Biomaterial Database

Expanding psychopharmacologic treatment options for the depressed medical patient. 1995

A Stoudemire

Emory University School of Medicine, NE, Atlanta, GA.

Psychopharmacologic treatment of depression in medically ill patients is greatly enhanced by the availability of new antidepressant medications that have low or no anticholinergic, anti-alpha-adrenergic, antihistaminic, and quinidine-like properties. This article discusses the important pharmacodynamic and pharmacokinetic properties of the selective serotonin reuptake inhibitors (fluoxetine, paroxetine, and sertraline), bupropion, venlafaxine, and nefazodone--with an emphasis on their side effects relevant to medical patients as well as important drug interactions. In addition, the safety of these newer medications is compared with that of tricyclics; the role for continued tricyclic use in the medical-psychiatric population is examined; the use of electroconvulsive therapy in medically ill patients who are refractory to antidepressants is also briefly discussed.

UI	MeSH Term	Description	Entries
D003866	Depressive Disorder	An affective disorder manifested by either a dysphoric mood or loss of interest or pleasure in usual activities. The mood disturbance is prominent and relatively persistent.	Depression, Endogenous,Depression, Neurotic,Depression, Unipolar,Depressive Syndrome,Melancholia,Neurosis, Depressive,Unipolar Depression,Depressions, Endogenous,Depressions, Neurotic,Depressions, Unipolar,Depressive Disorders,Depressive Neuroses,Depressive Neurosis,Depressive Syndromes,Disorder, Depressive,Disorders, Depressive,Endogenous Depression,Endogenous Depressions,Melancholias,Neuroses, Depressive,Neurotic Depression,Neurotic Depressions,Syndrome, Depressive,Syndromes, Depressive,Unipolar Depressions
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000928	Antidepressive Agents	Mood-stimulating drugs used primarily in the treatment of affective disorders and related conditions. Several MONOAMINE OXIDASE INHIBITORS are useful as antidepressants apparently as a long-term consequence of their modulation of catecholamine levels. The tricyclic compounds useful as antidepressive agents (ANTIDEPRESSIVE AGENTS, TRICYCLIC) also appear to act through brain catecholamine systems. A third group (ANTIDEPRESSIVE AGENTS, SECOND-GENERATION) is a diverse group of drugs including some that act specifically on serotonergic systems.	Antidepressant,Antidepressant Drug,Antidepressant Medication,Antidepressants,Antidepressive Agent,Thymoanaleptic,Thymoanaleptics,Thymoleptic,Thymoleptics,Antidepressant Drugs,Agent, Antidepressive,Drug, Antidepressant,Medication, Antidepressant
D012803	Sick Role	Set of expectations that exempt persons from responsibility for their illness and exempt them from usual responsibilities.	Role, Sick,Roles, Sick,Sick Roles
D018687	Antidepressive Agents, Second-Generation	A structurally and mechanistically diverse group of drugs that are not tricyclics or monoamine oxidase inhibitors. The most clinically important appear to act selectively on serotonergic systems, especially by inhibiting serotonin reuptake.	Antidepressants, Atypical,Atypical Antidepressants,Second-Generation Antidepressive Agents,Antidepressive Drugs, Second-Generation,Agents, Second-Generation Antidepressive,Antidepressive Agents, Second Generation,Antidepressive Drugs, Second Generation,Drugs, Second-Generation Antidepressive,Second Generation Antidepressive Agents,Second-Generation Antidepressive Drugs
D019965	Neurocognitive Disorders	Diagnoses of DEMENTIA and AMNESTIC DISORDER are subsumed here. (DSM-5)	Clerambault Syndrome,Delirium, Dementia, Amnestic, Cognitive Disorders,Kandinsky Syndrome,Mental Disorders, Organic,Organic Brain Syndrome, Nonpsychotic,Organic Mental Disorders,Organic Mental Disorders, Psychotic,Psychoses, Traumatic,Mild Neurocognitive Disorder,Nonpsychotic Organic Brain Syndrome,Disorder, Mild Neurocognitive,Disorder, Neurocognitive,Disorders, Mild Neurocognitive,Disorders, Neurocognitive,Disorders, Organic Mental,Mental Disorder, Organic,Mild Neurocognitive Disorders,Neurocognitive Disorder,Neurocognitive Disorder, Mild,Neurocognitive Disorders, Mild,Organic Mental Disorder,Traumatic Psychoses