Antidepressants.pptx

Antidepressants are a class of medication used to treat major depressive disorder, anxiety disorders, chronic pain conditions and to help manage addictions. Common side-effects of antidepressants include dry mouth, weight gain, dizziness, headaches, sexual dysfunction, and emotional blunting

1. Antidepressants Prof. Amol B. Deore Department of Pharmacology MVP’s Institute of Pharmaceutical Sciences, Nashik

2. AFFECTIVE DISORDERS Affective disorders involve a disturbance of mood ( cognitive आकलनविषयक / emotional भावनिक symptoms) associated with changes in behavior, energy, appetite and sleep (biological symptoms). Affective disorders can be thought of as pathological extremes of the normal continuum of human moods, from extreme excitement ( उत्साह )and mania ( उन्माद ) to severe depressive states. Cognition is defined as ' the mental action or process of acquiring knowledge and understanding through thought, experience, and the senses . ( Cognition → Relevance /   Reasonable /  empirical .)

3. euphoria means अत्यानंदाची अवस्था

4. Reactive depression is where there is a clear psychological cause, e.g. bereavement. It involves less-severe symptoms and less likelihood of biological disturbance. It affects 3–10% of the population, with the incidence increasing with age, and it is more common in females. Endogenous depression is where there is no clear cause and more severe symptoms, e.g. suicidal thoughts, and a greater likelihood of biological disturbance, e.g. insomnia, anorexia . It affects1%of the population , usually starting in early adulthood, and affecting both sexes equally.

5. Classification of antidepressants

6. These are the drugs which inhibit the action of MAO enzyme which is involved in the metabolism of monoamine neurotransmitters (NA, Adrenaline, Dopamine and Serotonin) and thus increase the availability of these neurotransmitters in the brain, thereby elevate the mood. Deficiency of these monoamine neurotransmitters in mesolimbic system of brain produces mental depression. MAO was found to exist in two forms: MAO-A and MAO-B. MAO-A preferentially metabolises NA, Dopamine and Serotonin. MAO-B preferentially metabolises Dopamine and Phenylethylamine .

7. Non-selective MAO inhibitors produce irreversible inhibition of both MAO-A and MOA-B. Thereby increase the concentrations of NA, adrenaline, serotonin and dopamine in the brain. MAO inhibition produces feeling of well-being and increase in motor activity.

8. Tyramine is an amino acid which is utilized for synthesis of catecholamines . Catecholamines help regulate blood pressure. Tyramine present naturally in the body and also found in cheese, chocolates, citrus fruits, chicken liver, yeast, dairy milk products, red wines etc. Monoamine oxidase enzyme promote metabolism of tyramine in the body whereas Monoamine oxidase inhibitors ( MAOIs ) block monoamine oxidase enzyme. Blocking this enzyme helps relieve depression by raising the levels of catecholamines (NA, adrenaline, dopamine) and serotonin in the brain .

9. If MAO inhibitors and high- tyramine rich food taken simultaneously then tyramine can quickly reach dangerous levels. This can cause a serious hypertensive crisis (Alpha and Beta adrenergic action) and require emergency treatment. Hypertensive crisis include severe hypertension, cardiac arrhythmia, cerebral hemorrhage etc. Therefore avoid taking MAO inhibitor therapy with consumption of dairy products as well as red meat.