1. Topic-ANTIDEPRESSANT

2. ANTIDEPRESSANT
 Antidepressant are type of medication used to treat
depression or prevent it recurring
MECHANISM –
 Tricyclic antidepressants increase the amount of
serotonin , nor epinephrine , through reuptake
inhibition , thus normalizing the hyposensitive
receptor site associated receptor site associated with
depression.
 SSRI (selective serotonin reuptake inhibitor)

3.  block the reuptake of serotonin into the presynaptic
cells, thereby increasing serotonin level at the
synapse.
 Biogenic amines such as 5- hydroxytrptamine ,
noradrenalin and dopamine are inactivated by the
enzyme monoamine oxidase (MAO) . MAOI inhibit
enzyme NAO that leads to accumulation of these
amines in the brain thus produces antidepressant
effect.

4. DRUGS EXAMPLE OF DOSE
S.N. DRUGS DOSES
1 Imipramine 75-300mg orally/IM
2 Nortyptaline 25mg 3-4 time orally
3 Desipramine 100-200mg daily
4 Amitryptyline 25-100mg 3-4 time
5 Doxepine 25-150mg / daily orally
6 Trimipramine 50-150mg/ daily orally
7 Phenelzine 15 mg TDS
8 Fluoxetine 20-80mg / day orally
9 Fluoxemine 50-100mg OD orally
10 Sartraline 25-100mg daily orally

5. INDICATION/ USAGE
 Used in endogenous depression.
 Depression associated with other diseases.
 Also used in phobic anxiety states like school phobia
and compulsive phobic states.
 Enuresis
 Obsessive - compulsive disorder.
 Bulimia nervosa.
 Smoking Cessation.
 Premenstrual dysphoric disorder.

6. CONTRAINDICATION/PRECAUTIONS
 Concurrent used of Fluoxetine and MAO inhibitors is
contraindicated.
 Contraindicated in active liver disease.
 Precautiously used in elderly patients and with
hepatic and renal failure.

7. ADVERSE EFFECT
 TCA may cause orthostatic hypotension, tachycardia
, blurred vision , constipation , seizure dry mouth.
 Also may exacerbate heart failure.
 May caused testicular swelling and gynaecomastia in
male.
 Insomnia , nausea and ant cholinergic effect.
 Overdose can cause CNS stimulation , even
hallucinations and convulsions.

8. DRUG INTERACTIONS
 They alter the actions produced by the drugs acting
on sympathetic nervous system , when Administered
simultaneously.
 May reduce the effectiveness of anti hypertensive.
 Simultaneously used with alcohol , antihistamines ,
and other CNS depressant cause additive.
 Antidepressant with MAO inhibitors may cause
hypertensive crisis and seizure.

9. NURSING RESPONSIBILITIES
 Nurse should know that these drug should be
discontinue gradually.
 Nurse should instruct the patient about importance of
complying with therapy , these drugs may take several
week to produce desired effects.
 Nurse should warn the patient to avoid alcohol and other
non- prescribed drugs to prevent adverse drugs reaction.
 Nurse should known that a persistent headache is often a
warming of rising B. P. in a patient or MAO inhibitors.
 Nurse should tell the patient not to cruise -controlled –
release tablets but to swallow them whole