Segments in this Video

Major Depressive Disorder (01:21)


Major depressive disorder is the leading cause of disability for people 15-44. Antidepressant medications have revolutionized treatment.

Signs and Symptoms (01:17)

Patients with major depressive disorder may exhibit psychomotor agitation or retardation, difficulty thinking and concentrating, and diminished interest or pleasure in activities. In severe cases, they have thoughts of suicide or develop psychotic behavior.

Depression Pathology (01:08)

Genetic, environmental, psychological, and biochemical changes effect norepinephrine, serotonin, and dopamine. Antidepressants increase the level of target neurotransmitters at the neuronal synapse by boosting synthesis, blocking degradation, preventing reuptake, or mimicking its binding to receptors.

Depression Interventions (02:31)

An interdisciplinary team of health professionals should develop a care plan. Assessment tools determine a quantitative depression rating. In most cases, antidepressant medications, individual and group therapy, improved diet, and exercise are prescribed.

Tricyclic Agents (02:31)

TCAs are first generation agents, and are effective in treating all depressive subtypes but have largely been replaced by newer antidepressants. They include doxepin, amitriptyline, and imipramine. It takes a long time to achieve a therapeutic benefit, but side effects can occur after the first dose. Therapeutic and toxic doses are similar.

Monoamine Oxidase Inhibitors (02:01)

MAOIs are among the first generation antidepressants and include phenelzine and tranylcypromine. They may be used to treat other conditions, like Parkinsonism. They block enzymes responsible for breaking down monoamines, and have a stimulant effect. Hear why electroconvulsive therapy is effective.

Selective Serotonin Re-uptake Inhibitors (02:13)

SSRIs are second generation antidepressants causing less sedation or anticholinergic disturbances. They include fluoxetine, sertraline, paroxetine, escitalopram, and citalopram. They can cause suicidal thoughts and inhibit enzymes that metabolize other medications, including antiarrhymics, anticoagulants, antipsychotics, neuroleptics, and TCAs.

Dual-Mechanism Antidepressants (01:12)

Dual-mechanism antidepressants have a more robust efficacy than single mechanism antidepressants such as SSRIs. They include bupropion, venlafaxine, mirtazapine, and duloxetine.

Intervention Process (02:26)

Antidepressants have a 70% effectiveness rate, and may require combination therapy. Selection is based on treatment history, side effect likelihood, and drug's therapeutic range. Patient assessment and keeping thorough nursing notes is crucial. Use trial and error to find the right medication and dosage with fewest side effects. Patient education helps compliance.

Side Effects (06:44)

Hear side effects for TCAs, MAOIs, SSRIs, and dual-mechanism antidepressants. Combining MAOIs and SSRIs can cause death. Hear food and drug interactions for MAOIs. Hypertensive crises can occur with certain medications.

Credits: Antidepressant Agents: Psychotropic Medications (00:44)

Credits: Antidepressant Agents: Psychotropic Medications

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Antidepressant Agents: Psychotropic Medications

Part of the Series : Psychotropic Medications
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Looking at the signs and symptoms of depression and its potential pathophysiology, examines when to use the different classes of antidepressant medications: tricyclics, MAOIs, SSRIs, and multiple-mechanism antidepressants. It also considers their mechanisms of action and possible side effects.

Length: 25 minutes

Item#: BVL120746

ISBN: 978-1-63521-683-7

Copyright date: ©2014

Closed Captioned

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