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