Antidepressants

Antidepressants

Depression • Diagnostic criteria (DSM-5): – Five (or more) of the depressive symptoms have been present during the same 2-week period and represent a change from previous functioning: at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure. – The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. – The episode is not attributable to the physiological effects of a substance or to another medical condition

Depressive symptoms • Depressed mood most of the day, nearly every day. • Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day . • Significant weight loss when not dieting or weight gain, or decrease or increase in appetite nearly every day. • Insomnia or hypersomnia nearly every day. • Psychomotor agitation or retardation nearly every day • Fatigue or loss of energy nearly every day. • Feelings of worthlessness or excessive or inappropriate guilt nearly every day • Diminished ability to think or concentrate, or indecisiveness, nearly every day • Recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide

Depression etiology • Depression is not fully understood but it seems that there’s a complex interplay between biological mechanisms, genetic risk factors, environmental factors, and psychosocial stimuli. • Neurotransmitters Theory: Depression involves abnormal functioning of many neurotransmitters such as Monoamines (serotonin, norepinephrine, and dopamine), GABA, and Glutamate • Early theoretical models suggested that depression is due to diminished neurotransmission of monoamines, particularly serotonin and norepinephrine. It now appears that more complex dynamics, including intracellular cascades triggered by the monoamines, are involved in the onset of depression and the response to antidepressant medication

Monoamine Hypothesis