Antidepressants are medications used to treat depression and prevent recurrence. They work by increasing levels of serotonin, norepinephrine, and other neurotransmitters through inhibiting reuptake. Tricyclic antidepressants and MAOIs increase neurotransmitter levels by inhibiting reuptake or the enzyme that breaks them down, while SSRIs selectively inhibit serotonin reuptake. Common antidepressants include imipramine, nortriptyline, fluoxetine, and sertaline. They are used to treat endogenous depression, depression with other illnesses, and conditions like anxiety and OCD. Nurses should monitor for side effects and educate patients on safe usage and gradual discontinuation.

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