Antidepressant agents
Antidepressant agents
Clinical Indications
- Dysthymia, major depressive disorder, depression associated with organic disease, alcoholism, schizophrenia, intellectual disability, depressive phase of bipolar disorder, and depression accompanied by anxiety
Medication action
- Increase concentration of norepinephrine, serotonin, and/or dopamine in the body either by blocking their reuptake by the neurons (tricyclics, tetracyclic, SSRI’s, SNRI’s) or by inhibiting the release of monoamine oxidase inhibitors (MAOI’s).
Drug interactions
Drug Interactions with SSRI | |
Interacting Drugs | Adverse effects |
Buspirone (BuSpar), TCA’s (especially clomipramine), Selegiline (Eldepryl), Saint John’s Wort | Serotonin syndrome |
MAOI’s | Hypertensive crisis |
Warfarin, NSAID’s | Increased risk of bleeding |
Alcohol, benzodiazepines | Increased sedation |
Antiepileptics | Lowered seizure threshold |
Drug Interaction with TCA’s | |
Interacting Drugs | Adverse effects |
MAOI’s | High fever, convulsions, death |
Saint John’s Wort, tramadol (Ultram) | Seizures, serotonin syndrome |
Clonidine (Catapres), epinephrine | Severe hypertension |
Acetylcholine blockers | Paralytic ileus |
Alcohol and carbamezipine (Tegretol) | Block antidepressant action, increases sedation |
Cimetidine (Tagamet), bupropion (BuSpar) | Increased TCA blood levels, increased side effects |
Drug Interactions with MAOI’s | |
Interacting Drugs | Adverse effects |
SSRI’s, TCA’s, atomoxetine (Strattera), duloxetine (Cymbalta), dextromethorphan (an ingredient in many cough syrups), venlafaxine (Effexor), St. John’s Wort, Ginkgo | Serotonin syndrome |
Morphine and other narcotic pain relievers, antihypertensive | Hypotension |
All other antidepressants, pseudoephedrine, amphetamines, cocaine cyclobenzaprine (Flexeril), dopamine, methyldopa, levodopa, epinephrine, buspirone (BuSpar) | Hypertensive crisis (these side effects can occur even if take with 2 weeks of stopping MAOI’s) |
Buspirone (BuSpar) | Psychosis, agitation, seizures |
Antidiabetics | Hypoglycemia |
Tegretol | Fever, hypertension, seizures |
Nursing diagnosis
- Risk for suicide
- Risk for injury
- Social isolation
- Risk for constipation
- Insomnia