Antidepressant Medications Presentation PDF

Antidepressant Medications Presented by: Amro Tarawneh Ameer Aljandbeh Wae’l Alshabatat S U B M IT TED T O : D R. Y A Z A N A L M R AY AT Outline  Introduction  History of antidepressants  Classification  Antidepressant medication: Action, Interaction, side effect, contraindication  Tricyclic...

Antidepressant Medications Presented by: Amro Tarawneh Ameer Aljandbeh Wae’l Alshabatat S U B M IT TED T O : D R. Y A Z A N A L M R AY AT Outline  Introduction  History of antidepressants  Classification  Antidepressant medication: Action, Interaction, side effect, contraindication  Tricyclic Antidepressants (TCAs)  Monoamine Oxidase Inhibitors (MAOIs)  Selective Serotonin Reuptake Inhibitors (SSRIs)  Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)  Atypical Antidepressants  Client/Family Education  Summary  References Objectives At the end of this presentation, the students will be able to : Define the antidepressant medications Describe the classifications of antidepressant medication Identify the action of antidepressant medication Mention the contraindications of antidepressant medication Identify the side effects and the nursing interventions Describe the client’s and family’s education Introduction Antidepressants are medications used to treat depression and other mental health conditions, such as anxiety disorders, obsessive- compulsive disorder (OCD), and post-traumatic stress disorder (PTSD). They work by altering the levels of neurotransmitters—chemical messengers like serotonin, dopamine, and norepinephrine—in the brain, which helps regulate mood, emotions, and behavior. Antidepressants are not an instant cure but are often part of a broader treatment plan that includes therapy and lifestyle changes. History of antidepressants History of Antidepressants 1950s: The first antidepressants, including Tricyclic Antidepressants (TCAs) and Monoamine Oxidase Inhibitors (MAOIs), were introduced. These were groundbreaking but had significant side effects. 1980s: The development of Selective Serotonin Reuptake Inhibitors (SSRIs) such as Fluoxetine (Prozac) marked a shift toward drugs with fewer side effects and safer profiles. 2000s: New classes such as SNRIs and Atypical Antidepressants became available, providing additional options for patients with depression, anxiety, and other disorders.. Classification : 1.Tricyclic Antidepressants (TCAs): Action: Increase serotonin and norepinephrine levels. 2.Monoamine Oxidase Inhibitors (MAOIs):, Action: Inhibit the breakdown of neurotransmitters. 3.Selective Serotonin Reuptake Inhibitors (SSRIs): Action: Increase serotonin availability. 4.Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs): Action: Increase serotonin and norepinephrine. 5.Atypical Antidepressants: Action: Varies by drug, typically affects serotonin, norepinephrine, or dopamine.. Tricyclic antidepressant Tricyclic antidepressants ease depression by affecting chemical messengers (neurotransmitters) used to communicate between brain cells. Tricyclic antidepressants block the reabsorption (reuptake) of the neurotransmitters serotonin (ser-o-TOE-nin) and norepinephrine (nor-ep-ih-NEF-rin), increasing the levels of these two neurotransmitters in the brain. Tricyclic antidepressants also affect other chemical messengers, which can lead to several side effects  Tricyclic antidepressants Examples: generic names  Amitriptyline  Nortriptyline  Imipramine  Desipramine  Clomipramine  Doxepin  Trimipramine  Protriptyline A generic name is the official, standardized name of a medication, usually based on its chemical structure or active ingredient. It is not owned by any specific company and is used universally to identify the drug. Tricyclic Antidepressant uses Anxiety Chronic pain associated with nerves Migraine pain relief Panic attack Bipolar disorder Obsessive-compulsive disorder  Tricyclic antidepressant Interactions  Sedatives (e.g., sleeping pills, alcohol): Increased drowsiness.  Mood medications: Dangerous reactions, avoid together.  Drying effect medications: Worse dry mouth, constipation.  Heart medication: Higher risk of heart issues.  Blood pressure medications: Less effective at lowering blood pressure.  Liver-affecting medications: Can make TCAs (tricyclic AMC antidepressants) stronger or weaker. BIOTIN BENEFITS | Contraindications of Tricyclic Antidepressant 01. 04. ARE UNDER A G E 2 5 O V E R A G E 6 5 Y E A R H A V E A L I V E R D I S E ASE 02. 05. HAVE DIAB E TE S, H E A R T P R O B L EMS, O R A H A V E A H I S T O RY O F SEIZURES THYROID D I S O R DER S 03. HAVE ANY C O N D ITI ON A F F E CTI NG Y O U R URINARY T R A C T O R A N E N L A RG ED P R O S T AT E  NEXT Tricyclic antidepressant Side Effects O R T H OST ATIC B L U R RED V I S I ON C O N S TIP ATIO N W E I G HT G A I N H Y P O TEN SION offer reassurance Instruct the client Order food high in Provide that this to rise slowly from fiber increase fluid instructions for a symptoms should lying or sitting intake if not reduced- sub-side after a position contraindicated caloriediet. few weeks. monitor blood and encourage the encourage instruct the client pressure (lying client to increase increased level of not to drive until and standing) physical exercise if activity if vision is clear avoid long hot possible. appropriate. showers or tubbaths Mono amine oxidase inhibitors(MAOIs) Monoamin oxidase inhibitors (MAOIs) are an extremely strong class of antidepressant that treat depression by preventing the break down of the brain chemical serotonin, dopamine, and norepinephrine. This helps them do their work of regulating your mood Mono amine oxidase inhibitors(MAOIs) MAOIs Interactions. avoid combining. Antidepressants (e.g., SSRIs, TCAs): CNS Stimulants: Increased blood pressure, dangerous. Sympathomimetics :Severe high blood pressure. Opioids (e.g., tramadol): Risk of respiratory issues. Blood pressure meds: Unpredictable effects on blood pressure. Tyramine-rich foods (e.g., aged cheese): Risk of hypertensive crisis. Sedatives or alcohol: Excessive drowsiness or dangerous CNS depression. BI Diet restrictions for client on MAOIS therapy Avoid food containing tyramine 0 1. C H E E S E 04.Cold remedies cheese and MAOIs can cause high blood raise blood pressure when taken with MAOIs due to their interaction pressure due to tyramine buildup. with tyramine or other compounds. 02. SMOKED MEATS 05.D I E T P I L S S Smoked meat and MAOIs can raise Particularly those containing stimulants, can interact with MAOIs and raise blood pressure, increasing the risk of blood pressure due to tyramine. serious side effects. 0 3. SOY SAUCE 0 6. COFFEE, TEA Soy sauce can raise blood pressure Coffee and tea can raise blood when taken with MAOIs due to its high pressure when taken with MAOIs due tyramine content. to their caffeine content Mono amine oxidase inhibitors Contraindications Angina Severe headache Blood vessel disease Diabetes Kidney or liver disease Pheochromocytoma should not receive MAOIS therapy, since this may cause a hypertensive crisis. Side effect : T R O U BL E G E T T I NG T O S L E E P D I Z Z IN ESS , L I G H T HEA DEDN ESS , A N D F A I N T ING D R Y M O U T H , B L U R R ED V I S I ON, A N D A P P E T ITE C H A N GE W E I G HT G A I N S T O M AC H I S S U E S H E A D ACHE SELECTIVE SEROTONIN REUPTAKE INHIBITORS Selective Serotonin Reuptake Inhibitors (SSRIs) are a class of antidepressants commonlyEASE DEPRESSION prescribed for mood disorders, anxiety, and related conditions. They work by increasingBYthe INCREASING levels of serotonin in the brain, which can help improve mood, anxiety, and overall mental well- LEVEL OF being. SEROTONIN IN THE BRAIN Serotonin is a neurotransmitter that regulates mood, sleep, appetite, cognition, and blood clotting. It helps maintain feelings of well-being and happiness, influences sleep patterns, controls appetite, and aids in blood clotting and digestion. Low serotonin levels are linked to mood disorders like depression. Selective serotonin reuptake inhibitors (SSRIS) fluoxetine SSRIS Interactions There may be decreased effect of SSRIS with concomitant use of carbamazepine and cyproheptadine.  SSRIS CONTRAINDI C AT IO NS CONTRAINDI Monoamine Oxidase Inhibitors (MAOIs): CA TE D IN INDIVIDUALS WITH Combining SSRIs with MAOIs can cause serotonin syndrome, a potentially life-threatening condition. A 14-day gap is required HYPERSENSI when switching between these medications. TI VI TY Severe Liver or Kidney Impairment: WOMEN SSRIs are metabolized WHO in the liver, so ARE they should PREGNANT be used ORwith liver with caution in patients BREASTFEED or kidney problems. IN G Pregnancy (especially in the third trimester): SSRIs should be newborns. WHO used HAVE cautiously A SEVERE during pregnancy LIVER due to potential OR risks to the fetus, KIDNEY including DISEASE withdrawal symptoms in SHOULD NOT BE GIVEN SSRIs can trigger mania in people with bipolar disorder. Caution is needed, and a mood stabilizer may be required alongside the SSRI. Hypersensitivity: Disorder: History of Bipolar CAUTION SHOULD BE USED WHEN ADMINISTER IN G Contraindicated if the patient has an allergy or hypersensitivity to any components of the SSRI. Concurrent Use with THESE DRUGS Other Serotonergic Drugs: TO PERSONS WITH ASTHMA, URINARY SSRIs should not be combined with other serotonergic medications (e.g., other antidepressants, certain migraine medications) due RETENTION, to the risk of serotonin syndrome. HYPERTHYROI DI SM , CARDIOVASC UL AR DISORDERS, ALCOHOLISM, AND EPILEPSY. NEXT SSRIS Side Effects I N S O MNI A H E A D ACH E W E I G HT L O S S Administer or If relief is not Ensure that client instruct client to achieved, is provided with take dose early in physician may calorie intake the day order an sufficient to Instruct the Other maintain desired patient to avoid antidepressant. weight caffeinated foods Caution should be and drinks taken in presribing Teach relaxation these drugs for techniques to use anorectic client. before bedtime.  Examples: Venlafaxine, Duloxetine Action: Increase serotonin and norepinephrine. Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs) (SNRIs) are a class of antidepressants that work by increasing the levels of both serotonin and norepinephrine in the brain, which can help improve mood, alleviate pain, and reduce anxiety. Examples: Venlafaxine, Duloxetine. AMC BIOTIN BENEFITS |  (SNRIs)USES Major Depressive Disorder (MDD) – Improves mood and energy levels. Generalized Anxiety Disorder (GAD) – Reduces anxiety symptoms. Social Anxiety Disorder (SAD) – Alleviates fear in social situations. Panic Disorder – Reduces frequency and severity of panic attacks. Chronic Pain Disorders – Treats conditions like fibromyalgia and diabetic neuropathy. Post-Traumatic Stress Disorder (PTSD) – Helps regulate mood and anxiety. AMC BIOTIN BENETS |  SNRIs Interactions: MAOIs: Can cause serotonin syndrome. Avoid combining them, or wait 14 days between switching. Other Antidepressants (SSRIs, TCAs): Increases risk of serotonin syndrome. Use with caution. Blood Thinners (e.g., Warfarin): Increases bleeding risk. Monitor closely. Blood Pressure Meds: May raise blood pressure, especially at high doses. Monitor regularly. CNS Depressants (Alcohol, Benzodiazepines): Increases sedation. Avoid excessive alcohol. AMC St. John's Wort: BIOTIN BENEFITS | Can cause serotonin syndrome. Avoid using together. NSAIDs (e.g., Ibuprofen): Increases bleeding risk. Use cautiously.  SNRIs Contraindication: Contraindications of SNRIs: 1.Monoamine Oxidase Inhibitors (MAOIs): 1.Should not be taken with SNRIs due to the risk of serotonin syndrome. 2.Severe Liver or Kidney Impairment: 1.Caution is needed, as SNRIs are metabolized in the liver and excreted through the kidneys. 3.History of Seizures: 1.SNRIs may lower the seizure threshold, increasing the risk of seizures. 4.Glaucoma: 1.Caution in patients with narrow-angle glaucoma as SNRIs can increase intraocular pressure. 5.Pregnancy (especially in the third trimester): 1.Should be used only if the benefits outweigh the risks. Can cause withdrawal symptoms in AMC newborns. BIOTIN BENEFITS | 6.Hypersensitivity to SNRIs: 1.Contraindicated if the patient has a known allergy or hypersensitivity to any components of the drug.  SNRIs side effect: Common Side Effects: Nausea Dizziness Dry mouth Insomnia Sweating Fatigue Serious Side Effects: Increased blood pressure (especially at high doses) AMC Suicidal thoughts (particularly in children, adolescents, and young adults) Serotonin syndrome (symptoms: agitation, confusion, tremors, fever) BIOTIN BENEFITS | Sexual dysfunction (e.g., reduced libido, difficulty achieving orgasm) Hyponatremia (low sodium levels, particularly in elderly patients)  Atypical Antidepressants Atypical antidepressants are a diverse group of medications used to treat depression and other mental health conditions. They do not fit into the traditional categories of antidepressants (e.g., SSRIs, SNRIs, TCAs, MAOIs) and often have unique mechanisms of action Example: Bupropion AMC BIOTIN BENEFITS |  Atypical Antidepressants Side Effects: Insomnia Therapeutic Uses: Dry mouth Major Depressive Disorder (MDD) Increased risk of seizures (dose-dependent) Seasonal Affective Disorder (SAD) Drug Interactions: Smoking Cessation Support Alcohol: Increases risk of seizures Mechanism of Action: Medications lowering seizure threshold (e.g., Inhibits norepinephrine and dopamine reuptake (NDRI) antipsychotics) Minimal effect on serotonin reuptake Contraindications: History of seizures Eating disorders (e.g., bulimia, anorexia) Abrupt discontinuation of alcohol or benzodiazepines  Heterocyclic Antidepressants Amitriptyline Imipramine Doxepin Clomipramine Nortriptyline Desipramine Trimipramine AMC BIOTIN BENEFITS | Client/Family Education Avoid smoking while receiving Carry a card or other identification tricyclic therapy. Smoking increases at all times describing the the metabolism of tricyclic medications being taken. Not drink alcohol while taking Be aware of the side effects of antidepressant therapy. antidepressants. Not consume other medications Be aware of possible risks of (including over the- counter taking antidepressants during medications) without the pregnancy. Safe use during physician’s approval while pregnancy and lactation has not receiving antidepressan been fully established  SUMMARY Antidepressant medications are used to manage depressive disorders by balancing neurotransmitters like serotonin, norepinephrine, and dopamine in the brain. They are classified into major groups, including SSRIs, SNRIs, TCAs, MAOIs, and atypical antidepressants, each with unique mechanisms of action. Common side effects include nausea, insomnia, and dry mouth, while severe effects may include serotonin syndrome or hypertensive crises, depending on the class. Contraindications and interactions vary but often involve specific medical conditions or other medications.  References HTTPS://WWW.NC BI.N LM.N IH. GO V/ BO OK S/ NBK 55 77 91 / HTTPS://WWW.RX LI ST.C OM /AN TI DE PR ES SA NTS /D RU G - CL ASS.H TM HTTPS://WWW.MA YO CL IN IC.OR G/ DI SE AS ES CON DI TI ON S/ DEP RE SS IO N/IN - DEPTH/ MAO IS /A RT - 2 004 39 92 HTTPS://WWW.HE AL TH LI NE.CO M/ HE AL TH /D EPR ES SI ON /W HAT - AREMAO - INHI BIT OR S TOWNSEND, M. (2017).ESSEN TI AL OF PSYCHIATRIC MENTAL HEALTH NURSING :CONCEPT OF CARE IN EVIDENCE BASED PRACTICE. (7TH ED) PHILADELPHIA :F. A DAVIS CO Thank You!