Antidepressant drugs antidepressants sedative

A number of medications have been associated with an increased risk of falling, including drugs affecting mental status such as antipsychotics, benzodiazepines, tricyclic antidepressants, sedative-hypnotics, anticholinergics, and corticosteroids. Some cardiovascular and antihypertensive drugs also can contribute to falls, especially those causing orthostatic hypotension.9... 

Many antidepressant drugs have pronounced effects on sleep. Several tricyclic compounds (amitriptyline and others) have sedative actions while others (imipramine and others) are less sedative or even stimulant. Monoamine oxidase inhibitors (MAOIs) have central stimulant effects and may cause insomnia. Specific serotonin reuptake inhibitors (SSRls) and combined serotonin, noradrenaline reuptake inhibitors (SNRIs) can also cause insomnia. 

Hydromorphone should never be combined with other drugs that depress the central nervous system. Such drugs include sedatives, tranquilizers, alcohol, and anesthetics. In addition, other types of drugs, such as antidepressants, antihistamines, anticonvulsants, and... 

Other classes of drugs not included in Figure 22-3 that may exert sedative effects include most antipsychotic and many antidepressant drugs and certain antihistaminic agents (eg, hydroxyzine, promethazine). As discussed in other chapters, these agents differ from conventional sedative-hypnotics in both their effects and their major therapeutic uses. Since they commonly exert marked effects on the peripheral autonomic nervous system, they are sometimes referred to as "sedative-autonomic" drugs. Certain antihistaminics with sedative effects are available in over-the-counter sleep aids. Their autonomic properties and their long durations of action can result in adverse effects. 

All muscle relaxing agents should be given with caution to anyone who is taking other drugs. The muscle relaxers will enhance the sedative effects of many other classes of drugs such as antihistamines, antidepressants, sedatives, other muscle relaxants, and tranquilizers. 

Tricyclic antidepressants block neuronal uptake of norepinephrine and variably serotonin (those with tertiary amine side chains), and the degree of inhibition seems to correlate with antidepressant activity. However, the block in amine uptake occurs shortly after drug administration, whereas the antidepressant effects generally require several weeks to develop. Thus the mechanism of action is incompletely understood and may involve changes in presy-naptic and postsynaptic neurogenic amine receptor response. In addition to their mood-elevating actions, tricyclic antidepressants also have sedative effects that may be... 

Drugs digitalis, diuretics, antidepressant, sedative drugs, oestrogens, etc. 

The difficulty of attempting to classify psychotropic drugs on a chemical basis is well illustrated by these compounds. The formulae and pharmacological activities of a number of them are shown in Table 5.2. All classes of psychotropic drug from sedatives to central stimulants and psychoto-mimetics are represented in the table. Of the derivatives listed as minor tranquillizers, only hydroxyzine is of clinical value, though benactyzine deserves mention since it has been used both as a tranquillizer and as an antidepressant ... 

Lithium, the mainstay for bipolar disorder treatment often needs supplementation with antidepressant and/or sedative drugs. The uses, mechanisms of action, and adverse effects of lithium therapy as well as backup drugs used for treatment of bipolar disorder are considered. 

While the SSRIs are the most frequently used drugs for treatment of major depressions, the tricyclics remain valuable alternatives. In some patients a tricyclic may be the first choice, especially if the past history indicates a positive therapeutic response to such drugs. The sedative actions of tricyclics may be of value in depressed patients with insomnia or weight loss, since SSRIs tend to exacerbate such symptoms. Generic formulations of the tricyclics are much less costly than any of the other antidepressant drugs. 

Hydromorphone should be used with caution if other central nervous system depressants are given concomitantly. These drugs are other opioids, general anesthetics, phenothiazine, tricyclic antidepressants, sedative-hypnotics, and other central nervous system depressants (including ethanol). 

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