RT Book, Section
A1 Stork, Christine M.
A2 Hoffman, Robert S.
A2 Howland, Mary Ann
A2 Lewin, Neal A.
A2 Nelson, Lewis S.
A2 Goldfrank, Lewis R.
SR Print(0)
ID 1108432303
T1 Serotonin Reuptake Inhibitors and Atypical Antidepressants
T2 Goldfrank's Toxicologic Emergencies, 10e
YR 2015
FD 2015
PB McGraw-Hill Education
PP New York, NY
SN 9780071801843
LK accesspharmacy.mhmedical.com/content.aspx?aid=1108432303
RD 2024/04/19
AB In  the  United  States,  major  depressive  disorder  is  a  leading  cause  of  disability  and  affects  14.8  million  American  adults;  it  is  also  the  largest  cause  of  disability  for  adolescents  and  those  15  to  44  years  of  age.1,93  Although  major  depressive  disorder  can  develop  at  any  age,  the  median  age  at  onset  is  32  years  and  it  is  more  prevalent  in  women.94,95  The  exact  etiology  of  depression  and  the  mechanism  by  which  increased  serotonergic  and  norepinephrine  neurotransmission  modulates  mood  remains  unclear.  Antidepressants  modulate  the  activity  of  serotonin  and  norepinephrine  and  dopamine  to  achieve  their  effect.  The  class  of  selective  serotonin  reuptake  inhibitors  (SSRIs)  includes  citalopram,  escitalopram  (active  enantiomer  of  citalopram),  fluoxetine,  fluvoxamine,  paroxetine,  sertraline,  and  vilazodone  (Fig.  75–1).  Atypical  antidepressants  extend  the  pharmacologic  principles  of  SSRIs  to  achieve  beneficial  effects  for  patients  with  depression.  The  SSRIs  and  atypical  antidepressants  comprise  the  current  standard  for  the  treatment  of  depression.80  SSRIs  also  are  used  to  treat  obsessive–compulsive  disorders,  panic  disorders,  alcoholism,  obesity,  and  various  nonpsychiatric  disorders  such  as  migraine  headaches  and  chronic  pain  syndromes.11,125,131  They  have  excellent  safety  profiles  when  compared  with  monoamine  oxidase  inhibitors  (MAOIs)  and  the  cyclic  antidepressants.  Like  many  xenobiotics,  the  appropriateness  of  their  use  and  the  associated  morbidity  and  mortality  is  questioned  as  the  patient  population  has  aged  and  the  comorbidity  profiles  of  those  using  the  SSRIs  have  changed.