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Drugs for Depression Treatment
July 1, 2009 |
Depression
Depression is a natural reaction to disappointment and grief, but it is normally brief
and self-limiting. Excessive or prolonged depression is an illness, sometimes without
apparent cause, and it appears to be linked with an imbalance in the brain of certain
amine substances, including serotonin, that act as neuroregulators. Drug therapy
can assist in restoring a normal balance, but prolonged treatment is usually necessary
to evoke a full response. The drugs in most frequent use are the tricyclic
antidepressants, so-called from their chemical structure, together with the
monoamine oxidase inhibitors (MAOIs). All the tricyclic antidepressants have the
same general pattern of activity, but some, such as amitriptyline, are more sedative
than others. Some related compounds have a similar antidepressant action, but blood
counts are essential with mianserin and convulsions have been reported after
maprotiline therapy. The monoamine oxidase inhibitors are phenelzine,
isocarboxazid and tranylcypromine. They are now used less often, as they are potent
drugs that react with many other therapeutic agents, as well as certain food such as
cheese, broad beans, pickled herring, and meat/yeast extracts. A new MAGI is
moclobernide, which has a more selective and reversible action on the A-form of
MAO. Particular care is necessary with tranylcypromine. Fluvoxamine, fluoxetine,
paroxetine and sertraline are newer drugs that have a more selective antidepressant
action mediated by inhibiting the re-uptake of serotonin. They are referred to
collectively as SSRIs (selective serotonin re-uptake inhibitors).
amitriptyline
amoxapme
adothiepin
edoxepin
bfepramine
75-300 mg
mg
30-90 mg
15-60 mg
50-300 mg
Manerix
imipramine
150-600mg emaprotiline
Nardil10-30 mg
Daily dose range
Approved names Brand names
citalopram fluoxetine fluvoxamine mitazapine paroxetine reboxetine sertraline
flupenthixol nefazodone tryptophan venlafaxine
Lustral 50-200 mg
Cipramil 20-60 mg
Prozac 20 mg
Faverin 100-300 mg
Optimax 3-69
Efexor 75-150 mg
Dutonin 200-600 mg
Zispin 15-45 mg
Seroxat 20-50 mg
Fluanxol 1-3 mg
Edronax 4-8 mg
selective serotonin re-uptake inhibitors (SSRI*)