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Drugs used in mood disorders

• Many forms respond well to drugs.
• Drug therapy is based on the monoamine theory of mood 
  • depression is due to cerebral deficiency of monoamines NA, 5HT
• Management should include psychotherapy e.g. cognitive therapy.
• Tricyclics and SSRIs should be tried first as they have fewer side effects and are safer in overdose.
• All drugs can be taken orally. 
• Typically a delay of 10 days to 4 weeks before improvement
• Continue for at least 4 months to avoid relapse
• withdraw slowly 
• Doses should be reduced in the elderly 
• Hyponatraemia has been associated with all types of antidepressants (drowsy, confusion, convulsions)
• Atypical antidepressants which don’t inhibit amine uptake also exist e.g. mianserin, trazodone.
  • reduced autonomic side effects
  • fairly safe
  • sedative

Drugs

• Tricyclic Antidepressants
• Monoamine Oxidase Inhibitors
• Selective Serotonin Reuptake Inhibitors
• Lithium