Medications-List 5 Antidepressants Essay

Medications-List 5 Antidepressants Essay

Medications-List 5 Antidepressants Essay

Medications- Antidepressants

1. Fluoxetine

• Brand name: Prozac
• Class: Selective serotonin reuptake inhibitors (SSRIs)
• FDA-approved for: Major depressive disorder (8 years and above), panic disorder, obsessive-compulsive disorder, binge eating disorder, bulimia, bipolar depression, and premenstrual dysphoric disorder.
• Off-label indications: Body dysmorphic disorder, generalized anxiety disorder (GAD), dysthymia, and posttraumatic stress disorder (PTSD).
• The initial daily dose of fluoxetine for adults is 20 mg. Instead, the patient can start with a lower dose and have it raised gradually until it reaches a daily maximum of 60mg.
• For healthy people, routine lab tests are not required.
• However, older and population-specific patients may conduct blood glucose and liver function tests while prescribing the medicine and every four weeks during dose adjustment (Marko, 2020).
  

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2. Duloxetine

• Brand name: Cymbalta
• Class: Serotonin and norepinephrine reuptake inhibitors (SNRIs)
• Indications: major depressive disorder (MDD), fibromyalgia, generalized anxiety disorder (GAD), chronic musculoskeletal pain, and diabetic peripheral neuropathy.
• Off-Label Indications: Stress urinary incontinence and chemotherapy-induced peripheral neuropathy
• Adults should take 40 mg to 60 mg daily, divided into two doses of 20 mg each. If necessary, your doctor might raise your dose. The dose, though, is often limited to 120 mg per day.
• Serum creatinine, transaminase, blood urea nitrogen (BUN), HgbA1c values, and blood glucose values should all be monitored in patients with diabetes.
• When providing duloxetine to the elderly population, sodium levels need to be monitored after every two weeks (De Donatis et al., 2019).

3. Amitriptyline

• Brand name: Desyrel
• Class: Tricyclic antidepressants.
• Indications: Major depressive disorder, neuropathic pain, chronic tension headache, and migraine.
• Off-Label Indications: Post-traumatic stress disorder, chronic pain,insomnia, anxiety,  and postherpetic neuralgia
• Adults start with a daily dose of 25 mg.
• Amitriptyline can be taken up to 150 mg per day.
• Higher doses may be required for some hospitalized individuals.
• Teens and older individuals should take 10 mg three times daily and 20 mg before bed.
• Baseline electrocardiograms should be carried out on patients with a history of cardiac problems or who are over 50 years old to assess the baseline QTc value.
• Particularly in the first one to two months after beginning the medication or while the dosage is being modified, it is crucial to keep an eye out for an increase in suicidality and any unexpected behavioral changes (McClure & Daniels, 2021).

4. Trazodone 

• Brand name: Elavil
• Class: Serotonin modulators
• Indications: Major depressive disorder
• Off-Label Indications: Bulimia, diabetic neuropathy, chronic pain, schizophrenia, dementia, and fibromyalgia.
• The initial dose for adults is 150 mg per day, divided into two doses. Dogase may be modified as required. However, the dosage is often limited to 400 mg per day.
• In patients receiving trazodone, baseline liver functions need to be monitored before treatment, as well as intermittently throughout treatment (every four weeks) (Cuomo et al., 2019).

5. Mirtazapine

• Brand name: Remeron
• Class: Tetracyclic antidepressants (TeCA)
• Indications: Unipolar major depressive disorder (MDD)
• Off-Label Indications: Social anxiety disorder, Panic disorder, Insomnia, Prophylaxis of chronic tension-type headache, fibromyalgia, and Post-traumatic Stress Disorder.
• Currently, 15 mg per day is the suggested starting dose for mirtazapine.
• Dose increases up to a maximum of 45 mg per day may be beneficial for patients who were unresponsive to the first 15 mg dose.
• Before starting treatment, the lipid profile of patients taking mirtazapine must be evaluated.
• Mirtazapine has a lower clearance in older people and patients with severe hepatic and renal impairment. Clinicians should therefore check the blood levels of drugs and renal and liver function every two weeks (Davis, 2020).

References

Cuomo, A., Ballerini, A., Bruni, A. C., Decina, P., Sciascio, G. D., Fiorentini, A., Scaglione, F., Vampini, C., & Fagiolini, A. (2019). Clinical guidance for the use of trazodone in major depressive disorder and concomitant conditions: pharmacology and clinical practice. Rivista Di Psichiatria, 54(4), 137–149. https://www.rivistadipsichiatria.it/archivio/3202/articoli/31796/

Davis, M. P. (2020). Mirtazapine and Depressions. NeuroPsychopharmacotherapy, 1–29. https://doi.org/10.1007/978-3-319-56015-1_102-1

De Donatis, D., Florio, V., Porcelli, S., Saria, A., Mercolini, L., Serretti, A., & Conca, A. (2019). Duloxetine plasma level and antidepressant response. Progress in Neuro-Psychopharmacology and Biological Psychiatry, 92, 127–132. https://doi.org/10.1016/j.pnpbp.2019.01.001

Marko, V. (2020). Prozac. From Aspirin to Viagra, 167–181. https://doi.org/10.1007/978-3-030-44286-6_8

McClure, E. W., & Daniels, R. N. (2021). Classics in Chemical Neuroscience: Amitriptyline. ACS Chemical Neuroscience. https://doi.org/10.1021/acschemneuro.0c00467

List 5 antidepressants, with their generic/brand names, minimum and max doses, indication, off label indication, labs to be drawn when prescribed, frequency of lab monitoring.