1. CENTRAL NERVOUS SYSTEM
Dr. Nadeem akhtar
MBBS.M.Phil
Asst. Professor Pharmacology
Amna Inayat Medical College
Shaikhupura

2. ANTI-DEPRESSANTS
Drugs which are prescribed
to relieve depression

3. Depression
• Low mood
• Depressed feelings
• Lonely living
• Lack of energy
• Other physical problems

4. • 17 % world wide prevalence
• 4 th number in the list of 10 world wide
common diseases ,noted by WHO
• This will be on second number in 2020

5. Typical pic of depressed individual

6. Pathophysilogy
• 1. Amines hypothesis
• 2.Neurotrophic hypothesis

7. Physical or Pharmacological treatment
• A)Trycyclic antidepressants (TCAs)
• Imipramine
• Clomipramine
• Amitriptyline

8. Mode of action
• They inhibit re-uptake mechanisms
• Terminate synaptic actions of NE & 5-HT in the
brain

9. Effects
• A.N.S
• produce anticholinergic actions
• C.V.S
• Ventricular dysrythmias
• Hypertension (rarely)

10. Drug interactions
• Antagonize the centrally acting drug
antihypertensive agents e.g Clonidine
• If given with MAOS, patient develop severe
hypertension

11. Indications
• Major depressive disorder (MDD)
• Panic disorder (PD)
• Obsessive compulsive disorder (OCD)
• Enuresis
• Chronic fatigue
• Diabetic neuropathy
• Eating disorders

12. Adverse effects
• Dryness of mouth
• Constipation
• Tachycardia
• Blurring of the vision
• Retention of urine
• Postural hypotension
• Sedation
• Weight gain
• Tremors
• Sexual problems

13. Contra-indications
• Glaucoma
• Pregnancy
• Benign prostate hypertrophy (BPH)

14. Selective serotonin reuptake inhibitors
(SSRIs)
• Fluxetine
• Citalopram
• Escitalopram
• Paroxitine

15. Mode of action
• Highly selective on 5-HT receptors
• Minimal inhibitory effect on NE transporters
or blocking actions on adrenergic or
cholinergic receptors

16. Adverse effects
• Minimal anticholinergic action and mild
constipation
• Suicidal ideation with long term use
• Erectile dysfunction

17. Monoamine oxidase inhibitors
• Phenalzine
• tranylcypromine

18. Mode of action
• Increase amine level by interfering their
• metabolism at nerve endings and
• increasing storage of NE & 5-HT

19. usage
• Indicated when other treatment fail
• Dangerous drug-drug or drug & food
interactions can develop

20. Serotonin-norepinephrine reuptake
inhibitors (SNRIs)
• Venlafaxine
• Duloxetine
• Milancipran

21. 5-HT2 Antagonists
• Trazodone
• Nefazodone