ANTI DEPPRESANTS DRUGS WITH NURSES RESPONCIBILITY

1. ANTI DEPRESSANTS
DRUGS
MS. POOJA SEN
NURSING TUTOR

2. DEPRESSION
It is a mental illness characterized by pathological
changes in mood ,loss of interest or pleasure, feeling
of guilt or low self worth, disturbed sleep or appetite
,low energy and poor concentration.

3. ANTIDEPRESSANTS DRUGS
These are drugs which can be elevate mood in
depressive illness, practically all antidepressants
affect monoaminergic transmission in the brain in
one way or the other and many of them have other
associated properties.

4. DEFINITION
 Antidepressants are those drugs ,which are used for
the treatment of depressive illness. These are also
called as mood elevators or thymoleptics.
 Antidepressants is a psychiatric medication used to
alleviate mood disorder such as major depression,
dysthymia & anxiety disorder.

5. CLASSIFICATION
 Tricyclic Antidepressants(TCAs) – Imipramine 75-300
mg/day
Amitriptyline 75-300 mg/day
Clomipramine 75 -300 mg/day
Dothiepin 75-300 mg/day
Meanserin 30-120 mg/day

6. CLASSIFICATION
 Selective Serotonin Reuptake Inhibitors (SSRIs)-
Fluoxetine (10-80 mg/day)
Sertraline (50-200 mg/day)
Fluvoxamine (50-300 mg/day)

7. CLASSIFICATION
 Monoamine Oxidase Inhibitors (MMOIs)-
Isocarboxazid( 20-60 mg /day)
Phenelzine ( 45-90 mg/day)
Tranylcypromine (30-60 mg/day)
 Atypical Antidepressant – Amineptine (100-400
mg/day)
Mirtazapine(15-30 mg/day)

8. INDICATIONS
 DEPRESSION - Depressive episode, Dysthymia,
adjustment disorder with depressive mood, abnormal
type of grief reaction.
 CHILHOOD PSYCHIATIC DISORDER- Enuresis,
Separation anxiety disorder, somnambulism, school
phobia, night terror
 OTHER PSYCHIATRIC DISORDER- Panic attack,
Generalized anxiety disorder, Agoraphobia, Social
phobia

9. INDICATIONS
 OTHER PSYCHIATRIC DISORDER- OCD with or with
out depression, Eating Disorder, Borderline
personality disorder, Post traumatic stress disorder
 MEDICAL DISORDER- Chronic pain, Migraine, Peptic
ulcer disease .

10. CONTRA INDICATIONS
 Known hypersensitivity.
 Severe hepatic and renal impairment.
 Not used during pregnancy and lactation.
 Congestive cardiac failure .

11. PHARMACOKINETICS
Antidepressant's are highly lipophilic and protein
bound . The half life is long and usually more than 24
hours.it is predominantly metabolized in the liver.

12. MECHANISM OF ACTION
 Inhibit the re-uptake of neurotransmitter
 They inhibit the serotonin, nor epinephrine or
dopamine reuptake at pre synaptic nerve terminal
thus lead to increased concentration of these
transmitters in the synaptic cleft.
 Regulate the balance between the neurotransmitter.

13. SIDE EFFECTS
 Autonomic side effect- Dry mouth, constipation,
urinary retention, cycloplegia(paralysis of ciliary
muscles of eye), mydriasis(abnormal dilation of pupil
of the eye), orthostatic hypotension, Delirium.
 C N S Effect – Sedation, tremor and extrapyramidal
symptoms ,withdrawal syndrome, seizures
 CARDIAC EFFECTS- Trachy cardia, ECG Change

14. SIDE EFFECTS
 Allergic side effects- Agranulocytosis, skin rashes
 Metabolic side effects – wight gain

15. ROLE OF NURSE
 Instruct the patient not take any medication with out
prescription.
 Caution the patients to change his position slowly to
minimize orthostatic hypotension.
 Strict monitoring of vitals, especially blood pressure is
essential .
 Advice the patient to take high fiber diet.
 Closely monitor the suicidal patient during early therapy.
 Advice the patient do not crush the tablet.

16. THANK YOU