1) Antidepressant drugs like imipramine are used to treat depressive illnesses by blocking the reuptake of neurotransmitters like norepinephrine and serotonin. 2) Imipramine is a tricyclic antidepressant that is used to treat conditions like depression, anxiety, and chronic pain. Its main mechanisms of action involve blocking neurotransmitter reuptake. 3) Nurses monitor patients taking imipramine for side effects like dry mouth and constipation and check liver and kidney function through bloodwork. They also educate patients on risks, food interactions, and the need to wait 14 days between antidepressants and MAOIs.

1. ANTIDEPRESSENT DRUGS
MR.SUBIN RAJ R
ASST.PROFESSOR,MENTAL HELTH DEPART.
RAMACOLLEAGE OF NURSING,KANPUR

2. Antidepressants drug
 Antidepressants are those drugs,
which are used for the treatment
of depressive illness. These are
also called as mood elevator. i.e.
depression

3. Classification of antidepressants
1. Tricyclic antidepressants (TCAs) :-
Ex- Imipramine, Desipramine, clomipramine,
doxepin
2. Selective serotonin reuptake inhibitors (SARI) :-
Ex- fluoxetine, sertraline

4. Cont.....
3. Monoamine oxidase inhibitors (MAOs) :-
Ex- phenelzine, isocarboxazid
4. Atypical antidepressants :-
Ex- trazodone, mianserine.

5. Pharmocokinetics :-
Antidepressants are highly lipophilic
and protein bound. The half life is
long and usually more than 24 hours.
It is predominantly metabolized in
the liver.

6. Mechanism of action:-
 The pre- dominate action is by increasing
catecholamine level in the brain. Tricycline
antidepressants (TCAs) are also called as
mono amine re-uptake inhibitors (MARIs).
The main mode of action is by blocking the
re-uptake of norepinephrein (NE) and /or
serotonin (5-HT) at the nerve terminals. Thus
increasing the NE and 5-HT level at the
receptor site.

7. Cont....
 MAOIs ( mono amine oxidase inhibitors)
act on mono amine oxidase which is
responsible for the degradation of
catecholamine after re-uptake. The final
effect is the same, a function increase in
the NE and 5-HT level at the receptor site.

8. Imipramine
 Imipramine sold under the brand name
Antidep among other, is a TCA which is
used mainly in the treatment of
depression.

9. Cont...
 Trade name:- Antidep
 Classification :- Tricyclic antidepressants
drug
 Dose:- 75 to 300 mg per day orally.

10. Mechanism of action:-
 Their main mode of action are –
Blocking the re-uptake of norepinephrein
(NE) and serotonin (5-HT) at the nerve
terminals, thus increasing NE and 5-HT level
at receptor site.
Regulation of the B adrenergic receptors.

11. Indication
Depression :- depressive episode,
Reactive depression, Secondary
depression, Abnormal grief reaction.
Childhood psychiatric disorder :-
Separation anxiety disorder, school
phobia, Depression, Conduct disorder.

12. Cont....
Other psychiatric disorder:- Panic
attack, Generalized anxiety disorder,
Agoraphobia, social phobia, Eating
disorder, Borderline personality disorder.
 Medical disorder:- Chronic pain,
migraine, peptic ulcer disease.

13. Contraindication
 Cardic disorder, acute recovery period
after MI, use within 14 days of MAOIs.

14. Side effects
1. Autonomic side effects :- Dry mouth,
urinary retension, hypotension,
impotence, impaired ejaculation,
delirium.
2. CNS effects:- sedation, withdrawal
syndrome, precipitation of mania.

15. Cont...
 Cardic side effects:- ECG change, direct
myocardial depression.
 Allergic side effects:- Agranulocytosis,
skin rashes.
 Metabolic and endocrine sides effects:-
weight gain.

16. Nurse’s responsibility
 Perform CBC, blood serum chemistry test to
specifically assess the blood glucose level
and liver and renal function tests.
 Plan to perform a baseline ECG if the patient
is at risk for arrhythmia.
 Use of drug is not recommended for children
younger than 6 year.

17. Cont...
 Except to administer a lower dosage to elderly pt.
Because they are at risk for Drug toxicity.
 Make sure at least 14 days elapse between the use
of MAOls and imipramine
 Give with food or milk if GI distress occurs
 Assess the patient’s pattern of daily bowel activity
and stool consistency.

18. Cont...
 Assess the patient appearance, behavior,
level of interest, mood and sleep pattern
before and during therapy
 Advise the patient’s to take high fiber
diet.

19. Thank you