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Related Experiment Videos

Second generation antidepressants: a comparative review.

E F Coccaro, L J Siever

    Journal of Clinical Pharmacology
    |May 1, 1985
    PubMed
    Summary
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    This review compares four second-generation antidepressants: maprotiline, amoxapine, trazodone, and nomifensine. Trazodone and nomifensine show favorable profiles, especially for elderly patients, with distinct benefits for anxious or apathetic individuals.

    Area of Science:

    • Pharmacology
    • Neuroscience
    • Psychiatry

    Background:

    • Tricyclic antidepressants (TCAs) are traditional treatments for depression.
    • Second-generation antidepressants offer potentially improved efficacy and safety profiles.
    • Understanding the specific actions and side effects of newer agents is crucial for clinical practice.

    Purpose of the Study:

    • To review four second-generation antidepressants: maprotiline, amoxapine, trazodone, and nomifensine.
    • To compare their actions on biogenic amines and receptors, antidepressive efficacy, and adverse effects.
    • To evaluate their suitability for specific patient populations, including the elderly.

    Main Methods:

    • Comparative review of existing literature on four second-generation antidepressants.

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  • Analysis of pharmacological actions (biogenic amines, receptors).
  • Assessment of antidepressive efficacy and adverse effect profiles, including overdose scenarios.

    • Main Results:

    • Maprotiline: Selective noradrenergic agent, similar side effects to TCAs, high seizure risk in overdose.
    • Amoxapine: Mixed action with neuroleptic activity, adverse effects linked to neuroleptic properties, seizure and renal failure risk in overdose.
    • Trazodone: Selective serotonergic agent, low anticholinergic activity, minimal overdose risk, but priapism is a concern.
    • Nomifensine: Potent noradrenergic/dopaminergic agent, low anticholinergic activity, minimal cardiotoxicity and overdose risk, but overstimulation and hypersensitivity reactions.
    • Trazodone and nomifensine are favorable for the elderly; trazodone suits anxious patients, nomifensine suits apathetic patients.

    Conclusions:

    • Second-generation antidepressants exhibit diverse pharmacological profiles and side effect patterns.
    • Trazodone and nomifensine present favorable options, particularly for the elderly and specific symptom presentations.
    • Careful consideration of individual drug properties is essential for optimal antidepressant selection.