Anti-Depressant Agent

Anti-Depressant Agent

Antidepressant medications are primarily used to treat depressive disorders brought on by emotional or environmental stress in affective disorders or disturbances. Antidepressants are effective in treating a variety of emotional disorders. These medications improve mood and lessen other signs and symptoms of moderate to severe depression. These also go by the name "mood elevators." Tricyclics, second-generation antidepressants like SSRIS and SNRIS, and the MAOIS drug class all fall within this category (serotonin-norepinephrine reuptake inhibitors).

Indication

• Depression (such as dysthymia, reactive depression, depression linked to organic disease, bipolar disorder's depression phase, and depressive episode with psychotic symptoms).
• Child psychiatric illness (e.g. neurosis, separation anxiety disorder, school phobia, night terrors, attention deficit disorder with hyperactivity).
• Other psychiatric disorders (such as alcoholism, eating disorders, posttraumatic stress disorder, migraines, agoraphobia, panic attacks, generalized anxiety disorder, and OCD with or without depression)

Mechanism of Action

Unknown is the exact mechanism. Catecholamine levels in the brain are elevated as the main mechanism of action. In the end, these medications aim to raise blood levels of norepinephrine and serotonin. By preventing the reuptake of these substances by the neurons, this is achieved in the brain. Additionally, it happens when the body's various locations inhibit the monoamine oxidase (MAO), an enzyme known to deactivate norepinephrine and serotonin (MAO inhibitors). Serotonin and norepinephrine, two monoamine neurotransmitters, are kept active in the brain at higher levels by blocking the enzymes that oxidize them. Serotonin, norepinephrine, and dopamine are just a few of the neurotransmitters that tricyclic antidepressants (TCAS) stop from being reabsorbed. Selective serotonin raises the amount of active serotonin in brain synapses.

Precautions

• Hypersensitivity.
• Acute phase of recovery after myocardial infarction.
• Glaucoma with an angle closure.

Caution

• Senior patient
• Patient with heart, renal, or liver dysfunction
• Patients with psychosis.
• Benign prostatectomy.
• Patient with a seizure history.

Classification of Antidepressant

• Amitriptyline
  • 75-300 mg/day
• Amoxapine
  • 100-600 mg/day
• Imipramine
  • 75-300 mg/day
• Doxepin
  • 30-300 mg/day
• Mianserin
  • 30-120 mg/day
• Clomipramine
  • 75-150 mg/day
• Fluoxetine
  • 10-80 mg/day
• Sertraline
  • 50-200 mg/day
• Trazodone
  • 150-600 mg/day
• Isocarboxazid
  • 10-30 mg/day

Nursing Intervention

Side Effect

• Mouth arid
• Distorted vision
• Constipation.
• Bladder retention
• Sedation.
• Hypotension while standing.
• Decrease in seizure threshold
• Arrhythmias and tachycardia.
• Photosensitivity.
• Hypertensive emergency
• Gaining weight
• The patient laments a loss of sexual drive as well as prolonged or inappropriate penile erections.

Nursing Implication

• Give out chewing gum, mouthwash, and frequent mouth rinses.
• Reassurance: in a few weeks, this symptom will go away.
• Until their vision is clear, tell the patient not to drive.
• If it's not contraindicated, increase your hydration intake.
• If at all possible, encourage the patient to exercise more frequently.
• Observe your intake and output.
• There are many ways to increase urination, including:
  • Encourage regular urination
  • Pouring water over the perineum or running water in the restroom.
• Give the patient the advice to avoid operating risky machinery or driving while sedated.
• If a patient is lying down, tell them to get up gradually.
• Routinely keeping an eye on vital signs and OH.
• Skip the hot, long showers.
• Keep an eye on your pulse and blood pressure.
• When spending time outside, make sure the patient is wearing protective clothing, sunglasses, and sunscreen.
• According to a doctor's instructions, administer antihypertensive medicine.
• Utilize cooling techniques outside the body to manage hyperpyrexia.
• Inform the patient about a low-calorie diet.
• Weight record per week.