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Effects of antidepressants - Coggle Diagram
Effects of antidepressants
Abstract
Effects of antidepressants can delay recovery. It is important to think of side effects before taking. No antidepressant is free of reactions, but others can be safer, can be tolerated better, and be more compliant.
Duration
70% of patients taking antidepressants are non compliant. 44% stopped taking medications after 3 months and 22% stopped after 1 month. 7%-23% of people who stop due to side effects take serotonin reuptake inhibitors at 7%-44%are taking tricyclic antidepressants.
Mechanisms of serotonin reuptake inhibitors.
This medication blocks serotonin reuptake at the nerve terminal. There are many different types, least effects are in Citalopram and Sertraline. Fluoxetine has the largest alf-life and causes the metabolism to be active. Each medication is metabolized by the liver and has hepatic enzymes. This can cause an increase in other medication and can become toxic.
Side effects of serotonin reuptake inhibitors.
Sexual dysfunction- the most common side effect, this includes decreased libido, delayed ejaculation and anorgasmia. This side effect only lasts while on the medication and effects 60% of patients.
Gastrointestinal effects- most common in Sertraline, this includes nausea and diarrhea. Paroxetine effects are constipation and dry mouth due to its anticholinergic components.
Central nervous system side effects- This includes anxiety, nightmares, sleep disturbances and insomnia. 25% of patients have these effects but other drugs are used to counteract these or have gone away after 2 weeks of taking the medication.
Bleeding- serotonin uptake inhibitors have platelet functions included, this can prohibit bleeding from stopping. This also contributes to easier bruising.
Serotonin Syndrome- extreme restless and agitation that can lead to delirium and seizures. Rare cases have resulted in a coma.
Discontinuation syndrome- This occurs if there is an abrupt stop to taking the medication if taking a large dose or taking medication for a long period of time. This results in dizziness, nausea, restless sleeping, and headaches.
Tricyclic antidepressants
Became popular in the 1980s but are not used now due to less toxic and selective medications being available. These types of antidepressants block reuptake of norepinephrine and serotonin. This can cause characteristic side effects. Phenytoin levels also increase when taking this medication so blood levels need to be monitored closely.
This medication should be started on a small does and should not be taken if elderly because of the increase in dizziness and falls.
Side effects of tricyclic antidepressants
Anticholinergic side effects- dry mouth, urinary retention, delirium, and confusion.
Cardiac- This medication slows down cardiac conduction which causes a delay causing tachycardia, this is the number one reason why patients stopped this medication.
Seduction is the most common side effect that has an antihistamine type effect
weight gain
Discontinuation syndrome.
Citation
Khawam EA, Laurencic G, Malone DA. 2006. Side effects of antidepressants: an overview. Cleveland Clinic Journal of Medicine. 73(4):351–353. doi:10.3949/ccjm.73.4.351.