Antidepressive agents are also used to treat other disorders

• Anxiety disorders

1. Panic disorders

-All classes of antidepressants are quite useful, but not in acutely stopping panic attacks. Instead, they are generally used in preventing panic attacks.

-Usually, we would start the pt on meds and assure him/her that in a couple of weeks the panic attacks will start to subside and decrease in frequency and severity; it takes some time for the antidepressant meds to become effective.

-In the meantime, we would give small amounts of benzodiazepines at the beginning of a panic attack to abort the panic attack. Optimally, we want to give a drug that has a short half-life and quick onset of action – kicks in quickly.

-Antidepressants work by changing the balance of NE in the locus ceruleus.

2. Obsessive Compulsive Disorder

-We want to use a SSRI as a first line drug and clomipramine as a second line drug. It responds only to antidepressants that have a significant degree of 5HT reuptake blockade.

-Generally with obsessive compulsive disorder the pt needs much higher doses than when treating depression, and even so, the obsessive compulsive disorder never really goes away entirely. Symptoms are generally reduced so that pt can live with it. Treatment is not at all curative; pt still needs behavioral intervention to treat disorder.

3. Post traumatic stress disorder

-This disorder is helped somewhat by antidepressants, but there isn’t a complete response. Psychotherapeutic interventions are also needed for severe cases.

Category: Pharmacology Notes