Drugs used in affective disorders—antidepressants

Tile cause of depression and the mechanism of aeiion of antidepressants are unknown. The monoamine theory wa.s ba.sed on the idea that depression resulted from a dcctea.se in the activity of central noradrenergic and/or serotonergic systems. There are problems with thi.s theory, but it has not been replaced with a heeler one. More recently, interest has focused on the mechanism of action of aniidepressanis. 

In mama and in bipolar ertive tl.ixordi rs (where mania alternates with depression), lithium ha.s a mood-siabillzing action. Lithium salts have a low thcrapeuiie/loxic ratio and adverse effects are common. Carbama/epinc and valproate also have mood-slubitizing properties and can be used in cases of non-response or intolerance to lithiitm. 

Lithium is used for prophylaxis mmanicldcpre. i.sive illness. It is also used in the treatment of acute mania, but. because it may lake seveniJ days for the antimanic effect to develop, an antipsychotic drug i.s usually preferred for acutely disturbed patients. Lithium is used as an antidepressant in comhinaiion with tricyclics in refractory patients. 

---