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Chapter 3.3 - Drug and Physical Treatments of Depression

Published online by Cambridge University Press:  04 April 2024

By
Ryan Williams  and
Anthony Cleare
Edited by
David Kingdon ,
Paul Rowlands  and
George Stein
David Kingdon
Affiliation:
University of Southampton
Paul Rowlands
Affiliation:
Derbyshire Healthcare NHS foundation Trust
George Stein
Affiliation:
Emeritus of the Princess Royal University Hospital
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Summary

Classification of drug treatments for depression is described noting the ambiguities of current terminology and the move towards standardised nomenclature based on pharmacology and mode of action, such as that proposed by the Neuroscience-based Nomenclature group. Antidepressant drugs are described in terms of background, mechanism of action, pharmacokinetics, side effects, interactions, contraindications and toxicity in overdose. Groups include selective serotonin re-uptake inhibitors (SSRI), serotonin and noradrenaline re-uptake inhibitors (SNRI), tricyclics, noradrenergic and specific serotoninergic antidepressants (NaSSA), monoamine oxidase inhibitors (MAOI) and others such as buproprion, agomelatine, reboxetine, trazadone and vortioxetine. Augmentary medications are also described, including antipsychotics, antiepileptics and lithium. Developments with the use of ketamine and other compounds are discussed.

The classification of physical treatments for depression is into neuromodulatory (e.g. electroconvulsive therapy, transcranial magnetic stimulation, deep brain stimulation and phototherapy) and neuroablative techniques (e.g. stereotactic psychosurgery).

Keywords

antidepressantsSSRISNRIMAOINaSSAaugmentationlithiumantiepilepticsketamineECTTMSpsychosurgerytreatment algorithms
Type
Chapter
Information
Seminars in General Adult Psychiatry , pp. 108 - 146
Publisher: Cambridge University Press
Print publication year: 2024

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