There are three types of depression:REACTIVE (EXOGENOUS)
Reactive depression has a sudden onset and lasts for months and is usually
caused by an event such as the loss of a loved one. Benzodiazepine is used to
treat reactive depression.MAJOR (UNIPOLAR)
Major depression is characterized by losing interest in work and home. The
patient is unable to complete tasks and falls into a deep depression. Causes of
major depression can include genetic predisposition, social and environmental
factors, and biologic conditions. Benzodiazepines are the drugs of choice to treat
major depressions.BIPOLAR AFFECTIVE (MANIC-DEPRESSIVE)
Bipolar affective is when the patient undergoes moods swings from manic
(euphoric) to depressive (dysphoric). Lithium is prescribed for bipolar affective
disorders.
Antidepressants are used to treat depressions, however they also can mask sui-
cidal tendencies (Table 15-3). There are four groups of antidepressants. These are
tricyclics, second-generation antidepressants (Serontonin Reuptake Inhibitors or
SSRIs), atypical antidepressants, and Monoamine oxidase (MAO) inhibitors.
Tricyclics are the most commonly prescribed drug to treat major depression.
Tricyclics include clomipramine HCl (Anafranil), desipramine HCl (Norpramin,
Pertofrane), doxepin HCl (Sinequan), imipramine HCl (Tofranil), Nortriptyline
HCl (Aventyl), Protriptyline HCl (Vivactil), and trimipramine maleate (Surmontil).
Second-generation antidepressants have fewer side effects than tricyclics.
They do not cause hypotension, sedation, anticholinergic effects, or cardiotoxi-
city. Second-generation antidepressants include- SSRI: fluoxetine HCl (Prozac), paroxetine HCl (Paxil), sertraline HCl
(Zoloft), fluvoxamine (Luvox) - Atypical: amoxapine (Asendin), bupropion HCl (Wellbutrin), maprotiline
HCl (Ludiomil), nefazodone HCl (Serzone), trazodone HCl (Desyrel)
(^298) CHAPTER 15 Nervous System Drugs