Antidepressant drugs types

Depression is treated with the use of antidepressan t drugs. Psychotherapy is used in conjunction with the antidepressant drug s in treating major depressive episodes. The four types of antidepressants are ... 

Serotonin mediates many central and peripheral physiological functions, including contraction of smooth muscle, vasoconstriction, food intake, sleep, pain perception, and memory, a consequence of it acting on several distinct receptor types. Although 5-HT may be metabolized by monoamine oxidase, platelets and neurons possess a high-affinity mechanism for reuptake of 5-HT. This mechanism may be inhibited by the widely prescribed antidepressant drugs termed selective serotonin re-uptake inhibitors (SSRl), e.g. fluoxetine (Prozac ), thereby increasing levels of 5-HT in the central nervous system. 

The analyses reviewed thus far are all observational studies using econometric procedures. In contrast, Kravitz et al. (2005) examined prescribing behavior of antidepressant drugs in a randomized controlled trial setting. Mostly professional actors, middle-aged, white, nonobese women, called standardized patients, were trained to depict to physicians two types of patients with differing severity of symptoms one with symptoms of major depression of moderate severity, and the other having an adjustment disorder with depressed mood. 

These two patient types were chosen to represent different levels of illness severity. Clinical treatment guidelines recommend quite clearly that the first type of patient presenting with moderate major depression symptoms receive treatment (psychotherapy, antidepressant drugs, or some combination), but for the second type of patient presenting with less severe symptoms the appropriate treatment is equivocal and ambiguous. ... 

Using a different set of statistical procedures, Kravitz et al. (2005) found that prescribing an antidepressant drug was 2.92 times more likely when a standardized patient presented with major depressive rather than adjustment disorder symptoms, and 8.50 and 10.3 times more likely when the patient made a brand-specihc or a general medication request, relative to no specific medication request, respectively. Physicians varied systematically in their propensity to prescribe an antidepressant, regardless of the type of patient presenting. But none of the standardized patients was systematically more or less likely than other patients to receive an antidepressant drug prescription. 

Historically, Saletu (1976) performed a series of EP experiments in health subjects to stud the action of several antipsychotics, antidepressants, anxiolytics and psychostimulants. Similar to Fink and Itil for the pharmaco-EEG, he reported on systematic, drug-type-related changes in EP latencies after somatosensoiy stimulation of his subjects. 

Enantioselective reduction of jS-keto nitriles to optically active 1,3-amino alcohols has been carried out in one step using an excess of borane-dimethyl sulfide complex as a reductant and a polymer-supported chiral sulfonamide as a catalyst with moderate to high enantioselectivity (Figure 3.11). The facile and enantioselective method to prepare optically active 1,3-amino alcohols has been used to prepare 3-aryloxy-3-arylpropylamine type antidepressant drugs, for example (l )-fluoxetine. 

FIGURE 7-2 T Effects of antidepressant drugs on amine synapses. All three types of drugs... 

Little research has been conducted on how LSD interacts with other drugs. The most complete research is with antidepressant drugs because these commonly prescribed medications affect the same brain chemical, serotonin, that LSD does. There are three types of antidepressants, and each interacts differently with LSD ... 

Some researchers believe the mood-elevating properties of oxycodone make it a reasonable treatment for depression in certain individuals, although that use of the drug is not yet common. The most likely to benefit from this type of therapy are people with major depression whose illness has not been successfully controlled with standard antidepressant medications. Careful, close monitoring is essential since, unlike antidepressant drugs, oxycodone does cause side effects and poses a risk of addiction. 

The type of research described under this heading aims at correlating therapeutic outcome and pre-therapy sleep as well as therapy-induced sleep alterations. This section is voluntarily limited to the two therapies whose relationships to sleep are the most documented, i.e., antidepressant drugs and sleep deprivation therapy. The effects of these two therapies are examined in the light of the three theories. According to these theories, effective therapies have either to decrease the arousal level, to increase process S, or to restore the aminergic/cholinergic balance. 

The sulfuric acid salt of 5 (Parnate Jatrosom ) is used as an antidepressant drug, and best results were achieved in chronic neurotic patients. (+ )-(5) was reported to be also effective as an adjuvant in Parkinson s disease therapy . Differences of activities of the pure enantiomers (for a minireview see Ref. 629 for resolution of racemic 5 see Refs 42, 103, 160, 654, 655 for g.c. separation of racemic 5 as iV-trifluoracetyl-L-prolyl derivative, see Ref. 656) and the trans-cis diastereomers 5/628 have been studied as well as the selectivities of 5 on inhibition of MAO type A and B (e.g. Refs 637, 638, 658-674). (+ )-(5) showed stronger inhibition of platelet (dopamine ... 

Aminocyclopropyl compounds 630 (Lilly 51641) and 631 (Encyprat) have also been tested clinically as antidepressant drugs 630 turned out to be a fairly selective inhibitor for type A MAO, e.g. Refs 637, 638, 658, 669, 670, 675, 676 a similar behavior was found for the corresponding iodo compound (630, I instead of Cl). Derivatives 632 (AB 15) " 633 and 53468 -690 further examples for compounds with remarkable inhibitory effects for MAO. 

---