Antidepressant drugs antidepressants experiments

Antidepressant drugs are used to manage depressive episodes such as major depression or depression accompanied by anxiety. These drugs may be used in conjunction with psychotherapy in severe depression. The SSRIs also are used to treat obsessive-compulsive disorders. The uses of individual antidepressants are given in the Summary Drug Table Antidepressants. Treatment is usually continued for 9 months after recovery from the first major depressive episode. If the patient, at a later date, experiences another major depressive episode, treatment is continued for 5 years, and with a third episode, treatment is continued indefinitely. 

In a way, these critics are right. Clinical experience does show that prescribing antidepressant drugs works - and so did our... 

These types of antidepressant were introduced around 10 years after the SSRIs. They include the serotonin noradrenaline reuptake inhibitor venlafaxine and the selective noradrenaline reuptake inhibitor reboxetine. Although there are fewer data about these drugs, clinical experience has shown they are well tolerated and, unlike the SSRIs, they are only weak inhibitors of drug metabolism (Kent, 2000). Depression is a common psychiatric disorder seen in the elderly and often remains untreated or inadequately treated (Forsell and Fastbom, 2000). Venlafaxine was shown to improve the mood in a group of 36 older patients without any effect on cognitive function, an important consideration where there is the possibility of the coexistence of mild or undiagnosed dementia (Tsolaki et al., 2000). 

Some patients with bipolar disorder will need antidepressants. Although the switch rate into mania or induction of rapid cychng by antidepressants is controversial, these agents do appear to present a risk for some patients, often with devastating consequences. Therefore, when a patient with bipolar disorder is prescribed an antidepressant, it should only be in combination with a medication that has established antimanic properties. Controlled comparative data on the use of specific antidepressant drugs in the treatment of bipolar depression are sparse. Current treatment guidelines extrapolate from these few studies and rely heavily on anecdotal chnical experience. Overah, tricyclic antidepressants should be avoided when other viable treatment options exist. Electroconvulsive therapy should be considered in severe cases. 

The so-called tail suspension test applies a similar principle (Steru et id., 1985 Fujishiro et ah, 2001). Instead of being immersed in water the animal (usually a mouse) is suspended by its tail. Following an initial period of struggling, untreated (control) animals remain predominantly in an immobile posture whereas animals treated immediately before the experiment with an antidepressant drug show a reduction in the time spent immobile. 

Because there are also some data that concurrent use of antidepressants can lead to rapid cycling in vulnerable patients, these agents may best be cautiously used on an as-needed basis or as adjuncts when there are early signs of breakthrough depressive, psychotic, or anxious symptoms. In particular, antidepressants do not prevent manic episodes, and may even precipitate them. The fact that many patients on antidepressants experience a manic phase, however, could be coincidental, rather than drug-induced. To definitively answer this question, we need to show that the number who switch to mania is higher on, as opposed to off, antidepressant therapy. Given these concerns, however, we advocate the initial use of a mood stabilizer alone to lessen the chance of a switch to mania in bipolar depressed patients. If this is insufficient, a mood stabilizer should be used concurrently with an antidepressant. 

MAO inhibitors are indicated for depressed patients who are unresponsive or allergic to tricyclic antidepressants or who experience strong anxiety. Patients with low psychomotor activity may benefit from the stimulant properties of MAO inhibitors. These drugs are also useful in the treatment of phobic states. A special subcategory of depression, called atypical depression, may respond to MAOIs. Atypical depresssion is characterized by labile mood, rejection sensitivity and appetite disorders. 

The antidepressant drugs are hardly panaceas. Only about 50-60% of padents experience a response to the medicadons, where response is arbidrarily defined as 50% or greater reducdon in symptoms (Hirschfeld, 1999). This compares with a 30 0% response to placebo. Rates for remission, with complete recovery and absence of symptoms, are even lower, in the 20-30% range. No one anddepressant is more... 

Whenever a new antidepressant drug is being tested for efficacy, researchers must also give half the test subjects a pill that does not have any drug in it. Patients participating in the experiment are told they may be treated with an active drug or just a sugar pill, but they will not be told until after the study which one they received. 

After ingestion of a meal that included sardines, cheese, and red wine, a patient taking an antidepressant drug experiences a hypertensive crisis. The drug most likely to be responsible is (A) Bupropion Fluoxetine Imipramine Phenelzine Trazodone... 

Goldman, D., Clinical experience with newer antidepressant drugs and some related electroencephalographic observations, Ann. N. Y. Acad. Sci. 80, 687 (1959). 

The pharmacoeconomics of the anxiety disorders has received litde attention. In the past drug costs were largely incurred by use of benzodiazepines, most of which are available in generic forms and are cheap. They are effective and acceptable in the short term. Long-term use is associated with the risk of physical dependence, with an adverse risk—benefit ratio and high cost terms to facilitate withdrawal. There is now a trend towards the use of antidepressants in the anxiety disorders. Clinical experience has been followed by formal trial evaluation. 

However, experience proves that depression can be reversed by drugs that augment serotonergic and noradrenergic transmission (and reinstated by a deficit in the synthesis of these monoamines). These, then seem to be crucial targets that ultimately determine mood. This would explain why, despite numerous neurochemical options for the causes of depression, all antidepressants developed so far (and even those discovered by chance) target these neuronal systems. Whatever the cause of depression, therefore, its relief seems to rest on appropriate secretion of these monoamines. This would be entirely... 

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