), escitalopram (Lexapro, Esipram), citalopram (Celexa), and sertraline (Zoloft). These antidepressants typically have fewer adverse side effects than the tricyclics or the MAOIs, although such effects as drowsiness, dry mouth, nervousness, anxiety, insomnia, decreased appetite, and decreased ability to function sexually may occur. Some side effects may decrease as a person adjusts to the drug, but other side effects may be persistent. Though safer than first generation antidepressants, SSRI's may not work as often, suggesting the role of norepinephrine. Prozac redirects here. ... Paroxetine (Paxil, Seroxat, Pexeva) is a selective serotonin reuptake inhibitor (SSRI) antidepressant. ... Lexapro pills Escitalopram (Lexapro, Lexaprin, Cipralex, Sipralexa, Entact and Seroplex)[1] is an antidepressant of the selective serotonin reuptake inhibitor (SSRI) class. ... Citalopram is an antidepressant drug used to treat depression associated with mood disorders. ... Zoloft bottles, with blue and green tablets Sertraline hydrochloride (also sold under brand names Zoloft, Lustral, Apo-Sertral, Asentra, Gladem, Serlift, Stimuloton, Xydep, Serlain, Concorz) is an antidepressant of the selective serotonin reuptake inhibitor (SSRI) class. ...


Serotonin-norepinephrine reuptake inhibitors (SNRIs)

Serotonin-norepinephrine reuptake inhibitors (SNRIs) such as venlafaxine (Effexor) and duloxetine (Cymbalta) are a newer form of antidepressant that works on both norepinephrine and 5-HT. They typically have similar side effects to the SSRIs, although there may be a withdrawal syndrome on discontinuation that may necessitate dosage tapering. Serotonin Norepinephrine Serotonin-norepinephrine reuptake inhibitors (SNRIs) are a class of antidepressant used in the treatment of clinical depression and other affective disorders. ... Venlafaxine (Effexor) is an antidepressant of the serotonin-norepinephrine reuptake inhibitor (SNRI) class first introduced by Wyeth in 1993. ... Duloxetine (brand names Cymbalta, Yentreve, and in parts of Europe, Xeristar or Ariclaim) is a drug which primarily targets major depressive disorder (MDD), generalized anxiety disorder (GAD), pain related to diabetic peripheral neuropathy and in some countries stress urinary incontinence (SUI). ...


Noradrenergic and specific serotonergic antidepressants (NASSAs)

Noradrenergic and specific serotonergic antidepressants (NASSAs) form a newer class of antidepressants which purportedly work to increase norepinephrine (noradrenaline) and serotonin neurotransmission by blocking presynaptic alpha-2 adrenergic receptors while at the same time minimizing serotonin related side-effects by blocking certain serotonin receptors. The only example of this class in clinical use is mirtazapine (Avanza, Zispin, Remeron). Noradrenergic and specific serotonergic antidepressants (abbreviated: NaSSAs) are a relatively new class of antidepressants. ... Norepinephrine, known as noradrenaline outside the USA, is a catecholamine and a phenethylamine with chemical formula C8H11NO3. ... Epinephrine Norepinephrine The adrenergic receptors (or adrenoceptors) are a class of G protein-coupled receptors that are targets of the catecholamines. ... Mirtazapine is an antidepressant introduced by Organon International in 1996 used for the treatment of mild to severe depression. ...


Norepinephrine (noradrenaline) reuptake inhibitors (NRIs)

Norepinephrine (noradrenaline) reuptake inhibitors (NRIs) such as reboxetine (Edronax) act via norepinephrine (also known as noradrenaline). NRIs are thought to have a positive effect on concentration and motivation in particular, though they have been known to increase aggression.[citation needed] Norepinephrine reuptake inhibitors (NRIs) are compounds that increase amounts of the neurotransmitter norepinephrine in the brain by inhibiting its reuptake at synapses. ... Reboxetine is an antidepressant drug used in the treatment of clinical depression, panic disorder and ADD/ADHD. Its mesilate ( methanesulfonate) salt is sold under tradenames including Edronax®, Norebox®, Prolift®, Solvex® or Vestra®. Reboxetine has two chiral centers, but it only exists as two enantiomers, (R,R)-(-)- and (S,S)-(+)-reboxetine. ...


Norepinephrine-dopamine reuptake inhibitors

Norepinephrine-dopamine reuptake inhibitors such as bupropion (Wellbutrin, Zyban) inhibit the neuronal reuptake of dopamine and norepinephrine (noradrenaline).[27] A Norepinephrine-dopamine reuptake inhibitor is a class of drugs that is both: Dopamine reuptake inhibitor Norepinephrine reuptake inhibitor An example is Bupropion. ... Bupropion (INN; also amfebutamone,[1] brand names Wellbutrin, Zyban, Budeprion and Buproban) is an atypical antidepressant, which acts as a norepinephrine reuptake inhibitor and dopamine reuptake inhibitor,[2] and a nicotinic antagonist. ... For other uses, see Dopamine (disambiguation). ... Norepinephrine (INN)(abbr. ...


Tricyclic antidepressants (TCAs)

Tricyclic antidepressants are the oldest and include such medications as amitriptyline and desipramine. Tricyclics block the reuptake of certain neurotransmitters such as norepinephrine (noradrenaline) and serotonin. They are used less commonly now due to the development of more selective and safer drugs. Several side effects include increased heart rate, drowsiness, dry mouth, constipation, urinary retention, blurred vision, dizziness, confusion, and sexual dysfunction. Toxicity occurs at approximately ten times normal dosages. However, tricyclic antidepressants are still used because of their high potency, especially in severe cases of clinical depression. Chemical structure of the tricyclic antidepressant amitriptyline. ... Amitriptyline (or Amitryptyline) hydrochloride (sold as Elavil, Tryptanol, Endep, Elatrol, Tryptizol, Trepiline, Laroxyl) is a tricyclic antidepressant drug. ... Desipramine is a tricyclic antidepressant (TCA) that inhibits the reuptake of norepinephrine. ... The heart and lungs, from an older edition of Grays Anatomy. ...


Monoamine oxidase inhibitor (MAOIs)

Monoamine oxidase inhibitors (MAOIs) such as phenelzine (Nardil) may be used if other antidepressant medications are ineffective. Because there are potentially fatal interactions between this class of medication and certain foods (particularly those containing Tyramine), as well as certain drugs, classic MAOIs are rarely prescribed anymore. MAOIs work by blocking the enzyme monoamine oxidase which breaks down the neurotransmitters dopamine, serotonin, and norepinephrine (noradrenaline). MAOIs can be as effective as tricyclic antidepressants, although they can have a higher incidence of dangerous side effects (as a result of inhibition of cytochrome P450 in the liver). A new generation of MAOIs has been introduced; moclobemide (Manerix), known as a reversible inhibitor of monoamine oxidase A (RIMA), acts in a more short-lived and selective manner and does not require a special diet. Additionally, (selegiline) marketed as Emsam in a transdermal form is not a classic MAOI in that at moderate dosages it tends to effect MAO-B which does not require any dietary restrictions. MAOI redirects here. ... Phenelzine (brand name Nardil) is an antidepressant drug that belongs to the monoamine oxidase inhibitor (MAOI) class of drugs. ... In organic chemistry tyramine (4-hydroxy-phenethylamine, para-tyramine, p-tyramine) is a monoamine compound derived from the amino acid tyrosine. ... Moclobemide (sold as Aurorix®, Manerix®) is a psychiatric drug primarily used to treat depression and social anxiety. ... These drugs, a subset of monoamine oxidase inhibitors (MAOIs), inhibit only isoenzyme A and are reversible. ... Selegiline (l-deprenyl, Eldepryl® or Anipryl® [veterinary]) is a drug used for the treatment of early-stage Parkinsons disease and senile dementia. ... Emsam is a transdermal patch for the MAOI antidepressant Selegiline. ...


Augmenter drugs

Some antidepressants have been found to work more effectively in some patients when used in combination with another drug. Such "augmenter" drugs include tryptophan (Tryptan) and buspirone (Buspar). Tryptophan (abbreviated as Trp or W)[1] is one of the 20 standard amino acids, which are the building blocks of proteins, and an essential amino acid in the human diet. ... Buspirone (brand-names Ansial, Ansiced, Anxiron, Axoren, Bespar, BuSpar, Buspimen, Buspinol, Buspisal, Narol, Spitomin, Sorbon) is an anxiolytic agent and a serotonin receptor agonist belonging to the azaspirodecanedione class of compounds. ...


Tranquillizers and sedatives, typically the benzodiazepines, may be prescribed to ease anxiety and promote sleep. Because of their high potential for fostering dependence, these medications are intended only for short-term or occasional use. Medications often are used not for their primary function but to exploit what are normally side effects. Quetiapine fumarate (Seroquel) is designed primarily to treat schizophrenia and bipolar disorder, but a frequently reported side-effect is somnolence. Therefore, this drug can be used in place of an antianxiety agent such as clonazepam (Klonopin, Rivotril). A sedative is a drug that depresses the central nervous system (CNS), which causes calmness, relaxation, reduction of anxiety, sleepiness, slowed breathing, slurred speech, staggering gait, poor judgment, and slow, uncertain reflexes. ... A sedative is a substance that depresses the central nervous system (CNS), resulting in calmness, relaxation, reduction of anxiety, sleepiness, and slowed breathing, as well as slurred speech, staggering gait, poor judgment, and slow, uncertain reflexes. ... Adverse effect, in medicine, is an abnormal, harmful, undesired and/or unintended side-effect, although not necessarily unexpected, which is obtained as the result of a therapy or other medical intervention, such as drug/chemotherapy, physical therapy, surgery, medical procedure, use of a medical device, etc. ... Quetiapine (IPA: , kwe-TYE-a-peen), marketed by AstraZeneca with the brand name Seroquel, belongs to a series of neuroleptics known as atypical antipsychotics, which have, over the last two decades, become increasingly popular alternatives to typical antipsychotics, such as haloperidol. ... Somnolence (or drowsiness) is a state of near-sleep, a strong desire for sleep, or sleeping for unusually long periods. ... Clonazepam (marketed by Roche under the trade-names Klonopin in the United States and Rivotril in Europe, South America, Canada, India, and Australia) is a drug which is a benzodiazepine derivative. ...


Antipsychotics such as risperidone (Risperdal), olanzapine (Zyprexa), and quetiapine (Seroquel) are prescribed as mood stabilizers and are also effective in treating anxiety. Their use as mood stabilizers is a recent phenomenon and is controversial with some patients. Antipsychotics (typical or atypical) may also be prescribed in an attempt to augment an antidepressant, to make antidepressant blood concentration higher, or to relieve psychotic or paranoid symptoms often accompanying clinical depression. However, they may have serious side effects, particularly at high dosages, which may include blurred vision, muscle spasms, restlessness, tardive dyskinesia, and weight gain. The term antipsychotic is applied to a group of drugs used to treat psychosis. ... Risperdal tablets Risperidone (pronounced Ris-PER-ǐ-dōn and sold under the trade name Risperdal in the United States, Canada, the United Kingdom, Portugal and several other countries, Risperdal or Ridal in New Zealand, Rispolept in Eastern Europe, and Belivon, or Rispen elsewhere) is an atypical antipsychotic medication developed by... Olanzapine (oh-LAN-za-peen, sold as Zyprexa®, Zyprexa Zydis®, or in combination with fluoxetine, as Symbyax®) was the third atypical antipsychotic to gain approval by the Food and Drug Administration (FDA) and has become one of the most commonly used atypical antipsychotics. ... Quetiapine (IPA: , kwe-TYE-a-peen), marketed by AstraZeneca with the brand name Seroquel, belongs to a series of neuroleptics known as atypical antipsychotics, which have, over the last two decades, become increasingly popular alternatives to typical antipsychotics, such as haloperidol. ... Psychosis is a psychiatric classification for a mental state in which the perception of reality is distorted. ... For other senses of this word, see paranoia (disambiguation). ... In psychology, visual perception is the ability to interpret visible light information reaching the eyes which is then made available for planning and action. ... Tardive dyskinesia is a serious neurological disorder caused by the long-term and/or high-dose use of dopamine antagonists, usually antipsychotics and among them especially the typical antipsychotics. ...


Antidepressants by their nature behave similarly to psychostimulants. Antianxiety medications by their nature are depressants. Close medical supervision is critical to proper treatment if a patient presents with both illnesses because the medications tend to work against each other.


Psycho-stimulants are sometimes added to an antidepressant regimen if the patient suffers from anhedonia, hypersomnia and/or excessive eating as well as low motivation. These symptoms which are common in atypical depression can be quickly resolved with the addition of low to moderate dosages of amphetamine or methylphenidate (brand names Adderall and Ritalin, respectively) as these chemicals enhance motivation and social behavior, as well as suppress appetite and sleep. These chemicals are also known to restore sex drive. Extreme caution must be used however with certain populations. Stimulants are known to trigger manic episodes in people suffering from bipolar disorder. They are also easily abused as they are effective substitutes for Methamphetamine when used recreationally. Close supervision of those with substance abuse disorders is urged. Emotionally labile patients should avoid stimulants, as they exacerbate mood shifting. In psychology, anhedonia is a patients inability to experience pleasure from normally pleasurable life events such as eating, exercise, and social/sexual interactions. ... Hypersomnia, also known as excessive daytime sleepiness (EDS), is excessive amount of sleepiness. ... Atypical Depression (AD) is a subtype of Dysthymia and Major Depression characterized by mood reactivity — being able to experience improved mood in response to positive events. ... Adderall XR 15 mg capsule Adderall is a pharmaceutical psychostimulant comprised of mixed amphetamine salts. ... Methylphenidate (C14H19NO2), or MPH, is an amphetamine-like prescription stimulant commonly used to treat Attention Deficit Hyperactivity Disorder (ADHD) in children and adults. ... This article is about the psychostimulant, d-methamphetamine. ...


Lithium remains the standard treatment for bipolar disorder and is often used in conjunction with other medications, depending on whether mania or depression is being treated. Lithium's potential side effects include thirst, tremors, light-headedness, and nausea or diarrhea. Some of the anticonvulsants, such as carbamazepine (Tegretol), sodium valproate (Epilim), and lamotrigine (Lamictal), are also used as mood stabilizers, particularly in bipolar disorder. This article discusses the pharmacological uses of lithium salts; for information on the chemistry of individual lithium salts, see Category:Lithium compounds. ... For the film see Tremors (film). ... For other uses, see Nausea (disambiguation). ... Diarrhea, also spelled diarrhoea (see spelling differences), is a condition in which the sufferer has frequent watery, loose bowel movements (from the Greek word διάρροια; literally meaning through-flowing). Acute infectious diarrhea is a common cause of death in developing countries (particularly among infants), accounting for 5 to 8 million deaths... The anticonvulsants, sometimes also called antiepileptics, belong to a diverse group of pharmaceuticals used in prevention of the occurrence of epileptic seizures. ... Carbamazepine (CBZ) is an anticonvulsant and mood stabilizing drug, used primarily in the treatment of epilepsy and bipolar disorder. ... Sodium valproate (INN) or valproate sodium (USAN) is the sodium salt of valproic acid and is an anticonvulsant used in the treatment of epilepsy. ... Lamotrigine (marketed as Lamictal (IPA: ) by GlaxoSmithKline, called Lamictin in South Africa, (Lamogine)[1] in Israel, and in South Korea) is an anticonvulsant drug used in the treatment of epilepsy and bipolar disorder. ...


Prescription trends

In the United Kingdom the use of antidepressants increased by 234% in the 10 years up to 2002.[28] In the United States a 2005 independent report stated that 11% of women and 5% of men in the non-institutionalized population (2002) now take antidepressants[29] A 1998 survey found that 67% of patients diagnosed with depression were prescribed an antidepressant.[30] A 2007 study purports that 25% of Americans were overdiagnosed with depression, regardless of any medical intervention.[31] The findings were based on a national survey of 8,098 people.


A 2002 survey found that about 3.5% of all people in France were being prescribed antidepressants, compared to 1.7% in 1992, often for conditions other than depression and often not in line with authorizations or guidelines[32] Between 1996 and 2004 in British Columbia, antidepressant use increased from 3.4% to 7.2% of the population[33] Data from the Netherlands indicated an increasing rate of prescriptions of SSRIs, and an increasing duration of treatment.[34] Motto: Splendor sine occasu (Latin: Splendour without diminishment) Capital Victoria Largest city Vancouver Official languages English (de facto) Government Lieutenant-Governor Steven Point Premier Gordon Campbell (BC Liberal) Federal representation in Canadian Parliament House seats 36 Senate seats 6 Confederation July 20, 1871 (6th province) Area  Ranked 5th Total 944...


Surveys indicate that antidepressant use, particularly of SSRIs, has increased rapidly in most developed countries, driven by an increased awareness of depression together with the availability and commercial promotion of new antidepressants.[35] Antidepressants are also increasingly used worldwide for non-depressive patients as studies continue show the potential of immunomodulatory, analgesic and anti-inflammatory properties in antidepressants.


The choice of particular antidepressant is reported to be based, in the absence of research evidence of differences in efficacy, on seeking to avoid certain side effects, and taking into account comorbid (co-occurring) psychiatric disorders, specific clinical symptoms and prior treatment history[36]


It is also reported that, despite equivocal evidence of a significant difference in efficacy between older and newer antidepressants, clinicians perceive the newer drugs, including SSRIs and SNRIs, to be more effective than the older drugs (tricyclics and MAOIs).[37] A survey in the UK found that male general physicians were more likely to prescribe antidepressants than female doctors.[38]


Most commonly prescribed antidepressants

Structural formula of the SSRI escitalopram, in its free base form.
Structural formula of the SSRI escitalopram, in its free base form.

The most commonly prescribed antidepressants in the US retail market in 2006 [39] were: Image File history File links Download high resolution version (2575x2003, 35 KB) File links The following pages link to this file: Escitalopram ... Image File history File links Download high resolution version (2575x2003, 35 KB) File links The following pages link to this file: Escitalopram ... Lexapro pills Escitalopram (Lexapro, Lexaprin, Cipralex, Sipralexa, Entact and Seroplex)[1] is an antidepressant of the selective serotonin reuptake inhibitor (SSRI) class. ...

  • Sertraline (Zoloft) - of the SSRI class, with 28.060 million prescriptions
  • Escitalopram (Lexapro) - of the SSRI class, with 26.098 million prescriptions
  • Fluoxetine (Prozac) - of the SSRI class, with 21.733 million prescriptions
  • Bupropion (Wellbutrin, Zyban) - of the NDRI class, with 21.141 million prescriptions
  • Paroxetine (Paxil) - of the SSRI class, with 19.472 million prescriptions
  • Venlafaxine (Effexor) - of the SNRI class, with 17.101 million prescriptions
  • Trazodone (Desyrel), with 14.628 million prescriptions
  • Amitriptyline (Elavil), with 13.924 million prescriptions
  • Citalopram (Celexa), of the SSRI class, with 11.986 million prescriptions
  • Duloxetine (Cymbalta), of the SNRI class, with 8.520 million prescriptions
  • Mirtazapine (Remeron), with 4.852 million prescriptions
  • Nortriptyline (Pamelor), with 3.174 million prescriptions
  • Imipramine (Tofranil), with 1.629 million prescriptions

The most commonly prescribed antidepressant in Germany is reported to be (concentrated extracts of) hypericum perforatum (St John's Wort). [13] In the Netherlands, paroxetine, marketed as Seroxat® among generic preparations, is the most prescribed antidepressant, followed by the tricyclic antidepressant amitriptyline, citalopram and venlafaxine. [14] Zoloft bottles, with blue and green tablets Sertraline hydrochloride (also sold under brand names Zoloft, Lustral, Apo-Sertral, Asentra, Gladem, Serlift, Stimuloton, Xydep, Serlain, Concorz) is an antidepressant of the selective serotonin reuptake inhibitor (SSRI) class. ... SSRI is an acronym that stands for several things: It is a class of antidepressants called selective serotonin reuptake inhibitor SSRI also is used as the stock symbol for Silver Standard Resources Inc. ... Lexapro pills Escitalopram (Lexapro, Lexaprin, Cipralex, Sipralexa, Entact and Seroplex)[1] is an antidepressant of the selective serotonin reuptake inhibitor (SSRI) class. ... SSRI is an acronym that stands for several things: It is a class of antidepressants called selective serotonin reuptake inhibitor SSRI also is used as the stock symbol for Silver Standard Resources Inc. ... Prozac redirects here. ... SSRI is an acronym that stands for several things: It is a class of antidepressants called selective serotonin reuptake inhibitor SSRI also is used as the stock symbol for Silver Standard Resources Inc. ... Bupropion (INN; also amfebutamone,[1] brand names Wellbutrin, Zyban, Budeprion and Buproban) is an atypical antidepressant, which acts as a norepinephrine reuptake inhibitor and dopamine reuptake inhibitor,[2] and a nicotinic antagonist. ... A Norepinephrine-dopamine reuptake inhibitor is a class of drugs that is both: Dopamine reuptake inhibitor Norepinephrine reuptake inhibitor An example is Bupropion. ... Paroxetine (Paxil, Seroxat, Pexeva) is a selective serotonin reuptake inhibitor (SSRI) antidepressant. ... SSRI is an acronym that stands for several things: It is a class of antidepressants called selective serotonin reuptake inhibitor SSRI also is used as the stock symbol for Silver Standard Resources Inc. ... Venlafaxine (Effexor) is an antidepressant of the serotonin-norepinephrine reuptake inhibitor (SNRI) class first introduced by Wyeth in 1993. ... Serotonin norepinephrine reuptake inhibitors (SNRIs) are a class of antidepressant used in the treatment of clinical depression and other affective disorders. ... Trazodone (trade names Desyrel, Molipaxin, Trittico, Thombran, Trialodine) is a psychoactive compound with sedative, anxiolytic, and antidepressant properties. ... Amitriptyline (or Amitryptyline) hydrochloride (sold as Elavil, Tryptanol, Endep, Elatrol, Tryptizol, Trepiline, Laroxyl) is a tricyclic antidepressant drug. ... Citalopram is an antidepressant drug used to treat depression associated with mood disorders. ... SSRI is an acronym that stands for several things: It is a class of antidepressants called selective serotonin reuptake inhibitor SSRI also is used as the stock symbol for Silver Standard Resources Inc. ... Duloxetine (brand names Cymbalta, Yentreve, and in parts of Europe, Xeristar or Ariclaim) is a drug which primarily targets major depressive disorder (MDD), generalized anxiety disorder (GAD), pain related to diabetic peripheral neuropathy and in some countries stress urinary incontinence (SUI). ... Serotonin norepinephrine reuptake inhibitors (SNRIs) are a class of antidepressant used in the treatment of clinical depression and other affective disorders. ... Mirtazapine is an antidepressant introduced by Organon International in 1996 used for the treatment of mild to severe depression. ... Nortriptyline is a tricyclic antidepressant marketed under the tradenames Aventyl® and Pamelor®. It is used to treat depression. ... This article does not cite any references or sources. ...


Mechanisms of action

The therapeutic effects of antidepressants are believed to be related to their effects on neurotransmitters. Monoamine oxidase inhibitors (MAOIs) block the break-down of monoamine neurotransmitters (serotonin and norepinephrine) by inhibiting the enzymes which oxidize them, thus leaving higher levels still active in the brain (synaptic cleft). Chemical structure of D-aspartic acid, a common amino acid neurotransmitter. ... MAOI redirects here. ... For the professional wrestling stable, see Ravens Nest#Serotonin. ... Norepinephrine (INN)(abbr. ... Ribbon diagram of the enzyme TIM, surrounded by the space-filling model of the protein. ... Synapses allow nerve cells to communicate with one another through axons and dendrites, converting electrical signals into chemical ones. ...


Tricyclic antidepressants (TCAs) prevent the reuptake of various neurotransmitters, including serotonin, norepinephrine, and dopamine. Selective serotonin reuptake inhibitors (SSRIs) more specifically prevent the reuptake of serotonin (thereby increasing the level of active serotonin in synapses of the brain). Other novel antidepressants specifically affect serotonin and other neurotransmitters. Neurotransmitters are chemicals that are used to relay, amplify and modulate electrical signals between a presynaptic and a postsynaptic neuron. ... For the professional wrestling stable, see Ravens Nest#Serotonin. ... Norepinephrine (INN)(abbr. ... For other uses, see Dopamine (disambiguation). ... SSRI redirects here; for other uses, see SSRI (disambiguation). ... Illustration of the major elements in a prototypical synapse. ... Human brain In animals, the brain (enkephale) (Greek for in the skull), is the control center of the central nervous system, responsible for behavior. ...


A theory centered on neurotransmitter effects appears to be incomplete, however. Neurotransmitter levels are altered as soon as the antidepressant chemicals build up in the bloodstream, but effects on mood appear to occur several days or weeks later.


One explanation of this holds that the "down-regulation" of neurotransmitter receptors—an apparent consequence of excess signaling and a process that takes several weeks—is actually the mechanism responsible for the alleviation of depressive symptoms. Another hypothesis is that antidepressants may have some longer-term effects due to the promotion of neurogenesis in the hippocampus, an effect found in mice[40][41] Other animal research suggests that antidepressants can also affect the expression of genes in brain cells, by influencing "clock genes".[42] Downregulation is the process by which a cell decreases the number of receptors to a given hormone or neurotransmitter to reduce its sensitivity to this molecule. ... Transmembrane receptors are integral membrane proteins, which reside and operate typically within a cells plasma membrane, but also in the membranes of some subcellular compartments and organelles. ... Neurogenesis (birth of neurons) is the process by which neurons are created. ... For other uses, see Hippocampus (disambiguation). ... A circadian rhythm is a roughly-24-hour cycle in the physiological processes of living beings, including plants, animals, fungi and cyanobacteria. ...


New research suggests that delayed onset of clinical effects from antidepressants indicates involvement of adaptive changes in antidepressant effects. Rodent studies have consistently shown upregulation of the 3, 5-cyclic adenosine monophosphate (cAMP) system induced by different types of chronic but not acute antidepressant treatment including serotonin and norepinephrine uptake inhibitors, monoamine oxidase inhibitors, tricyclic antidepressants, lithium and electroconvulsions. cAMP is synthesized from adenosine 5-triphosphate (ATP) by adenylyl cyclase and metabolized by cyclic nucleotide phosphodiesterases (PDEs).[43] Data also suggest antidepressants to have the ability of modulating neural plasticity in longterm administration.[44] Structure of cAMP cAMP represented in three ways, the left with sticks-representation, the middle with structure formula, and the right with space filled representation. ... Adenosine 5-triphosphate (ATP) is a multifunctional nucleotide that is most important as a molecular currency of intracellular energy transfer. ... A phosphodiesterase (PDE) is an enzyme that catalyzes the hydrolysis of phosphodiester bonds. ... Neuroplasticity challenges the idea that brain functions are fixed in certain locations. ...


Anti-inflammatory and immunomodulation

Recent studies show pro-inflammatory cytokine processes take place during depression, mania and bipolar disease, and is possible that symptoms manifest in these psychiatric illnesses are being attenuated by pharmacological affect of antidepressants on the immune system.[45][46][47][48][49] Cytokines are a group of proteins and peptides that are used in organisms as signaling compounds. ... On the Threshold of Eternity. ... This article is an expansion of a section entitled Mania from within the main article Bipolar disorder. ... For other uses, see Bipolar. ...


Studies also show that the chronic secretion of stress hormones as a result of disease, including somatic infections or autoimmune syndromes may reduce the effect of neurotransmitters or other receptors in the brain by cell-mediated pro-inflammatory pathways, thereby leading to the dysregulation of neurohormones.[50] SSRIs, SNRIs and tricyclic antidepressants acting on serotonin, norepinephrine and dopamine receptors have been shown to be immunomodulatory and anti-inflammatory against pro-inflammatory cytokine processes, specifically on the regulation of Interferon-gamma (IFN-gamma) and Interleukin-10 (IL-10), as well as TNF-alpha and Interleukin-6 (IL-6). Antidepressants have also been shown to suppress TH1 upregulation.[51][52][53][54][55] In medical terms, stress is the disruption of homeostasis through physical or psychological stimuli. ... Hormone is also the NATO reporting name for the Soviet/Russian Kamov Ka-25 military helicopter. ... The term somatic refers to the body, as distinct from some other entity, such as the mind. ... Infection is also the title of an episode of the television series Babylon 5; see Infection (Babylon 5). ... Autoimmune diseases arise from an overactive immune response of the body against substances and tissues normally present in the body. ... Neurotransmitters are chemicals that are used to relay, amplify and modulate electrical signals between a presynaptic and a postsynaptic neuron. ... Cell-mediated immunity is an immune response that does not involve antibodies but rather involves the activation of macrophages and NK-cells, the production of antigen-specific cytotoxic T-lymphocytes, and the release of various cytokines in response to an antigen. ... SSRI is an acronym that stands for several things: It is a class of antidepressants called selective serotonin reuptake inhibitor SSRI also is used as the stock symbol for Silver Standard Resources Inc. ... Serotonin norepinephrine reuptake inhibitors (SNRIs) are a class of antidepressant used in the treatment of clinical depression and other affective disorders. ... Chemical structure of the tricyclic antidepressant amitriptyline. ... An antidepressant is a medication used primarily in the treatment of clinical depression. ... For the professional wrestling stable, see Ravens Nest#Serotonin. ... Norepinephrine (INN)(abbr. ... For other uses, see Dopamine (disambiguation). ... Cytokines are a group of proteins and peptides that are used in organisms as signaling compounds. ... Interferon-gamma or IFN-g is a dimerized soluble cytokine which is a Type II Interferon. ... Interleukin-10 (IL-10 or IL10), also known as human cytokine synthesis inhibitory factor (CSIF), is an anti-inflammatory cytokine, capable of inhibiting synthesis of pro-inflammatory cytokines like IFN-gamma, IL-2, IL-3, TNFα and GM-CSF by cells such as macrophages and Th1 cells. ... In medicine, tumor necrosis factor alpha (TNFα, cachexin or cachectin) is an important cytokine involved in systemic inflammation and the acute phase response. ... Interleukin-6 (IL-6) is a pro-inflammatory cytokine secreted by T cells and macrophages to stimulate immune response to trauma, especially burns or other tissue damage leading to inflammation. ... T helper cells (also known as effector T cells or Th cells) are a sub-group of lymphocytes (a type of white blood cell or leukocyte) that play an important role in establishing and maximising the capabilities of the immune system. ...


Antidepressants, specifically TCAs and dual serotonergic-noradrenergic reuptake inhibition by dual SNRIs (or SSRI-NRI combinations), have also shown analgesic properties additionally.[56][57] An analgesic (colloquially known as a painkiller) is any member of the diverse group of drugs used to relieve pain (achieve analgesia). ...


These studies warrant investigation for antidepressants for use in both psychiatric and non-psychiatric illness and that a psycho-neuroimmunological approach may be required for optimal pharmacotherapy.[58] Future antidepressants may be made to specifically target the immune system by either blocking the actions of pro-inflammatory cytokines or increasing the production of anti-inflammatory cytokines.[59] Psychoneuroimmunology (PNI) investigates the relations between the psychophysiological and immunophysiological dimensions of living beings. ... Pharmacotherapy is the practice of treating diseases with medication. ...


Therapeutic efficacy

There is a large amount of research evaluating the potential therapeutic effects of antidepressants, whether through efficacy studies under experimental conditions (including randomized clinical trials) or through studies of "real world" effectiveness. A sufficient response to a drug is often defined as at least a 50% reduction in self-reported or observed symptoms, with a partial response often defined as at least a 25% reduction. The term remission indicates a virtual elimination of depression symptoms, albeit with the risk of a recurrence of symptoms or complete relapse. Full remission or recovery signifies a full sustained return to a "normal" psychological state with full functioning.


Review studies

Recent clinical reviews include: Image File history File links This is a lossless scalable vector image. ...

  • A comparison of the relative efficacy of different classes of antidepressants[60] in different settings[61] and in regard to different kinds of depression[62]
  • An assessment of antidepressants compared with an "active placebo"[63]
  • An assessment of the newer types of the MAOI class[64]
  • A meta-analysis of randomized trials of St John's Wort[65]
  • A review of the use of antidepressants for childhood depression[66][67]
  • A review of all antidepressant trials submitted to the US FDA from 1987 to 2004 has shown that around half of the trials failed to show any benefit over placebo. All but one of the successful trial results were published in scientific journals, while nearly all the unsuccessful trials were either not published or were presented in a misleadingly positive light (compared to the FDA's own evaluation of the data). This arose because whilst studies are required for medical approval, studies showing adverse findings are not necessarily required to be published or (if published) given similar prominence. As a result, while it appeared in the research literature that 94 percent of trials had positive outcomes, in the actual data submitted to the Food and Drug Administration, only 51 percent did. This publication bias inflated the apparent statistical effect of every antidepressant studied, by between 11% and 69%.[68]
  • Meta-analysis published in 2008 assessed linear and quadratic effects of initial severity on improvement scores for drug and placebo groups and on drug-placebo difference scores. Drug-placebo differences increased as a function of initial severity, rising from virtually no difference at moderate levels of initial depression to a relatively small difference for patients with very severe depression, reaching conventional criteria for clinical significance only for patients at the upper end of the very severely depressed category.[69]

The United States Food and Drug Administration is the government agency responsible for regulating food, dietary supplements, drugs, cosmetics, medical devices, biologics and blood products in the United States. ... Publication bias, also called the positive outcome bias, is typically the tendency for researchers to publish experimental results that have a positive result (found something), while consequently not publishing findings which have a negative result (found that something did not happen). ...

Clinical guidelines

The American Psychiatric Association 2000 Practice Guideline for the Treatment of Patients with Major Depressive Disorder [15] indicates that, if preferred by the patient, antidepressant medications may be provided as an initial primary treatment for mild major depressive disorder; antidepressant medications should be provided for moderate to severe major depressive disorder unless electroconvulsive therapy is planned; and a combination of antipsychotic and antidepressant medications or electroconvulsive therapy should be used for psychotic depression. It states that efficacy is generally comparable between classes and within classes and that the initial selection will largely be based on the anticipated side effects for an individual patient, patient preference, quantity and quality of clinical trial data regarding the medication, and its cost. Due to the epidemic of medical errors, readers are cautioned to be aware that the American Psychiatric Association isnt immune to this. ... Electroconvulsive therapy (ECT), also known as electroshock, is a controversial psychiatric treatment in which seizures are induced with electricity for therapeutic effect. ...


The UK National Institute for Clinical Excellence (NICE) 2004 guidelines indicate that antidepressants should not be used for the initial treatment of mild depression, because the risk-benefit ratio is poor; that for moderate or severe depression an SSRI is more likely to be tolerated than a tricyclic; and that antidepressants for severe depression should be combined with a psychological treatment such as Cognitive Behavioural Therapy. [16] The National Institute for Controlling Expenditure or NICE is an agency of the National Health Service in the United Kingdom. ... Cognitive therapy or cognitive behavior therapy is a kind of psychotherapy used to treat depression, anxiety disorders, phobias, and other forms of psychological disorder. ...


Efficacy limitations and strategies

Between 30% and 50% of individuals treated with a given antidepressant do not show a response.[70][71] Even where there has been a robust response, significant continuing depression and dysfunction is common, with relapse rates 3 to 6 times higher in such cases.[72] In addition, antidepressant drugs tend to lose efficacy over the course of treatment[73] A number of strategies are used in clinical practice to try to overcome these limits and variations.[74]


"Trial and error" switching

The American Psychiatric Association 2000 Practice Guideline advises that where no response is achieved following six to eight weeks of treatment with an antidepressant, to switch to an antidepressant in the same class, then to a different class of antidepressant. Due to the epidemic of medical errors, readers are cautioned to be aware that the American Psychiatric Association isnt immune to this. ...


A recent meta-analysis review found wide variation in the findings of prior studies; for patients who had failed to respond to an SSRI antidepressant, between 12% and 86% showed a response to a new drug, with between 5% and 39% ending treatment due to adverse effects. The more antidepressants an individual had already tried, the less likely they were to benefit from a new antidepressant trial.[71]


Augmentation and combination

For a partial response, the American Psychiatric Association guidelines advise adding a different kind of pharmaceutical agent to the antidepressant. Studies suggest that most patients fail to achieve remission on a given antidepressant, and augmentation strategies used in clinical practice include the use of lithium and thyroid augmentation, but there is not a good evidence base for these practices or for more novel strategies such as the use of selective dopamine agonists, sex steroids, NRI's, glucocorticoid-specific agents, or the newer anticonvulsants[75] This article is about the chemical element named Lithium. ... A dopamine agonist is a compound that activates dopamine receptors, mimicking the effect of the neurotransmitter dopamine. ... A sex steroid is a steroid hormone which interacts with vertebrate androgen or estrogen receptors. ... Norepinephrine reuptake inhibitors (NRIs) are compounds that increase amounts of the neurotransmitter norepinephrine in the brain by inhibiting its reuptake at synapses. ... Glucocorticoids are a class of steroid hormones characterised by an ability to bind with the cortisol receptor and trigger similar effects. ... The anticonvulsants, sometimes also called antiepileptics, belong to a diverse group of pharmaceuticals used in prevention of the occurrence of epileptic seizures. ...


A combination strategy involves adding one or more additional antidepressants, usually from different classes so as to have a diverse neurochemical effect. Although this may be used in clinical practice, there is little evidence for the relative efficacy or adverse effects of this strategy.[76]


Long-term use

The therapeutic effects of antidepressants typically do not continue once the course of medication ends, resulting in a high rate of relapse. A recent meta-analysis of 31 placebo-controlled antidepressant trials, mostly limited to studies covering a period of one year, found that 18% of patients who had responded to an antidepressant relapsed while still taking it, compared to 41% whose antidepressant was switched for a placebo.[77] The American Psychiatric Association guidelines advise four to five months of continuation treatment on an antidepressant following the resolution of symptoms. For patients with a history of depressive episodes, the British Association for Psychopharmacology's 2000 Guidelines for Treating Depressive Disorders with Antidepressants advise remaining on an antidepressant for at least six months and as long as five years or indefinitely.


Whether or not someone relapses after stopping an antidepressant does not appear to be related to the duration of prior treatment, however, and gradual loss of therapeutic benefit during the course also occurs. A strategy involving the use of pharmacotherapy in the treatment of the acute episode, followed by psychotherapy in its residual phase, has been suggested by some studies.[78][79]


Medication failure

Approximately 30% of patients have remission of depression with medications.[80] For patients with inadequate response, either adding sustained-release bupropion (initially 200 mg per day then increase by 100 mg up to total of 400 mg per day) or buspirone (up to 60 mg per day) for augmentation as a second drug can cause remission in approximately 30% of patients,[81] while switching medications can achieve remission in about 25% of patients.[82] Bupropion (INN; also amfebutamone,[1] brand names Wellbutrin, Zyban, Budeprion and Buproban) is an atypical antidepressant, which acts as a norepinephrine reuptake inhibitor and dopamine reuptake inhibitor,[2] and a nicotinic antagonist. ... Buspirone (brand-names Ansial, Ansiced, Anxiron, Axoren, Bespar, BuSpar, Buspimen, Buspinol, Buspisal, Narol, Spitomin, Sorbon) is an anxiolytic agent and a serotonin receptor agonist belonging to the azaspirodecanedione class of compounds. ...


By pregnancy

There is uncertainty whether pregnancy contributes to medication failure, because the only report so far has drawn much controversy on itself:


In 2006, a widely reported study published in the Journal of the American Medical Association (JAMA) challenged the common assumption that hormonal changes during pregnancy protected expectant mothers against depression, finding that discontinuing anti-depressive medication during pregnancy led to more frequent relapse.[83] The JAMA article did not disclose that several authors had financial ties to pharmaceutical companies making antidepressants. The JAMA later published a correction noting the ties[84] and the authors maintain that the ties have no bearing on their research work. Obstetrician and perinatologist Adam Urato told the Wall Street Journal that patients and medical professionals need advice free of industry influence.[85] JAMA, published continuously since in 1883, is an international peer-reviewed general medical journal published 48 times per year. ... The Wall Street Journal is an influential international daily newspaper published in New York City, New York with an average daily circulation of 1,800,607 (2002). ...


Tolerance and dependence

Most antidepressants, including the SSRIs and tricyclics, are known to produce tolerance (i.e. a decrease in the effects of a drug over time), and withdrawal (particularly if abrupt) may produce adverse effects, which can range from mild to extremely severe. Drug tolerance occurs when a subjects reaction to a drug (such as a painkiller or intoxicant) decreases so that larger doses are required to achieve the same effect. ... Withdrawal, also known as withdrawal syndrome, refers to the characteristic signs and symptoms that appear when a drug that causes physical dependence is regularly used for a long time and then suddenly discontinued or decreased in dosage. ...


Antidepressants do not seem to have all of the same addictive qualities as other substances such as nicotine, caffeine, cocaine, or other stimulants - in other words, while antidepressants may cause dependence and withdrawal they do not seem to cause uncontrollable urges to increase the dose due to euphoria or pleasure, and thus do not meet the strict definition of an addictive substance. However, antidepressants do meet the World Health Organisation definition of "dependency-inducing", and indeed the SSRIs are listed by the organisation as among the most strongly dependency-inducing substances in existence.[citation needed] Heroin bottle An addiction is a recurring compulsion by an individual to engage in some specific activity, despite harmful consequences to the individuals health, mental state or social life. ... This article is about the chemical compound. ... Caffeine is a xanthine alkaloid compound that acts as a stimulant in humans. ... Cocaine is a crystalline tropane alkaloid that is obtained from the leaves of the coca plant. ... Stimulants are drugs that temporarily increase alertness and wakefulness. ... Euphoria (Greek ) is a medically recognized emotional state related to happiness. ... Look up Pleasure in Wiktionary, the free dictionary. ... For other meanings of the acronym WHO, see WHO (disambiguation) WHO flag Headquartered in Geneva, Switzerland, the World Health Organization (WHO) is an agency of the United Nations, acting as a coordinating authority on international public health. ...


If an SSRI medication is suddenly discontinued, it may produce both somatic and psychological withdrawal symptoms, a phenomenon known as "SSRI discontinuation syndrome" (Tamam & Ozpoyraz, 2002). When the decision is made to stop taking antidepressants it is common practice to "wean" off of them by slowly decreasing the dose over a period of several weeks or months, although often this will reduce the severity of the discontinuation reaction, rather than prevent it. Most cases of discontinuation syndrome last between one and four weeks, though there are examples of patients (especially those who have used the drugs for longer periods of time, or at a higher dose) experiencing adverse effects such as impaired concentration, poor short-term memory, elevated anxiety and sexual dysfunction, for months or even years after discontinuation.[citation needed] SSRI redirects here; for other uses, see SSRI (disambiguation). ... Withdrawal, also known as withdrawal syndrome, refers to the characteristic signs and symptoms that appear when a drug that causes physical dependence is regularly used for a long time and then suddenly discontinued or decreased in dosage. ... Heroin bottle An addiction is a recurring compulsion by an individual to engage in some specific activity, despite harmful consequences to the individuals health, mental state or social life. ... SSRI discontinuation syndrome, also known as SSRI withdrawal syndrome or SSRI cessation syndrome, is a condition that can occur during or following the interruption, lowering of dose or discontinuation of regular SSRI or SNRI antidepressant drug usage. ...


It is generally not a good idea to take antidepressants without a prescription. The selection of an antidepressant and dosage suitable for a certain case and a certain person is a lengthy and complicated process, requiring the knowledge of a professional. Certain antidepressants can initially make depression worse, can induce anxiety, or can make a patient aggressive, dysphoric or acutely suicidal. In certain cases, an antidepressant can induce a switch from depression to mania or hypomania, can accelerate and shorten a manic cycle (i.e. promote a rapid-cycling pattern), or can induce the development of psychosis (or just the re-activation of latent psychosis) in a patient with depression who was not psychotic before the antidepressant. Anxiety is a physiological state characterized by cognitive, somatic, emotional, and behavioral components (Seligman, Walker & Rosenhan, 2001). ... Suicide (from Latin sui caedere, to kill oneself) is the act of willfully ending ones own life. ... This article is an expansion of a section entitled Mania from within the main article Bipolar disorder. ... Hypomania is a mood state characterized by persistent and pervasive elated or irritable mood, and thoughts and behaviors that are consistent with such a mood state. ... For other uses, see Psychosis (disambiguation). ...


Side effects

Antidepressants can often cause side effects, and an inability to tolerate these is the most common cause of discontinuing an otherwise working medication. An adverse drug reaction (abbreviated ADR) is a term to describe the unwanted, negative consequences sometimes associated with the use of medications. ...


Side effects of SSRIs: Nausea, diarrhea, headaches. Sexual side effects are also common with SSRIs, such as loss of libido, failure to reach orgasm and erectile problems. Serotonin syndrome is also a worrying condition associated with the use of SSRIs. The Food and Drug Administration has included Black Box warnings on all SSRIs stating how they double suicidality (from 2 in 1,000 to 4 in 1,000) in children and adolescents who are prescribed these drugs.[citation needed] For other uses, see Nausea (disambiguation). ... Diarrhea, also spelled diarrhoea (see spelling differences), is a condition in which the sufferer has frequent watery, loose bowel movements (from the Greek word διάρροια; literally meaning through-flowing). Acute infectious diarrhea is a common cause of death in developing countries (particularly among infants), accounting for 5 to 8 million deaths... A headache (cephalgia in medical terminology) is a condition of pain in the head; sometimes neck or upper back pain may also be interpreted as a headache. ... For other uses, see Libido (disambiguation). ... // An orgasm (sexual climax) is the conclusion of the plateau phase of the sexual response cycle, and is experienced by both males and females. ... Erectile dysfunction (ED) or impotence is a sexual dysfunction characterized by the inability to develop or maintain an erection of the penis. ... Serotonin syndrome is a rare, but potentially life-threatening adverse drug reaction that results from intentional self-poisoning, therapeutic drug use, or inadvertent interactions between drugs. ...


Side effects of TCAs (tricyclic antidepressants): Fairly common side effects include dry mouth, blurred vision, drowsiness, dizziness, tremors, sexual problems, skin rash, and weight gain or loss. Xerostomia is the medical term for a dry mouth due to a lack of saliva. ... Somnolence (or drowsiness, or hypersomnia) is a state of near-sleep, a strong desire for sleep, or sleeping unusually long periods. ... // Pre-syncope is a sensation of feeling faint. ... For the manga by Tsukasa Hôjô, see Rash. ...


Side effects of MAOIs (monoamine oxidase inhibitors): Rare side effects of MAOIs like phenelzine (brand name: Nardil) and tranylcypromine (brand name: Parnate) include liver inflammation, heart attack, stroke, and seizures.Serotonin syndrome is a side effect of MAOIs and SSRIs when they are combined. Phenelzine (brand name Nardil) is an antidepressant drug that belongs to the monoamine oxidase inhibitor (MAOI) class of drugs. ... Tranylcypromine (sold under the brand name Parnate®) is a monoamine oxidase inhibitor (MAOI) used as an antidepressant drug. ... Hepatitis (plural hepatitides) implies injury to liver characterised by presence of inflammatory cells in the liver tissue. ... Heart attack redirects here. ... For other uses, see Stroke (disambiguation). ... This article is about the medical condition. ... Serotonin syndrome is a rare, but potentially life-threatening adverse drug reaction that results from intentional self-poisoning, therapeutic drug use, or inadvertent interactions between drugs. ...


General

Although recent drugs may have fewer side effects, patients sometimes report severe side effects associated with their discontinuation, particularly with paroxetine and venlafaxine[citation needed]. Additionally, a certain percentage of patients do not respond to antidepressant drugs. Another advantage of some newer antidepressants is they can show effects within as few as five days, whereas most take four to six weeks to show a change in mood. However, some studies show that these medications might be even more likely to result in moderate to severe sexual dysfunction. However, there are medications in trials that appear to show an improved profile in regard to sexual dysfunction and other key side effects. Paroxetine (Paxil, Seroxat, Pexeva) is a selective serotonin reuptake inhibitor (SSRI) antidepressant. ... Venlafaxine (Effexor) is an antidepressant of the serotonin-norepinephrine reuptake inhibitor (SNRI) class first introduced by Wyeth in 1993. ...


MAO inhibitors can produce a potentially lethal hypertensive reaction if taken with foods that contain high levels of tyramine, such as mature cheese, cured meats or yeast extracts. Likewise, lethal reactions to both prescription and over the counter medications have occurred. Any patient currently undergoing therapy with an MAO inhibiting medication should be monitored closely by the prescribing physician and always consulted before taking an over the counter or prescribed medication. Such patients should also inform emergency room personnel and information should be kept with one's identification indicating the fact that the holder is on MAO inhibiting medications. Some doctors even suggest the use of a medical alert ID bracelet. Although the reactions in question are dramatic when they happen, the total number of deaths due to interactions and dietary concerns are comparable to over-the-counter medications. In organic chemistry tyramine (4-hydroxy-phenethylamine, para-tyramine, p-tyramine) is a monoamine compound derived from the amino acid tyrosine. ...


Antidepressants should be used with great care, usually in conjunction with mood stabilisers, in the treatment of bipolar disorder, as they can exacerbate symptoms of mania. They have also been known to trigger mania or hypomania in some patients with bipolar disorder and in a small percentage of patients with depression.[17] SSRIs are the antidepressants most frequently associated with this side effect. A mood stabilizer is a psychiatric medication used in the treatment of bipolar disorder to suppress swings between mania and depression. ... For other uses, see Bipolar. ... This article is an expansion of a section entitled Mania from within the main article Bipolar disorder. ... This article is an expansion of a section entitled Mania from within the main article Bipolar disorder. ... Hypomania is a mood state characterized by persistent and pervasive elated or irritable mood, and thoughts and behaviors that are consistent with such a mood state. ...


In particular, it has been noted that the most dangerous period for suicide in a patient with depression is immediately after treatment has commenced, as antidepressants may reduce the symptoms of depression such as psychomotor retardation or lack of motivation before mood starts to improve. Although this appears to be a paradox, studies indicate the suicidal ideation is a relatively common component of the initial phases of antidepressant therapy, and it may be even more prevalent in younger patients such as pre-adolescents and teenagers. It is strongly recommended that other family members and loved ones monitor the young patient's behavior, especially in the first eight weeks of therapy, for any signs of suicidal ideation or behaviors. For other uses, see Suicide (disambiguation). ... Psychomotor retardation comprises a slowing down of thought and a reduction of physical movements in a person. ...


Until the black box warnings on these drugs were issued by FDA as well as by agencies in other nations, side effects and alerting families to risk were largely ignored and downplayed by manufacturers and practitioners. This may have resulted in some deaths by suicide although direct proof for such a link is largely anecdotal. The higher incidence of suicide ideation reported in a number of studies has drawn attention and caution in how these drugs are used.


People under the age of 24 who suffer from depression are warned that the use of antidepressants could increase the risk of suicidal thoughts and behaviour. Federal health officials unveiled Proposed changes to the labels on antidepressant drugs in December 2006 to warn people of the inherent danger.


On September 6, 2007, the Centers for Disease Control and Prevention reported suicide rate in American adolescents (especially girls, 10 to 24 years old) increased 8% (2003 to 2004), the largest jump in 15 years.[86] Specifically, in 2004 - 4,599 suicides in Americans ages 10 to 24, up from 4,232 in 2003, for a rate of 7.32 per 100,000 people that age. Before, the rate dropped to 6.78 per 100,000 in 2003 from 9.48 per 100,000 in 1990. The findings also reinforced the fact that antidepressant drugs reduce suicide risk. Psychiatrists found that the increase is due to the decline in prescriptions of antidepressant drugs like Prozac to young people since 2003, leaving more cases of serious depression untreated. In a December 2006 study, The American Journal of Psychiatry said that a decrease in antidepressant prescriptions to minors of just a few percentage points coincided with a 14 percent increase in suicides in the United States; in the Netherlands, the suicide rate was 50% up, upon prescription drop.[87] The critics of this study contend that the US "2004 suicide figures were compared simplistically with the previous year, rather than examining the change in trends over several years".[88] The pitfalls of such attempts to infer a trend using just two data points (years 2003 and 2004) are further demonstrated by the fact that, according to the new epidemiological data, the suicide rate in 2005 in children and adolescents actually declined despite the continuing decrease of SSRI prescriptions. "It is risky to draw conclusions from limited ecologic analyses of isolated year-to-year fluctuations in antidepressant prescriptions and suicides. One promising epidemiological approach involves examining the associations between trends in psychotropic medication use and suicide over time across a large number of small geographic regions. Until the results of more detailed analyses are known, prudence dictates deferring judgment concerning the public health effects of the FDA warnings."[89][90] Subsequest follow-up studies have supported the hypothesis that antidepressant drugs reduce suicide risk.[91] [92] However, the conclusion that societal suicide rate decreases are due to antidepressant prescription is extraordinarily dubious given the plethora of confounding variables. The Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia, is recognized as the leading United States agency for protecting the public health and safety of people. ... For other uses, see Suicide (disambiguation). ... The Adolescents were a punk band in the 1980s. ... Plural of Girl. ... Look up prescription in Wiktionary, the free dictionary. ... Many drugs are provided in tablet form. ... On the Threshold of Eternity. ... The American Journal of Psychiatry (AJP) is the most widely read psychiatric journal in the world. ...


Sexual

Sexual dysfunction is a very common side effect, especially with SSRIs. Common sexual side effects include problems with libido (sexual desire), lack of interest in sex, and anorgasmia (trouble achieving orgasm). [18] Although usually reversible, these sexual side effects can, in rare cases, last for months or years after the drug has been completely withdrawn. This disorder is known as Post SSRI Sexual Dysfunction. Sexual dysfunction or sexual malfunction (see also sexual function) is difficulty during any stage of the sexual act (which includes desire, arousal, orgasm, and resolution) that prevents the individual or couple from enjoying sexual activity. ... SSRI redirects here; for other uses, see SSRI (disambiguation). ... For other uses, see Libido (disambiguation). ... Anorgasmia (also known as Retarded Ejaculation in males) is a form of sexual dysfunction, sometimes classified as a psychiatric disorder, where the patient cannot achieve orgasm, even with adequate stimulation. ... Post SSRI Sexual Dysfunction (PSSD) is a type of sexual dysfunction caused by the previous use of SSRI antidepressants. ...


Bupropion, a dual reuptake inhibitor (NE and DA), in many cases results in a moderately increased libido, due to increased dopamine activity. This effect is also seen with dopamine reuptake inhibitors, CNS stimulants and dopamine agonists, and is due to increases in testosterone production (due to inhibition of prolactin) and increased nitric oxide synthesis. Apomorphine, nefazodone and nitroglycerin have been shown to reverse some sexual dysfunction via increased nitric oxide activity. MAOIs are reported to have fewer negative effects on sexual function and libido, particularly moclobemide at a 1.9% rate of occurrence. Betanechol has been reported to reverse MAOI-induced sexual dysfunction via its cholinergic agonist properties (Gross 1982). Bupropion (INN; also amfebutamone,[1] brand names Wellbutrin, Zyban, Budeprion and Buproban) is an atypical antidepressant, which acts as a norepinephrine reuptake inhibitor and dopamine reuptake inhibitor,[2] and a nicotinic antagonist. ... Apomorphine is a type of dopaminergic agonist, a morphine derivative. ... Nefazodone hydrochloride (trade name Serzone) is an antidepressant drug marketed by Bristol-Myers Squibb. ... Nitroglycerin (NG), also known as nitroglycerine, trinitroglycerin, and glyceryl trinitrate, is a chemical compound. ... Monoamine oxidase inhibitors (MAOIs) are a class of antidepressant drugs prescribed for the treatment of depression. ... Moclobemide (sold as Aurorix®, Manerix®) is a psychiatric drug primarily used to treat depression and social anxiety. ...


In order for the physician to select the appropriate response, the patient should provide the physician with information to distinguish between reduced libido (little or no desire for sex), reduced sexual function (impotence, vaginal dryness) and anorgasmia, as these have separate causes and prompt different treatment. Impotence or, more clinically, erectile dysfunction is the inability to develop or maintain an erection of the penis for satisfactory sexual intercourse regardless of the capability of ejaculation. ... Anorgasmia (also known as Retarded Ejaculation in males) is a form of sexual dysfunction, sometimes classified as a psychiatric disorder, where the patient cannot achieve orgasm, even with adequate stimulation. ...


Thymoanesthesia

Closely related to sexual side effects is the phenomenon of emotional blunting, or mood anesthesia. Many users of SSRIs complain of apathy, lack of motivation, emotional numbness, feelings of detachment, and indifference to surroundings. They may describe this as a feeling of "not caring about anything anymore." All SSRIs, SNRIs, and serotonergic TCAs are liable to cause this effect to varying degrees, especially at higher dosages.


REM Sleep

It is well recognized that virtually all major antidepressant drugs but trimipramine suppress REM sleep and it has, in fact, been proposed that the clinical efficacy of these drugs largely derives from their suppressant effects on REM sleep. The three major classes of antidepressant drugs, monoamine oxidase inhibitors (MAOIs), tricyclic antidepressants (TCAs) and selective serotonin reuptake inhibitors (SSRIs), profoundly suppress REM sleep.[19] The MAOIs virtually completely abolish REM sleep, while the TCAs and SSRIs have been shown to produce immediate (40-85%) and sustained (30-50%) reductions in REM sleep. Abrupt discontinuation of MAOIs can cause a temporary phenomenon known as "REM rebound" in which the patient experiences extremely vivid dreams and nightmares. Rapid eye movement (REM) is the stage of sleep during which the most vivid (though not all) dreams occur. ...


Weight Gain

Many antidepressants in all categories are associated with weight gain usually in the range of 10-50 pounds but not uncommonly upwards of 100 pounds. The specific cause is unknown, but it is known that antidepressants are associated with increased cravings (usually for high fat carbohydrates), an inability to feel full despite ingestion of adequate calories, low energy levels and increased daytime sleepiness which can lead to overeating and a lack of desire to exercise, and dry mouth which can lead to ingestion of calorie-laden beverages. Eating low fat, low protein carbohydrate snacks and carbohydrate-rich dinners allows the brain to make serotonin which then controls appetite and balances mood. Carbohydrates thus eaten, as part of a balanced diet, by virtue of their effect on brain serotonin levels, thus support weight loss in the setting of antidepressant weight gain.[93][94]


Controversy

Several studies have stimulated doubt about the effectiveness of antidepressants. A 2002 study cited that the difference between antidepressants and placebo is close to negligible.[95]


The paper in question has been severely criticized by independent researchers, however. One reason for this is that it deals almost exclusively with the SSRI class of medication. In leveling criticism against the efficacy of SSRIs, critics state, it is not the best paper, merely the most widely known one. Also, other classes of antidepressants have demonstrated superior efficacy, and it has been argued that this paper is "throwing the baby out with the bathwater", while its thrust should in fact be leveled at the serotonin hypothesis of depression.


Furthermore, not all patients necessarily respond to a given medication, studies do not always address dosage versus drug-placebo differences for those who do. Data submitted to the FDA can also underestimate how a drug will perform in clinic practice, as studies sometimes are designed as much for marketing purposes as they are to estimate the magnitude of a medication's effects.[96]


Through a Freedom of Information Act request, two psychologists obtained 47 studies used by the FDA for approval of the six antidepressants prescribed most widely between 1987-99. Overall, antidepressant pills worked 18% better than placebos, a statistically significant difference, "but not meaningful for people in clinical settings", says University of Connecticut psychologist Irving Kirsch. He and co-author Thomas Moore released their findings in "Prevention and Treatment", an e-journal of the American Psychological Association.[20] Nearly sixty countries around the world have implemented some form of freedom of information legislation, which sets rules on governmental secrecy. ...


More than half of the 47 studies found that patients on antidepressants improved no more than those on placebos, Kirsch says. "They should have told the American public about this. The drugs have been touted as much more effective than they are." He says studies finding no benefit have been mentioned only on labeling for Celexa, the most recently approved drug. The others included in his evaluation: Prozac, Paxil, Zoloft, Effexor and Serzone.[citation needed] Citalopram (nitalapram, CelexaTM, CipramilTM) is a medication that acts as a selective serotonin reuptake inhibitor or SSRI. It is typically used as an antidepressant to treat the depression associated with mood disorders although also may be used in the treatment of body dysmorphic disorder and anxiety. ... Background Fluoxetine hydrochloride (brand names include Prozac®, Symbyax® (compounded with olanzapine), Sarafem®, Fontex® (Sweden), Fluctine (Austria, Germany), Prodep (India), Fludac (India)) is an antidepressant drug used medically in the treatment of depression, obsessive-compulsive disorder, bulimia nervosa, premenstrual dysphoric disorder, and many other disorders. ... Paroxetine (paroxetine hydrochloride; trade names Paxil® (United States), Seroxat® (UK), Aropax® (Australia)) is an antidepressant of the selective serotonin reuptake inhibitor (SSRI) type. ... Sertraline hydrochloride (Zoloft®, Lustral®, Apo-Sertral®, Asentra®, Gladem®, Serlift®, Stimuloton®) is an orally administered antidepressant of the selective serotonin reuptake inhibitor (SSRI) type. ... Venlafaxine hydrochloride is a prescription antidepressant first introduced by Wyeth in 1993, and marketed under the tradename Effexor®. It is used primarily for the treatment of depression, generalized anxiety disorder, and social anxiety disorder in adults. ... Serzone is an antidepressant drug formerly marketed by Bristol-Myers Squibb. ...


Dr Joseph Glenmullen, a Harvard psychiatrist, has written a book on the subject for the layperson; see link below.


In 2005, anti-depressants became the most prescribed drug in the United States, causing more debate over the issue. Some doctors believe this is a positive sign that people are finally seeking help for their issues. Others disagree, saying that this shows that people are becoming too dependent on anti-depressants. [21]


Lawsuits

In many cases SSRI drug manufacturers have withheld information from the FDA and the public to play down the risks and adverse effects associated with SSRIs. This had led to litigation against many of the pharmaceutical manufacturers of SSRI anti-depressants in cases covering suicidality, SSRI withdrawal and birth defects in neonates from nursing mothers on SSRIs.


In one of the only three cases to ever go to trial for SSRI indication in suicide, Eli Lilly was caught corrupting the judicial process by making a deal with the plaintiff's attorney to throw the case, in part by not disclosing damaging evidence to the jury. The case, known as the Fentress Case involved a Kentucky man, Joseph Wesbecker, on Prozac, who went to his workplace and opened fire with an assault rifle killing 8 people (including Fentress), and injuring 12 others before turning the gun on himself. The jury returned a 9-to-3 verdict in favor of Lilly. The judge, in the end, took the matter to the Kentucky Supreme Court, which found that "there was a serious lack of candor with the trial court and there may have been deception, bad faith conduct, abuse of judicial process and, perhaps even fraud." The judge later revoked the verdict and instead, recorded the case as settled. The value of the secret settlement deal has never been disclosed, but was reportedly "tremendous".[97] One of the worlds largest corporations, Eli Lilly and Company (NYSE: LLY) is a global pharmaceutical company with headquarters in Indianapolis,Indiana, USA. A Fortune 500 corporation, the company had revenues of $12. ... Joseph Wesbecker (1942 - September 14, 1989) was a mentally disturbed American spree killer. ...


On December 22, 2006, a US court decided in Hoorman, et al. v. SmithKline Beecham Corp. that individuals who purchased Paxil(R) or Paxil CR(TM) (paroxetine) for a minor child may be eligible for benefits under a $63.8 million Proposed Settlement. The lawsuit won the claim that pharmaceutical maker GlaxoSmithKline (GSK) promoted Paxil(R) or Paxil CR(TM) for prescription to children and adolescents while withholding and concealing material information about the medication's safety and effectiveness for minors.[98] GlaxoSmithKline plc (LSE: GSK NYSE: GSK) is a British based pharmaceutical, biological, and healthcare company. ...


The lawsuit stemmed from a consumer advocate protest against Paroxetine manufacturer GSK. Since the FDA approved paroxetine in 1992, approximately 5,000 U.S. citizens – and thousands more worldwide – have sued GSK. Most of these people feel they were not sufficiently warned in advance of the drug's side effects and addictive properties.


According to the Paxil Protest website, hundreds more lawsuits have been filed against GSK.[99] The Paxil Protest website was launched August 8, 2005 to offer both information about the protest and information on Paxil previously unavailable to the public. Just three weeks after its launch, the site received more than a quarter of a million hits. is the 220th day of the year (221st in leap years) in the Gregorian calendar. ... Year 2005 (MMV) was a common year starting on Saturday (link displays full calendar) of the Gregorian calendar. ...


The original Paxil Protest website is no longer available. It is understood that the action to remove the site from the internet was undertaken as part of a confidentiality agreement or 'gagging order' which the owner of the site entered into as part of a settlement of his action against GlaxoSmithKline. (However, in March 2007, the website Seroxat Secrets [22]discovered that an archive of Paxil Protest site [23]was still available on the internet via Archive.org) Gagging orders are common in such cases and can extend to documents that defendants wish to remain hidden from the public. However, in some cases, such documents can become public at a later date, such as those made public by Peter Breggin in February 2006. A press release from Dr. Breggin can be seen here: [24] Gagging Order is a song by the British music group Radiohead. ...


In January 2007, according to the Seroxat Secrets website, [25], the national group litigation in the United Kingdom, on behalf of several hundred people who allege withdrawal reactions through their use of the drug Seroxat, against GlaxoSmithKline plc, moved a step closer to the High Court in London, with the confirmation that Public Funding had been reinstated following a decision by the Public Interest Appeal Panel. The issue at the heart of this particular action claims Seroxat is a defective drug in that it has a propensity to cause a withdrawal reaction. Hugh James Solicitors confirm this news on their website [26] This article is about the capital of England and the United Kingdom. ...


On January 29, 2007, the BBC in the UK aired a fourth documentary in its 'Panorama' [27] series about the controversial drug Seroxat. This programme, entitled Secrets of the Drug Trials, focuses on three GSK paediatric clinical trials on depressed children and adolescents. The documentary claims Seroxat could not be proven to work for teenagers, and that one clinical trial indicated they were six times more likely to become suicidal after taking it.[citation needed] is the 29th day of the year in the Gregorian calendar. ... Year 2007 (MMVII) is the current year, a common year starting on Monday of the Gregorian calendar and the AD/CE era in the 21st century. ...


Non-mainstream treatments

There are numerous alternative treatments for depression, whether medications or other kinds of intervention.


Opiates

Various Opiates were commonly used as antidepressants until the mid-1950s, when they fell out of favor with medical orthodoxy due to their addictive nature, tolerance buildup issues and their side-effect profile. Today the use of opioids in treating depression is a large taboo in the medical field due to associations with drug abuse; hence, research has proceeded at a very slow rate. A small clinical trial conducted at Harvard Medical School in 1995[28], demonstrated that a majority of treatment-refractory, unipolar, non-psychotic, major depression patients could be successfully treated with an opioid medication called Buprenorphine, which is a partial mu agonist and potent kappa antagonist. The exact mechanism of its action in depression is not known, as kappa (κ) antagonists are antidepressants in their own right. An opioid is any agent that binds to opioid receptors found principally in the central nervous system and gastrointestinal tract. ... In health care, including medicine, a clinical trial (synonyms: clinical studies, research protocols, medical research) is a process in which a medicine or other medical treatment is tested for its safety and effectiveness, often in comparison to existing treatments. ... Harvard Medical School (HMS) is one of the graduate schools of Harvard University. ... Psychosis is a psychiatric classification for a mental state in which the perception of reality is distorted. ... Buprenorphine, is an opioid drug with partial agonist and antagonist actions. ... For other uses, see Kappa (disambiguation). ...


In 2006, The Journal of European Neuropsychopharmacology published a follow-up study to the 1995 Harvard experiment, with results very consistent with the original Harvard findings. Eleven severely depressed patients, refractory to all the conventional depression treatments, were given small doses of buprenorphine. Most of these patients found the buprenorphine to be of significant benefit in relieving their inner torment. The researchers theorized that "Possibly, the response to opiates describes a special subtype of depressive disorders e.g corresponding to a dysregulation of the endogenous opioid system and not of the monaminergic system." [29]


Yet another relevant scientific paper was published in the American Journal of Psychiatry in 1999, detailing how researchers found Oxycodone/Oxymorphone to help 5 out of 6 'incurable' refractory severe depression patients. [30] Not to be confused with oxytocin. ... Oxymorphone (Opana, Numorphan) or 14-Hydroxydihydromorphinone is a powerful semi-synthetic opioid analgesic that is derived from thebaine, and is approximately 6–8 times more potent than morphine. ...


While opioids have been proven to substantially relieve symptoms of depression for a large class of patients, re-acceptance of this fact has been severely hampered by governmental narcotic prohibition efforts, and the (until buprenorphine) lack of alternatives with low risk of tolerance and addiction. Buprenorphine is generally preferred as the first-line opiate in depression treatment, as managing the tolerance buildup of other opiates can be complicated. For the general concept, see Prohibitionism. ... Buprenorphine, is an opioid drug with partial agonist and antagonist actions. ...


Other treatments

  • Gamma-Hydroxybutyric acid (GHB) has been used by some as an antidepressant. Claude Rifat, a French biologist, conducted some early research into GHB's antidepressant potential. Rifat noted that GHB did not cause the emotional blunting effects caused by conventional antidepressants, but instead intensified pleasurable and rewarding feelings in the user while powerfully suppressing depression.[31] However, GHB has now been outlawed, except for use as a prescription treatment for narcolepsy.
  • Clinical trials have shown the effect of acupuncture to be comparable with amitriptyline; in addition, specifically Electroacupuncture has been found to be more effective in depressive patients with decreased excretion of 3-methyl-4-hydroxy-phenylglycol (the principal metabolite of the central neurotransmitter norepinephrine), while amitriptyline is more effective for those with inhibition in the dexamethasone suppression test.[100] Acupuncture has also been proven to prompt the body to produce greater levels of endorphins.[101]
  • Most studies conclude that St. John's wort is usually as effective against depressions as other modern medication, again with fewer side effects, and it is widely prescribed for depression in Europe. A recent study showed St. John's wort to be no more effective than a placebo in cases of severe depression, although an SSRI was also no more effective on the primary outcome measure.[102]
  • The amino acid derivative SAM-e has been studied in recent years[103][104]
  • Tryptophan dietary supplements, although banned in many countries due to impurities that caused a blood disease, have also been used as natural antidepressants.[citation needed] Dietary supplements of 5-HTP, a chemical the body forms from tryptophan and uses to make serotonin, have shown some promising research results but need further study.
  • NMDA antagonists such as ketamine and dextromethorphan have recently gained some interest in this field as their apparent ability to reverse opioid tolerance, and can give fast-acting dramatic effects. However, their acute psychoactive effects have been a problem.[105]
  • Memantine, a moderate affinity NMDA antagonist, has been used to avoid tolerance buildup, and has seen use in opioid tolerance reversal. Proglumide is used to induce acute reversal of tolerance prior to this maintenance strategy; it does not work by itself in the long term, due to tolerance to its effects.
  • Opiorphin is a very recently discovered substance that increases the effectiveness of endorphins, meaning that it has effects similar to opioid agonists without the addiction and withdrawal effects. While it has been shown to be extremely effective for analgesia, any ability to treat depression or the presence of an abuse potential are largely informed guesswork at this stage.

Gamma-Hydroxybutyric acid (4-hydroxybutanoic acid, C4H8O3), commonly abbreviated GHB, is a neuroprotective therapeutic drug that is illegal in a number of countries[1], and is a naturally-occurring substance found in the central nervous system, wine, beef, small citrus fruits, and almost all living creatures in small amounts. ... Gamma-Hydroxybutyric acid (4-hydroxybutanoic acid, C4H8O3), commonly abbreviated GHB, is a neuroprotective therapeutic drug that is illegal in a number of countries[1], and is a naturally-occurring substance found in the central nervous system, wine, beef, small citrus fruits, and almost all living creatures in small amounts. ... Claude Rifat (died July 31, 2002) was a french biologist, psychonaut, political activist, writer, and researcher. ... For other uses, see Narcolepsy (disambiguation). ... Acupuncture chart from Hua Shou (fl. ... Electroacupuncture is a form of acupuncture in which acupuncture needles are attached to a device that generates continuous electric pulses, generating a small electric current that flows between pairs of needles. ... Endorphins are endogenous opioid biochemical compounds. ... Binomial name Hypericum perforatum Linnaeus, St Johns wort used alone refers to the species Hypericum perforatum, also known as Klamath weed or Goat weed, but is used with qualifiers to refer to any species of the genus Hypericum. ... This article does not cite its references or sources. ... Tryptophan (abbreviated as Trp or W)[1] is one of the 20 standard amino acids, which are the building blocks of proteins, and an essential amino acid in the human diet. ... 5-HTP (5-Hydroxy-tryptophan) is decarboxylated to the neurotransmitter serotonin (5-HT) by the enzyme aromatic-L-amino-acid decarboxylase. ... NMDA (N-methyl-D-aspartic acid) is an amino acid derivative acting as a specific agonist at the NMDA receptor, and therefore mimics the action of the neurotransmitter glutamate on that receptor. ... Ketamine is a dissociative anesthetic for use in human and veterinary medicine developed by Parke-Davis (1962). ... Dextromethorphan (DXM or DM) is an antitussive (cough-suppressant) drug found in many over-the-counter cold and cough medicines. ... Memantine is the first in a novel class of Alzheimers disease medications acting on the glutamatergic system. ... Opiorphin is a chemical compound isolated from human saliva. ... For other uses of painkiller, see painkiller (disambiguation) An analgesic (colloquially known as painkiller) is any member of the diverse group of drugs used to relieve pain. ...

Classes and members

The following clickable info-box is from the Anatomical Therapeutic Chemical Classification System published by the World Health Organization. See also Wikipedia's list of antidepressants. The Anatomical Therapeutic Chemical Classification System is used for the classification of drugs. ... WHO redirects here. ... This is a list of antidepressants by drug group. ...

In pharmacology, a psychoanaleptic is a medication which produces an arousing effect upon the patient. ... A section of the Anatomical Therapeutic Chemical Classification System containing Psychoanaleptics. ... MAOI redirects here. ... Iproclozide is a monoamine oxidase inhibitor antidepressant. ... Iproniazid is a monamine oxidase inhibitor (MAOI) that was developed as the first anti-depressant (Also first psychiatric drug). ... Isocarboxazid is a nonselective hydrazine-derived monoamine oxidase inhibitor used in treatment resistant depression. ... Nialamide (Espril®, Niamid®, Niaquitil®, Nuredal®, Nyazin®, and Psicodisten®) was one of the first MAOI (monoamine oxidase inhibitor) antidepressants. ... Pargyline is a monoamine oxidase B (MAO-B) inhibitor indicated for the treatment of moderate to severe hypertension. ... Phenelzine (brand name Nardil) is an antidepressant drug that belongs to the monoamine oxidase inhibitor (MAOI) class of drugs. ... Rasagiline (trade name Azilect®) is a irreversible inhibitor of monoamine oxidase used as a monotherapy in early Parkinsons disease or as an adjunct therapy in more advanced cases. ... Selegiline (l-deprenyl, Eldepryl® or Anipryl® [veterinary]) is a drug used for the treatment of early-stage Parkinsons disease and senile dementia. ... Toloxatone is a monoamine oxidase inhibitor antidepressant. ... Tranylcypromine (sold under the brand name Parnate®) is a monoamine oxidase inhibitor (MAOI) used as an antidepressant drug. ... These drugs, a subset of monoamine oxidase inhibitors (MAOIs), inhibit only isoenzyme A and are reversible. ... Brofarmine is a psychiatric drug primarily used to treat depression and anxiety. ... β-Carboline (9H-pyrid-[3,4-b]-indole) is an organic amine that is the prototype of a class of compounds known as β-Carbolines. ... Harmala, also known at various times as Telepathine and Banisterine, is a blanket term for a group of naturally occurring beta-carbolines including harmine, harmaline, and others. ... Moclobemide (sold as Aurorix®, Manerix®) is a psychiatric drug primarily used to treat depression and social anxiety. ... A neurotransmitter uptake inhibitor is a drug which inhibits the reuptake of the neurotransmitter, thus extending the duration of its effect. ... A serotonin uptake inhibitor is a drug which acts as a neurotransmitter uptake inhibitor on serotonin receptors. ... SSRI redirects here; for other uses, see SSRI (disambiguation). ... Alaproclate is an antidepressant that increases serotonin levels by inhibiting the uptake of 5-HT. Today, its primarily used to stagment the cravings for cocaine. ... Citalopram is an antidepressant drug used to treat depression associated with mood disorders. ... Dapoxetine is the International Nonproprietary Name of a drug currently being considered for approval by the FDA for the treatment of premature ejaculation in men, which would make it the first drug approved for such treatment. ... Lexapro pills Escitalopram (Lexapro, Lexaprin, Cipralex, Sipralexa, Entact and Seroplex)[1] is an antidepressant of the selective serotonin reuptake inhibitor (SSRI) class. ... Etoperidone is a 5-HT agonist used primarily in the 1970s to impede the effects of LSD. ... Prozac redirects here. ... Fluvoxamine (brand name as Luvox®, Faverin®, Fevarin® and Dumyrox®) is an antidepressant which functions pharmacologically as a selective serotonin reuptake inhibitor. ... Paroxetine (Paxil, Seroxat, Pexeva) is a selective serotonin reuptake inhibitor (SSRI) antidepressant. ... Zoloft bottles, with blue and green tablets Sertraline hydrochloride (also sold under brand names Zoloft, Lustral, Apo-Sertral, Asentra, Gladem, Serlift, Stimuloton, Xydep, Serlain, Concorz) is an antidepressant of the selective serotonin reuptake inhibitor (SSRI) class. ... // General Remars and History Zimelidine is a pyridylallylamine and has a structure different from other antidepressants. ... Chemical structure of the tricyclic antidepressant amitriptyline. ... There are also several chemically unrelated tetracyclic antibiotics based on Tetracycline. ... Clomipramine (brand-name Anafranil®) is a tricyclic antidepressant. ... Nefazodone hydrochloride (trade name Serzone) is an antidepressant drug marketed by Bristol-Myers Squibb. ... Trazodone (trade names Desyrel, Molipaxin, Trittico, Thombran, Trialodine) is a psychoactive compound with sedative, anxiolytic, and antidepressant properties. ... Norepinephrine reuptake inhibitors (NRIs) are compounds that increase amounts of the neurotransmitter norepinephrine in the brain by inhibiting its reuptake at synapses. ... A adrenergic uptake inhibitor is a drug which blocks the reuptake of adrenergic neurotransmitters. ... Atomoxetine is the first non-stimulant drug approved for the treatment of attention-deficit hyperactivity disorder (ADHD). ... To meet Wikipedias quality standards, this article may require cleanup. ... Reboxetine is an antidepressant drug used in the treatment of clinical depression, panic disorder and ADD/ADHD. Its mesilate ( methanesulfonate) salt is sold under tradenames including Edronax®, Norebox®, Prolift®, Solvex® or Vestra®. Reboxetine has two chiral centers, but it only exists as two enantiomers, (R,R)-(-)- and (S,S)-(+)-reboxetine. ... Viloxazine is a bicyclic antidepressants[2] that inhibits the reuptake of serotonin, and to a lesser extent, dopamine and norepinephrine. ... Chemical structure of the tricyclic antidepressant amitriptyline. ... There are also several chemically unrelated tetracyclic antibiotics based on Tetracycline. ... Amitriptyline (or Amitryptyline) hydrochloride (sold as Elavil, Tryptanol, Endep, Elatrol, Tryptizol, Trepiline, Laroxyl) is a tricyclic antidepressant drug. ... Amoxapine (Asendin®; Asendis®; Defanyl®; Demolox®; Moxadil®) is a tricyclic antidepressant of the dibenzoxazepine class. ... Butriptyline (Dl-10,11-Dihydro-N,N,beta-trimethyl-5H-dibenzo[a,d]cycloheptene-5-propylamine) is a tricyclic antidepressant with sedative properties and uses similar to that of amitriptyline. ... Desipramine is a tricyclic antidepressant (TCA) that inhibits the reuptake of norepinephrine. ... Lofepramine (trademarked Gamanil) is a tricyclic antidepressant prescribed primarily for sleeping and eating disorders. ... Dibenzepin (Noveril®) is a muscarinic antagonist. ... Dosulepin hydrochloride (sometimes known outside the USA as dothiepin hydrochloride) is an antidepressant of the tricyclic family. ... Doxepin is a tricyclic antidepressant, known under many brand-names such as Aponal®, the original preparation by Boehringer-Ingelheim, now part of the Roche group; Adapine®, Sinquan® and Sinequan® (Pfizer Inc. ... This article does not cite any references or sources. ... Iprindole (C19H28N2), a 5-HT2 antagonist, is a tricyclic antidepressant that can be fatal when combined with MDMA. Categories: | ... Melitracen (or melitracene) is a tricyclic antidepressant. ... Nortriptyline is a tricyclic antidepressant marketed under the tradenames Aventyl® and Pamelor®. It is used to treat depression. ... Opipramol (Opipramol-neuraxpharm®, Insidon®), 4-[3-(5H-Dibenz[b,f]azepin-5-yl)propyl]-1-piperazinethanol, is a anxiolytic primarily used in Germany. ... Protriptyline (Vivactil®) is a tricyclic antidepressant indicated for depression and ADHD. Categories: | ... Trimipramine is an tricyclic antidepressant with sedative and anxiolytic properties. ... To meet Wikipedias quality standards, this article may require cleanup. ... This does not cite any references or sources. ... Vanoxerine, also known as GBR-12909, is a piperazine derivative which is a potent and selective dopamine reuptake inhibitor. ... Phenmetrazine is an amphetamine-like drug. ... Chemical structure of the tricyclic antidepressant amitriptyline. ... Amineptine is an atypical tricyclic antidepressant that selectively inhibits the reuptake of dopamine and to a lesser extent norepinephrine, thus exerting a powerful and fast-acting antidepressant effect. ... Serotonin Norepinephrine Serotonin-norepinephrine reuptake inhibitors (SNRIs) are a class of antidepressant used in the treatment of clinical depression and other affective disorders. ... Desvenlafaxine succinate, marketed under the name Pristiq, is an antidepressant of the serotonin-norepinephrine reuptake inhibitor class from Wyeth. ... Duloxetine (brand names Cymbalta, Yentreve, and in parts of Europe, Xeristar or Ariclaim) is a drug which primarily targets major depressive disorder (MDD), generalized anxiety disorder (GAD), pain related to diabetic peripheral neuropathy and in some countries stress urinary incontinence (SUI). ... Milnacipran is an antidepressant of the serotonin-norepinephrine reuptake inhibitor class. ... Nefazodone hydrochloride (trade name Serzone) is an antidepressant drug marketed by Bristol-Myers Squibb. ... Venlafaxine (Effexor) is an antidepressant of the serotonin-norepinephrine reuptake inhibitor (SNRI) class first introduced by Wyeth in 1993. ... A Norepinephrine-dopamine reuptake inhibitor is a class of drugs that is both: Dopamine reuptake inhibitor Norepinephrine reuptake inhibitor An example is Bupropion. ... Bupropion (INN; also amfebutamone,[1] brand names Wellbutrin, Zyban, Budeprion and Buproban) is an atypical antidepressant, which acts as a norepinephrine reuptake inhibitor and dopamine reuptake inhibitor,[2] and a nicotinic antagonist. ... Serotonin-norepinephrine-dopamine-reuptake-inhibitors (SNDRI) are a class of psychoactive antidepressants. ... Brasofensine is a serotonin-noradrenaline-dopamine reuptake inhibitor. ... Tesofensine is a serotonin-noradrenaline-dopamine reuptake inhibitor, which also seems to increase the action of acetylcholine in the brain, probably due to downstream effects. ... Nomifensine is a dopamine reuptake inhibitor that increases the amount of synaptic dopamine available to receptors by blocking dopamines re-uptake transporter. ... Tianeptine (INN) (Stablon®, Coaxil®, Tatinol®), is structurally similar to the tricyclic antidepressants. ... Tianeptine (INN) (Stablon®, Coaxil®, Tatinol®), is an SSRE, or Selective Serotonin Reuptake Enhancer, structurally similar to the tricyclic antidepressants. ... An Adrenergic antagonist is a pharmaceutical substance that acts to inhibit the action of the adrenergic receptors. ... There are also several chemically unrelated tetracyclic antibiotics based on Tetracycline. ... Mianserin is a tetracyclic antidepressant that has antihistaminic and hypnosedative, but almost no anticholinergic, effect. ... Mirtazapine is an antidepressant introduced by Organon International in 1996 used for the treatment of mild to severe depression. ...

See also

  • Antidepressants in Japan
  • Depression and natural therapies

The number of new psychiatric drugs, and especially antidepressants on the market in Japan, has significantly lagged behind Western countries. ... Depression, for the purposes of this article, refers to the illness known as clinical depression, major depression or unipolar depression. ...

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Additional reading

  • Zhengming Chen and Phil Skolnick, "Triple uptake inhibitors: therapeutic potential in depression and beyond", Expert Opinion on Investigational Drugs, September 2007, Vol. 16, No. 9, Pages 1365-1377 (doi:10.1517/13543784.16.9.1365)
  • David Healy, The Antidepressant Era, Paperback Reprint Edition, Harvard University Press (1999) ISBN 0674039580
  • Peter D. Kramer, Listening to Prozac: The Landmark Book about Anti-Depressants and the Remaking of the Self, Paperback Revised Edition, Penguin (1997) ISBN 0140266712
  • Syd Baumel, Natural Antidepressants, Paperback 1st edition, McGraw-Hill (1999) ISBN 0879839007
  • Stephen M. Stahl, Psychopharmacology of Antidepressants, Paperback 1st Edition, Taylor & Francis (1997) ISBN 1853175137
  • Pacher P, Kecskemeti V. Trends in the development of new antidepressants. Is there a light at the end of the tunnel? Curr Med Chem. 2004 Apr;11(7):925-43. PMID 15078174
  • Pacher P, Kohegyi E, Kecskemeti V, Furst S. Current trends in the development of new antidepressants.Curr Med Chem. 2001 Feb;8(2):89-100. PMID 11172668

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Image File history File links Commons-logo. ... Wikipedia does not have an article with this exact name. ... Wiktionary (a portmanteau of wiki and dictionary) is a multilingual, Web-based project to create a free content dictionary, available in over 151 languages. ... NIMH or NiMH may refer to: National Institute of Mental Health, a part of the United States National Institutes of Health. ... In pharmacology, a psychoanaleptic is a medication which produces an arousing effect upon the patient. ... A section of the Anatomical Therapeutic Chemical Classification System containing Psychoanaleptics. ... MAOI redirects here. ... Iproclozide is a monoamine oxidase inhibitor antidepressant. ... Iproniazid is a monamine oxidase inhibitor (MAOI) that was developed as the first anti-depressant (Also first psychiatric drug). ... Isocarboxazid is a nonselective hydrazine-derived monoamine oxidase inhibitor used in treatment resistant depression. ... Nialamide (Espril®, Niamid®, Niaquitil®, Nuredal®, Nyazin®, and Psicodisten®) was one of the first MAOI (monoamine oxidase inhibitor) antidepressants. ... Pargyline is a monoamine oxidase B (MAO-B) inhibitor indicated for the treatment of moderate to severe hypertension. ... Phenelzine (brand name Nardil) is an antidepressant drug that belongs to the monoamine oxidase inhibitor (MAOI) class of drugs. ... Rasagiline (trade name Azilect®) is a irreversible inhibitor of monoamine oxidase used as a monotherapy in early Parkinsons disease or as an adjunct therapy in more advanced cases. ... Selegiline (l-deprenyl, Eldepryl® or Anipryl® [veterinary]) is a drug used for the treatment of early-stage Parkinsons disease and senile dementia. ... Toloxatone is a monoamine oxidase inhibitor antidepressant. ... Tranylcypromine (sold under the brand name Parnate®) is a monoamine oxidase inhibitor (MAOI) used as an antidepressant drug. ... These drugs, a subset of monoamine oxidase inhibitors (MAOIs), inhibit only isoenzyme A and are reversible. ... Brofarmine is a psychiatric drug primarily used to treat depression and anxiety. ... β-Carboline (9H-pyrid-[3,4-b]-indole) is an organic amine that is the prototype of a class of compounds known as β-Carbolines. ... Harmala, also known at various times as Telepathine and Banisterine, is a blanket term for a group of naturally occurring beta-carbolines including harmine, harmaline, and others. ... Moclobemide (sold as Aurorix®, Manerix®) is a psychiatric drug primarily used to treat depression and social anxiety. ... A neurotransmitter uptake inhibitor is a drug which inhibits the reuptake of the neurotransmitter, thus extending the duration of its effect. ... A serotonin uptake inhibitor is a drug which acts as a neurotransmitter uptake inhibitor on serotonin receptors. ... SSRI redirects here; for other uses, see SSRI (disambiguation). ... Alaproclate is an antidepressant that increases serotonin levels by inhibiting the uptake of 5-HT. Today, its primarily used to stagment the cravings for cocaine. ... Citalopram is an antidepressant drug used to treat depression associated with mood disorders. ... Dapoxetine is the International Nonproprietary Name of a drug currently being considered for approval by the FDA for the treatment of premature ejaculation in men, which would make it the first drug approved for such treatment. ... Lexapro pills Escitalopram (Lexapro, Lexaprin, Cipralex, Sipralexa, Entact and Seroplex)[1] is an antidepressant of the selective serotonin reuptake inhibitor (SSRI) class. ... Etoperidone is a 5-HT agonist used primarily in the 1970s to impede the effects of LSD. ... Prozac redirects here. ... Fluvoxamine (brand name as Luvox®, Faverin®, Fevarin® and Dumyrox®) is an antidepressant which functions pharmacologically as a selective serotonin reuptake inhibitor. ... Paroxetine (Paxil, Seroxat, Pexeva) is a selective serotonin reuptake inhibitor (SSRI) antidepressant. ... Zoloft bottles, with blue and green tablets Sertraline hydrochloride (also sold under brand names Zoloft, Lustral, Apo-Sertral, Asentra, Gladem, Serlift, Stimuloton, Xydep, Serlain, Concorz) is an antidepressant of the selective serotonin reuptake inhibitor (SSRI) class. ... // General Remars and History Zimelidine is a pyridylallylamine and has a structure different from other antidepressants. ... Chemical structure of the tricyclic antidepressant amitriptyline. ... There are also several chemically unrelated tetracyclic antibiotics based on Tetracycline. ... Clomipramine (brand-name Anafranil®) is a tricyclic antidepressant. ... Nefazodone hydrochloride (trade name Serzone) is an antidepressant drug marketed by Bristol-Myers Squibb. ... Trazodone (trade names Desyrel, Molipaxin, Trittico, Thombran, Trialodine) is a psychoactive compound with sedative, anxiolytic, and antidepressant properties. ... Norepinephrine reuptake inhibitors (NRIs) are compounds that increase amounts of the neurotransmitter norepinephrine in the brain by inhibiting its reuptake at synapses. ... A adrenergic uptake inhibitor is a drug which blocks the reuptake of adrenergic neurotransmitters. ... Atomoxetine is the first non-stimulant drug approved for the treatment of attention-deficit hyperactivity disorder (ADHD). ... To meet Wikipedias quality standards, this article may require cleanup. ... Reboxetine is an antidepressant drug used in the treatment of clinical depression, panic disorder and ADD/ADHD. Its mesilate ( methanesulfonate) salt is sold under tradenames including Edronax®, Norebox®, Prolift®, Solvex® or Vestra®. Reboxetine has two chiral centers, but it only exists as two enantiomers, (R,R)-(-)- and (S,S)-(+)-reboxetine. ... Viloxazine is a bicyclic antidepressants[2] that inhibits the reuptake of serotonin, and to a lesser extent, dopamine and norepinephrine. ... Chemical structure of the tricyclic antidepressant amitriptyline. ... There are also several chemically unrelated tetracyclic antibiotics based on Tetracycline. ... Amitriptyline (or Amitryptyline) hydrochloride (sold as Elavil, Tryptanol, Endep, Elatrol, Tryptizol, Trepiline, Laroxyl) is a tricyclic antidepressant drug. ... Amoxapine (Asendin®; Asendis®; Defanyl®; Demolox®; Moxadil®) is a tricyclic antidepressant of the dibenzoxazepine class. ... Butriptyline (Dl-10,11-Dihydro-N,N,beta-trimethyl-5H-dibenzo[a,d]cycloheptene-5-propylamine) is a tricyclic antidepressant with sedative properties and uses similar to that of amitriptyline. ... Desipramine is a tricyclic antidepressant (TCA) that inhibits the reuptake of norepinephrine. ... Lofepramine (trademarked Gamanil) is a tricyclic antidepressant prescribed primarily for sleeping and eating disorders. ... Dibenzepin (Noveril®) is a muscarinic antagonist. ... Dosulepin hydrochloride (sometimes known outside the USA as dothiepin hydrochloride) is an antidepressant of the tricyclic family. ... Doxepin is a tricyclic antidepressant, known under many brand-names such as Aponal®, the original preparation by Boehringer-Ingelheim, now part of the Roche group; Adapine®, Sinquan® and Sinequan® (Pfizer Inc. ... This article does not cite any references or sources. ... Iprindole (C19H28N2), a 5-HT2 antagonist, is a tricyclic antidepressant that can be fatal when combined with MDMA. Categories: | ... Melitracen (or melitracene) is a tricyclic antidepressant. ... Nortriptyline is a tricyclic antidepressant marketed under the tradenames Aventyl® and Pamelor®. It is used to treat depression. ... Opipramol (Opipramol-neuraxpharm®, Insidon®), 4-[3-(5H-Dibenz[b,f]azepin-5-yl)propyl]-1-piperazinethanol, is a anxiolytic primarily used in Germany. ... Protriptyline (Vivactil®) is a tricyclic antidepressant indicated for depression and ADHD. Categories: | ... Trimipramine is an tricyclic antidepressant with sedative and anxiolytic properties. ... To meet Wikipedias quality standards, this article may require cleanup. ... This does not cite any references or sources. ... Vanoxerine, also known as GBR-12909, is a piperazine derivative which is a potent and selective dopamine reuptake inhibitor. ... Phenmetrazine is an amphetamine-like drug. ... Chemical structure of the tricyclic antidepressant amitriptyline. ... Amineptine is an atypical tricyclic antidepressant that selectively inhibits the reuptake of dopamine and to a lesser extent norepinephrine, thus exerting a powerful and fast-acting antidepressant effect. ... Serotonin Norepinephrine Serotonin-norepinephrine reuptake inhibitors (SNRIs) are a class of antidepressant used in the treatment of clinical depression and other affective disorders. ... Desvenlafaxine succinate, marketed under the name Pristiq, is an antidepressant of the serotonin-norepinephrine reuptake inhibitor class from Wyeth. ... Duloxetine (brand names Cymbalta, Yentreve, and in parts of Europe, Xeristar or Ariclaim) is a drug which primarily targets major depressive disorder (MDD), generalized anxiety disorder (GAD), pain related to diabetic peripheral neuropathy and in some countries stress urinary incontinence (SUI). ... Milnacipran is an antidepressant of the serotonin-norepinephrine reuptake inhibitor class. ... Nefazodone hydrochloride (trade name Serzone) is an antidepressant drug marketed by Bristol-Myers Squibb. ... Venlafaxine (Effexor) is an antidepressant of the serotonin-norepinephrine reuptake inhibitor (SNRI) class first introduced by Wyeth in 1993. ... A Norepinephrine-dopamine reuptake inhibitor is a class of drugs that is both: Dopamine reuptake inhibitor Norepinephrine reuptake inhibitor An example is Bupropion. ... Bupropion (INN; also amfebutamone,[1] brand names Wellbutrin, Zyban, Budeprion and Buproban) is an atypical antidepressant, which acts as a norepinephrine reuptake inhibitor and dopamine reuptake inhibitor,[2] and a nicotinic antagonist. ... Serotonin-norepinephrine-dopamine-reuptake-inhibitors (SNDRI) are a class of psychoactive antidepressants. ... Brasofensine is a serotonin-noradrenaline-dopamine reuptake inhibitor. ... Tesofensine is a serotonin-noradrenaline-dopamine reuptake inhibitor, which also seems to increase the action of acetylcholine in the brain, probably due to downstream effects. ... Nomifensine is a dopamine reuptake inhibitor that increases the amount of synaptic dopamine available to receptors by blocking dopamines re-uptake transporter. ... Tianeptine (INN) (Stablon®, Coaxil®, Tatinol®), is structurally similar to the tricyclic antidepressants. ... Tianeptine (INN) (Stablon®, Coaxil®, Tatinol®), is an SSRE, or Selective Serotonin Reuptake Enhancer, structurally similar to the tricyclic antidepressants. ... An Adrenergic antagonist is a pharmaceutical substance that acts to inhibit the action of the adrenergic receptors. ... There are also several chemically unrelated tetracyclic antibiotics based on Tetracycline. ... Mianserin is a tetracyclic antidepressant that has antihistaminic and hypnosedative, but almost no anticholinergic, effect. ... Mirtazapine is an antidepressant introduced by Organon International in 1996 used for the treatment of mild to severe depression. ... The Anatomical Therapeutic Chemical Classification System is used for the classification of drugs. ... Gut redirects here. ... A section of the Anatomical Therapeutic Chemical Classification System. ... A bottle of antacid tablets An antacid is any substance, generally a base, which counteracts stomach acidity. ... An antiemetic is a drug that is effective against vomiting and nausea. ... An H2-receptor antagonist, often shortened to H2-antagonist, is a drug used to block the action of histamine on parietal cells in the stomach, decreasing acid production by these cells. ... Proton pump inhibitors (or PPIs) are a group of drugs whose main action is pronounced and long-lasting reduction of gastric acid production. ... Laxatives (or purgatives are foods, compounds, or drugs taken to induce bowel movements, most often taken to treat constipation. ... An antidiarrhoeal drug is any medication which provides symptomatic relief for diarrhoea. ... For other uses, see Blood (disambiguation). ... A section of the Anatomical Therapeutic Chemical Classification System. ... An anticoagulant is a substance that prevents coagulation; that is, it stops blood from clotting. ... An antiplatelet drug is a member of a class of pharmaceuticals that decreases platelet aggregation and inhibits thrombus formation. ... Thrombolytic drugs are used in medicine to dissolve blood clots in a procedure termed thrombolysis. ... The circulatory system or cardiovascular system is the organ system which circulates blood around the body of most animals. ... A section of the Anatomical Therapeutic Chemical Classification System. ... Antiarrhythmic agents are a group of pharmaceuticals that are used to suppress fast rhythms of the heart (cardiac arrhythmias), such as atrial fibrillation, atrial flutter, ventricular tachycardia, and ventricular fibrillation. ... Antihypertensives are a class of drugs that are used in medicine and pharmacology to treat hypertension (high blood pressure). ... This illustration shows where some types of diuretics act, and what they do. ... A vasodilator is a drug or chemical that relaxes the smooth muscle in blood vessels, which causes them to dilate. ... An antianginal is any drug used in the treatment of angina pectoris, a symptom of ischaemic heart disease. ... Beta blockers or beta-adrenergic blocking agents are a class of drugs used to treat a variety of cardiovascular conditions and some other diseases. ... Captopril, the first ACE inhibitor ACE inhibitors, or inhibitors of Angiotensin-Converting Enzyme, are a group of pharmaceuticals that are used primarily in treatment of hypertension and congestive heart failure, in most cases as the drugs of first choice. ... Hypolipidemic agents, or antihyperlipidemic agents, are a diverse group of pharmaceuticals that are used in the treatment of hyperlipidemias. ... For other uses, see Skin (disambiguation). ... A section of the Anatomical Therapeutic Chemical Classification System. ... Emollients soften skin (and moisturisers add moisture). ... Antipruritics, also known as anti-itch drugs, are medications that inhibit the itching (Latin: pruritus) that is often associated with sunburns, allergic reactions, eczema, psoriasis, chickenpox, fungal infections, insect bites and stings like those from mosquitoes, fleas, and mites, and contact dermatitis and urticaria caused by plants such as poison... A pictorial illustration of the human female reproductive system. ... A section of the Anatomical Therapeutic Chemical Classification System. ... Hormonal contraception refers to birth control methods that act on the hormonal system. ... Fertility medication may in a larger sense include any medication that enhances fertility, but in a specific sense consists of agents that stimulate follicle development of the ovary. ... Selective estrogen receptor modulators (SERMs) is a class of medication that acts on the estrogen receptor. ... Sex hormones are hormones that affect the reproductive system. ... Major endocrine glands. ... A section of the Anatomical Therapeutic Chemical Classification System. ... An anti-diabetic drug or oral hypoglycemic agent is used to treat diabetes mellitus. ... In physiology, corticosteroids are a class of steroid hormones that are produced in the adrenal cortex. ... Sex hormones are hormones that affect the reproductive system. ... The thyroid hormones, thyroxine (T4) and triiodothyronine (T3), are tyrosine-based hormones produced by the thyroid gland. ... An infection is the detrimental colonization of a host organism by a foreign species. ... A section of the Anatomical Therapeutic Chemical Classification System. ... A section of the Anatomical Therapeutic Chemical Classification System. ... Staphylococcus aureus - Antibiotics test plate. ... Antiviral drugs are a class of medication used specifically for treating viral infections. ... A vaccine is an antigenic preparation used to establish immunity to a disease. ... An antifungal drug is medication used to treat fungal infections such as athletes foot, ringworm, candidiasis (thrush), serious systemic infections such as cryptococcal meningitis, and others. ... Antiprotozoal agents (ATC code: ATC P01) is a class of pharmaceuticals used in treatment of protozoal infections. ... Anthelmintics (in the U.S., antihelminthics) are drugs that expel parasitic worms (helminthes) from the body or kill them. ... In medicine, malignant is a clinical term that means to be severe and become progressively worse, as in malignant hypertension. ... A scanning electron microscope image of a single neutrophil (yellow), engulfing anthrax bacteria (orange). ... A section of the Anatomical Therapeutic Chemical Classification System. ... Chemotherapy is the use of chemical substances to treat disease. ... Immunostimulators are the drugs which stimulate the immune system by inducing activation or increasing activity of any of its components. ... For a list of immunosuppressive drugs, see the transplant rejection page. ... For other uses of Muscles, see Muscles (disambiguation). ... This article is about the skeletal organs. ... For other uses, see Joint (disambiguation). ... A section of the Anatomical Therapeutic Chemical Classification System. ... Crystal structure of human sex hormone-binding globulin, transporting 5-alpha-dihydrotestosterone. ... Anti-inflammatory refers to the property of a substance or treatment that reduces inflammation. ... Disease-modifying antirheumatic drugs is a category of drugs used in many autoimmune diseases to slow down disease progression. ... In physiology, corticosteroids are a class of steroid hormones that are produced in the adrenal cortex. ... A muscle relaxant is a drug which decreases the tone of a muscle. ... Human brain In animals, the brain (enkephale) (Greek for in the skull), is the control center of the central nervous system, responsible for behavior. ... The nervous system is a highly specialized network whose principal components are cells called neurons. ... A section of the Anatomical Therapeutic Chemical Classification System. ... Anesthesia or anaesthesia (see spelling differences) has traditionally meant the condition of having the perception of pain and other sensations blocked. ... An analgesic (colloquially known as a painkiller) is any member of the diverse group of drugs used to relieve pain (achieve analgesia). ... The anticonvulsants, sometimes also called antiepileptics, belong to a diverse group of pharmaceuticals used in prevention of the occurrence of epileptic seizures. ... A mood stabilizer is a psychiatric medication used to treat mood disorders characterized by rapid and unstable mood shifts. ... An anxiolytic is a drug prescribed for the treatment of symptoms of anxiety. ... The term antipsychotic is applied to a group of drugs used to treat psychosis. ... Stimulants are drugs that temporarily increase alertness and wakefulness. ... A sedative is a substance that depresses the central nervous system (CNS), resulting in calmness, relaxation, reduction of anxiety, sleepiness, and slowed breathing, as well as slurred speech, staggering gait, poor judgment, and slow, uncertain reflexes. ... The Respiratory System Among four-legged animals, the respiratory system generally includes tubes, such as the bronchi, used to carry air to the lungs, where gas exchange takes place. ... A section of the Anatomical Therapeutic Chemical Classification System. ... A bronchodilator is a medication intended to improve bronchial airflow. ... A decongestant is a broad class of drugs designed to symptomatically treat ailments affecting the respiratory system. ...

  Results from FactBites:
 
Antidepressant definition - Medical Dictionary definitions of popular medical terms (150 words)
Antidepressant: Anything, and especially a drug, used to prevent or treat depression.
Antidepressants should not be used unless the depression is severe and/or other treatments have failed.
As with all drugs, the use of antidepressants requires monitoring for side effects, and suicide should be considered a possible side effect of the newer antidepressants.
Antidepressant - Wikipedia, the free encyclopedia (2722 words)
Many antidepressants also are used for the treatment of anxiety disorders, and tricyclic antidepressants are used in the treatment of chronic pain disorders such as chronic functional abdominal pain (CFAP), myofascial pain syndrome, and post-herpetic neuralgia.
The therapeutic effects of antidepressants are believed to be related to an effect on neurotransmitters, particularly by inhibiting the monoamine transporter proteins of serotonin and norepinephrine.
Antidepressants should be used with great care, usually in conjunction with mood stabilisers, in the treatment of bipolar disorder, as they can exacerbate symptoms of mania.
  More results at FactBites »

 
 

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