High correlation particularly among kin Reserpine, a drug used in the treatment o hypertension and schizophrenia can cause depression because it depletes the vesicular storage of amine neurotransmitters (NE, 5-HT, DA). Depression could be relieved by isoniazid, a drug used in the treatment of tuberculosis. TCAs, MAOIs, SSRIs, and all the new drugs. ECT causes a massive release of NTs and is a very effective antidepressant.
ANTIDEPRESSANTS Martha I. Dávila-García, Ph.D. Howard University College of Medicine Spring 2002
Almost all NE pathways in the brain originate from the cell bodies of neuronal cells in the locus coereleus in the midbrain, which send their axons diffusely to the cortex, cerebellum and limbic areas (hippocampus, amygdala, hypothalamus, thalamus).
Mood : -- higher functions performed by the cortex.
Cognitive function : -- function of cortex.
Drive and motivation : -- function of brainstem
Memory and emotion : -- function of the hippocampus and amygdala.
Endocrine response : -- function of hypothalamus .
As with the NE system, serotonin neurons located in the pons and midbrain (in groups known as raphe nuclei) send their projections diffusely to the cortex, hippocampus, amygdala, hypothalamus, thalamus, etc. --same areas implicated in depression. This system is also involve in:
Any drug metabolized by MAOs * including SSRIs, TCAs and meperidine, alcohol, CNS depressants, sympathomimetics, phenylephrine (O/C nasal decongestants), ampetamines, and other indirect-acting adrenergic drugs.
* Interaction with drugs metabolized by MAOs (e.g. Meperidine (opioid analgesics) => hyperpyrexia or “hyperexcitation syndrome” involving high fever, delirium and hypertension).
Inhibits breakdown of IP 2 to IP 1 (during PIP hydrolysis) => depletion of DAG and IP 3 and [Ca 2 + ] in response to receptor activation (i.e. from 5-HT 2 R, 1 -AR, muscarinic receptors and others).
Alterations in adenylate cyclase and phospholipase C.
XVI. Anti-Manic Drugs PIP PIP 2 G IP 3 IP 2 IP 1 Inositol PI X Li + PLC DAG Ca 2+
A well known antiepileptic has been found to have antimanic effects. Shows efficacy equivalent as that of lithium during the early weeks of treatment and is being evaluated for maintenance treatment. Titrated well, the sedation can be controlled. Nausea being the only limiting factor in some patients.
May be used as first line treatment for mania, although it may not be as effective in maintenance treatment as lithium for some patients.