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Antidepressant Agents - Coggle Diagram
Antidepressant Agents
Bipolar disorder
Manic-depressive. Mania is characterised by elation, hyperactivity and uncontrolled thoughts and speech.
Treatment
: mood stabilizers
Lithium, Antiepileptic agents, Antidepressants (adjunct)
3 to 4 weeks to develop effect. Given long-term.
Acute attack: only effective to reduce mania, not depression.
Depression
mood disorders (mostly recurrent)
Bipolar disorder
Cycling mood
Strong hereditary tendency
Unipolar disorder
Mania
Depression
Monoamine hypothesis
A decrease in monoamines, particularly NA and 5-HT at critical synapses
Agents
MAOIs
2nd generation: SSRIs
TCAa
Miscellaneous/Atypical: NDRIs, SNRIs, SARIs, NaSSAs.NRIs, SMSs
Inhibition of enzymes that participate in signal transduction pathways
Inhibition of inositol monophosphate
Inhibition of inositol triphosphate formation
Inhibition of kinases
Therapeutic uses
Prophylaxis and treatment of mania
Prophylaxis of bipolar or unipolar disorder
narrow therapeutic window
Effective plasma concentration: 0.6 to 1.2 mmol/L
Toxic: >1.5 mmol/L
Lithium
PK
: oral as carbonate salt, absorbed readily from GIT. Steady state is achieved after 5 days. Half-life of about 24 hours.
Adverse effects
Pregnancy category: D
Polyuria, Thyroid enlargement, Weight gain, Acne
Common
: GI distress, eg. reduced appetite, N/V/D
Symptoms
Emotional symptoms
misery, apathy, pessimism, low self-esteem (eg. guilt, inadequancy, ugliness), indecisiveness, loss of motivation, suicidal behaviours
Biological symptoms
retardation of thought and action, loss of libido, low energy, poor concentration, sleep disturbance, loss of appetite