Antidepressants revolution

Much of what 1 write in this book will seem controversial, but it is all thoroughly grounded on scientific evidence - evidence that I describe in detail in this book. Furthermore, as controversial as my conclusions seem, there has been a growing acceptance of them. NICE has acknowledged the failure of antidepressant treatment to provide clinically meaningful benefits to most depressed patients the UK government has instituted plans for providing alternative treatments and neuroscientists have noted the inability of the chemical-imbalance theory to explain depression.6 We seem to be on the cusp of a revolution in the way we understand and treat depression. 

DIBENZOCYCLOHEPTANES AND DIBENZOCYCLOHEPTENES Drugs in this structural class have effected a revolution in the treatment of severely depressed patients such that deinstitutionalization is a feasible public policy. The compounds often show other CNS activities which depend on the length of the side chain. One-carbon chains generally lead to anticonvulsant activity amines separated from the nucleus by three carbons usually donvey antidepressant activity. Selected examples possess significant anticholinergic activity. 

Atypicai Antipsychotics. In the 1980s and early 1990s, the SSRIs began a revolution in the treatment of depression. Tried-and-true but side effect laden tricyclic antidepressants fell into disfavor as newer and safer medications became available. A similar revolution is taking place in the treatment of psychosis. A new generation of antipsychotics that have fewer of the more disturbing side effects and may well be more effective are now available. 

In the wake of the SSRI revolution, the 1990s saw the emergence of a number of antidepressant drugs with diverse mechanisms of action. Again, the common thread behind the different approaches was an increase of synaptic monoamine levels (Table 14.1). 

In the decade since this textbook was first conceived and created, nothing short of a revolution has occurred in the practice of psychopharmacotherapy. In addition to the growing population of antidepressants, antipsychotics, and mood stabilizers, we have witnessed the ascendancy of ... 

Owens, M.J. (2004). Selectivity of antidepressants from the monoamine hypothesis of depression to the SSRI revolution and beyond. J Clin Psychiatry, 65, 5-10. 

Thanks to the Prozac revolution of the 1980s and 1990s, a majority of people in America know someone who has used antidepressants. Over 34 million people in the United States have been issued prescriptions for Prozac or another selective serotonin reuptake inhibitor (SSRI). In other words, one American in ten has used... 

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