DEPRESSION-Cond...
Tricyclic antidepressants and MAOIs should not be given together as the combination will seriously result in excess accumulation of catecholamines at the receptors that lead to a crisis, convulsions, and coma.
Serotonin Specific Reuptake Inhibitors (SSRIs):-
1.Fluoxetine
2.Sertraline
3.Paroxetine
4.Fluvoxamine
Mechanism:-
These drugs increase the availability of serotonin (5-Hydroxy Tryptamine) at the synapses by inhibiting its reuptake mechanism. It has no specific effect on norepinephrine and dopamine and hence these drugs are mild and safe.
Therapeutics
1.Depression
2. Fluoxetine is used in Obsessive-Compulsive Disorder (OCD)
Route of Administration:-
By oral route.
Kinetics
They are well absorbed orally and metabolized in the liver by the induction of the enzyme Cytochrome-P-450. Fluvoxamine is exempted as it is metabolized but a powerful C P-450 inhibitor. The metabolites are excreted in the urine.
Side Effects
In general, these drugs are safer than tricyclic and traditional antidepressants as they are specific on serotonin reuptake only. They don't interfere with or inhibit the reuptake of norepinephrine and dopamine. Hence they are milder in producing anticholinergic, antihistaminic, and alpha-adrenergic blockades.
1.Nausea
2.Diarrhea
3.Nervousness
4.Insomnia
5.Dizziness
6.Impotence
7.Decreased libido.
Contraindicated:-
If used with any drug which inhibits the mitochondrial enzyme Mono Amine Oxidase which is responsible for metabolizing norepinephrine dopamine and other catecholamines, and serotonin the excess accumulation of these chemicals will leads to a crisis known as Serotonin Syndrome which leads to hyperthermia, muscle rigidity, myoclonus(spasmodic twitching of group of muscles), and rapid mental disorder.
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