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Antidepressants: update on new agents and indications
Adrienne Z Ables1, Otis L Baughman
1Spartanburg Family Medicine Residency Program, Spartanburg, South Carolina 29303, USA. aables@srhs.com
American Family Physician
|February 18, 2003
Summary
Selective serotonin reuptake inhibitors are key antidepressants for various mood and anxiety disorders. Treatment choice involves drug profiles, side effects, and augmentation strategies for resistant cases.
Area of Science:
- Pharmacology
- Psychiatry
Background:
- The past two decades have seen numerous antidepressant medications enter the U.S. market.
- Selective serotonin reuptake inhibitors (SSRIs) are now primary treatments for depression and other disorders.
Purpose of the Study:
- To review the current landscape of antidepressant medications.
- To discuss the efficacy, indications, and management of side effects for various antidepressants.
Main Methods:
- Literature review of antidepressant pharmacologic profiles and clinical applications.
- Discussion of treatment strategies including augmentation and managing side effects.
Main Results:
- SSRIs are effective for depression, obsessive-compulsive disorder, panic disorder, and social phobia.
- Newer indications for SSRIs include PTSD, PMDD, and GAD.
- Extended-release venlafaxine is approved for GAD; mirtazapine offers a unique mechanism.
- Antidepressant choice depends on pharmacology, side effects, and tolerability.
Conclusions:
- Managing antidepressant-related sexual dysfunction may involve dose adjustment, switching agents, or adding medications.
- Augmentation with lithium or triiodothyronine can benefit treatment-resistant patients.
- Gradual tapering of antidepressant medication is recommended to prevent discontinuation syndrome.