Facts on File Encyclopedia of Health and Medicine

OTHER ANTIDEPRESSANTS

bupropion nefazodone
trazodone venlafaxine

How These Medications Work
Most antidepressant medications, regardless of
class, work through selective reuptake inhibition:
they block the natural breakdown and reassimila-
tion of specific neurotransmitters, biochemicals
that carry NERVEimpulses between neurons. The
result is an extended presence of the neurotrans-
mitters, increasing the number of nerve impulses
they can transport. Researchers do not know the
precise mechanisms of this process, though the
result is an elevation of function in the affected
parts of the brain, which in the case of depression
are areas concerned with mood and emotion.
Though antidepressants affect neurotransmission
from the first dose, noticeable changes generally
do not occur until after several weeks of use.

Therapeutic Applications

The primary use of antidepressant medications is
to treat moderate to severe DEPRESSION. Doctors
may also prescribe antidepressants to treat BIPOLAR
DISORDER, BODY DYSMORPHIC DISORDER, eating disor-
ders, ACUTE STRESS DISORDER,POST-TRAUMATIC STRESS
DISORDER(PTSD), POSTPARTUM DEPRESSION;ADDICTION
recovery, SEASONAL AFFECTIVE DISORDER(SAD), and in
combination with other medications to treat psy-
chotic disorders such as SCHIZOPHRENIA. Some anti-
depressant medications have uses outside the
realm of psychiatric disorders and psychologic
conditions, such as smoking cessation, chronic
pain management, and relief of menopause dis-
comforts. Some of these are OFF-LABEL USE.

Risks and Side Effects

Though antidepressants make it possible for nearly
10 million Americans to participate fully in, and
enjoy, the activities of every day life, they have sub-
stantial risks. Any antidepressant that inhibits
reuptake of norepinephrine also has an effect on
smooth MUSCLE function throughout the body,
notably the gastrointestinal tract, genitourinary
tract, and cardiovascular system. Side effects such
as dry mouth, constipation, urinary hesitancy or
urinary frequency, and ERECTILE DYSFUNCTIONare
common, though they often improve after taking

the antidepressant for three months. Though each

classification of antidepressant drugs has risks and

side effects that are common to all drugs in the clas-

sification, each medication also has unique risks

and side effects. Often, side effects improve over

time and are temporary (go away when the person

stops taking the antidepressant).

Excessive serotonin levels can cause

serious and potentially life-threatening

symptoms, called serotonin syndrome,

that affect the functions of the LIVER,

HEART, KIDNEYS, and skeletal muscles. It

is important not to combine SSRIs with

other antidepressants or drugs, includ-

ing herbal and OVER-THE-COUNTER (OTC)

DRUGS, that increase serotonin levels.

Antidepressant medications interact or interfere

with numerous other medications including OVER-

THE-COUNTER(OTC) DRUGS, herbal, and prescription

products. MAOIs interact with numerous foods,

decongestant medications, ANTIHISTAMINE MEDICA-

TIONS, and antihypertensive medications (drugs to

treat high blood pressure).

See also ANTIANXIETY MEDICATIONS; NEURORECEP-

TOR; PSYCHOSIS; ST. JOHN’S WORT; SUICIDAL IDEATION

AND SUICIDE.

antipsychotic medications Medications to man-

age the symptoms of psychiatric disorders of PSY-

CHOSIS, including SCHIZOPHRENIA. The first of these

medications, the phenothiazine DRUG chlorpro-

mazine (Thorazine), debuted in the early 1950s

and revolutionized treatment for psychotic disor-

ders. Antipsychotic medications, also called neu-

roleptics, are powerful drugs that affect the ways

in which the BRAINprocesses information. Con-

ventional antipsychotics are the mainstay of ther-

apy for many psychotic disorders. Novel, or

atypical, antipsychotics are newer drugs that

attempt to provide a better balance between ther-

apeutic benefit and risk of side effects. They are

the first choice treatment for some moderate psy-

chotic disorders.

How These Medications Work

Antipsychotic medications work by altering the

balance of neurotransmitters (biochemicals that

362 Psychiatric Disorders and Psychologic Conditions