Tag archives for TCAs
Antidepressants: Drug Interactions
Posted By Kelly On Sunday, June 27th 2010 under: Antidepressants Tags: MAOIs, Selective serotonin reuptake inhibitors (SSRIs), TCAs
The most common drug interaction with antidepressants is their influence on the metabolism of other drugs. Antidepressants are metabolized through catabolic enzymes located in a variety of places, but primarily in the smooth endoplasmic reticulum of hepatocytes: the cytochrome P450 (CYP) enzymes. Many other drugs are also metabolized through similar pathways: it is estimated that about half of all drugs prescribed depend on CYP for their metabolism.
Of these enzymes, most ... Read More
Antidepressants: Side Effects
Posted By Kelly On Wednesday, June 23rd 2010 under: Antidepressants Tags: Selective serotonin reuptake inhibitors (SSRIs), SNRIs, TCAs
Once the choice of an antidepressant has been made, the main goal is to maximize therapeutic effects and minimize side effects. Good preparation and reassurance of the patient is essential. Even relatively benign side effects are a major cause of treatment nonadherence; drop-out rates ranging from 7 to 44% have been reported in various studies of tricyclic antidepressants (TCAs), and from 7 to 23% in studies of serotonin reuptake inhibitors. ... Read More
Treatment of Partially Responsive and Nonresponsive Patients. 2
Posted By Kelly On Sunday, June 20th 2010 under: Antidepressants Tags: Atypical antidepressants, MAOIs, non-responsive-depression-symptoms, SNRIs, SSRIs, TCAs
Continuation and Maintenance Periods, and Discontinuation
CONTINUATION PERIOD
This period usually lasts five to eight months after the end of the acute treatment period. The goal at this phase is the prevention of relapse. There is a high risk of relapse if treatment is discontinued after the acute treatment phase, with rates of 15% after six months and 22% after 12 months. The two best predictors of relapse are a high number ... Read More
Treatment of Partially Responsive and Nonresponsive Patients. 1
Posted By Kelly On Saturday, June 19th 2010 under: Antidepressants Tags: Atypical antidepressants, MAOIs, non-responsive-depression-symptoms, SNRIs, SSRIs, success-rate-of-lithium-augmentation-infor-depression, TCAs
There is little benefit in making treatment changes before three weeks, other than to mitigate side effects. Changes in treatment strategy should be considered after the physician is satisfied that the patient has been treated with an adequate dosage of the antidepressant for an adequate time, with current medications increased to the limit of side effect tolerance.
In patients showing an inadequate response after a reasonable time, the decision is either ... Read More
Drug Selection and Initiation of Treatment for Major Depression. Treatment
Posted By Kelly On Tuesday, June 15th 2010 under: Antidepressants Tags: Atypical antidepressants, MAOIs, SNRIs, SSRIs, TCAs
Initiation of Treatment
Starting doses, titration schemes, and target doses for commonly-used tricyclic antidepressants (TCAs), monoamine oxidase inhibitors (MAOIs), selective serotonin reuptake inhibitors (SSRIs), and other agents are shown in Table: Starting Dose, Titration Steps, and Target Doses for Common Antidepressants. Once medication is initiated, it should be gradually increased to therapeutic levels by titration.
TCAs are usually started at a relatively low dose; these low doses are preferred in elderly patients. ... Read More
Drug Selection and Initiation of Treatment for Major Depression
Posted By Kelly On Monday, June 14th 2010 under: Antidepressants Tags: Atypical antidepressants, MAOIs, SNRIs, SSRIs, TCAs
On average, all antidepressants are equally effective. Without a personal or family history of response to a particular agent, side effects are the most influential factors when selecting treatment.
Both longitudinal and cross-sectional factors should be considered when selecting an antidepressant for major depression:
• What were the course, duration, and severity of any previous episodes of depression?
• Is there a history of antidepressant response?
• How well was the antidepressant tolerated?
• Is ... Read More
Indications for Use of Antidepressants
Posted By Kelly On Thursday, June 10th 2010 under: Antidepressants Tags: Atypical antidepressants, MAOIs, SNRIs, SSRIs, TCAs
All antidepressants are indicated for the treatment of acute major depressive episodes; there is also evidence for their use in the prevention and relapse and recurrence. In addition, a number of more minor forms of depression may also respond to antidepressant medication, including dysthymic disorder, minor depression, and recurrent brief depression.
All antidepressants appear to treat more than depressive disorders. Particularly consistent have been data showing their utility for anxiety disorders; ... Read More
Antidepressants: Pharmacology
Posted By Kelly On Saturday, June 5th 2010 under: Antidepressants Tags: Atypical antidepressants, MAOIs, SNRIs, SSRIs, TCAs
The use of antidepressants in the treatment of depression remains the best-understood use of these medications; however, there is a growing list of other indications for antidepressants, including panic disorder (PD), obsessive-compulsive disorder (OCD), bulimia and posttraumatic stress disorder (PTSD). Many of these illnesses respond best to combination treatment modalities that include medication and various forms of psychotherapy.
The first antidepressant was the monoamine oxidase inhibitor (MAOI), iproniazid, initially licensed as ... Read More