An antidepressant, is a psychiatric medication or other substance (nutrient or herb) used for alleviating depression or dysthymia ('milder' depression).
Drug groups known as MAOIs, tricyclics and SSRIs are particularly associated with the term.
These medications are now amongst the drugs most commonly prescribed by psychiatrists and general practitioners, and their effectiveness and adverse effects are the subject of many studies and competing claims.
An example of an herbal remedy that is an antidepressant is St John's Wort.
Nutrients that are antidepressants include phenylalanine, tyrosine, tryptophan, 5-Hydroxytryptophan, and choline.
Most antidepressants have a delayed onset of action and are usually taken over the course of weeks, months or years.
They are generally considered distinct from stimulants, and drugs used for an immediate euphoric effect only are not generally considered antidepressants.
Despite the name, antidepressants are often used in the treatment of other conditions, including anxiety disorders, bipolar disorder, obsessive compulsive disorder, eating disorders and chronic pain.
Some have also become known as lifestyle drugs or \"mood brighteners\".
Other medications not known as antidepressants, including antipsychotics in low doses and benzodiazepines, are also widely used to manage depression.
The term antidepressant is sometimes applied to any therapy (e.g. psychotherapy, electro-convulsive therapy, acupuncture) or process (e.g. sleep disruption, increased light levels, regular exercise) found to improve clinically depressed mood.
An inert placebo tends to have a significant antidepressant effect, so establishing something as an antidepressant in a clinical trial involves demonstrating a significant additional effect.
Selective serotonin reuptake inhibitors (SSRIs) are a class of antidepressants used in the treatment of depression, anxiety disorders, and some personality disorders. They are also typically effective and used in treating premature ejaculation problems.
SSRIs increase the extracellular level of the neurotransmitter serotonin by inhibiting its reuptake into the presynaptic cell, increasing the level of serotonin available to bind to the postsynaptic receptor.
They have varying degrees of selectivity for the other monoamine transporters, having little binding affinity for the noradrenaline and dopamine transporters.
The first class of psychotropic drugs to be rationally designed, SSRIs are the most widely prescribed antidepressants in many countries.
Fluoxetine hydrochloride (Prozac) is an antidepressant of the selective serotonin reuptake inhibitor (SSRI) class.
Fluoxetine is approved for the treatment of depression (including pediatric depression), obsessive-compulsive disorder (in both adult and pediatric populations), bulimia nervosa, panic disorder and premenstrual dysphoric disorder. Other indications include hypochondriasis and body dysmorphic disorder.
Despite the availability of newer agents, it remains extremely popular.
Over 23.1 million prescriptions for generic formulations of fluoxetine were filled in the United States in 2006, making it the third most prescribed antidepressant.
According to David Wong, the work which eventually led to the discovery of fluoxetine began at Eli Lilly in 1970 as a collaboration between Bryan Molloy and Robert Rathburn.
It was known at that time that antihistamine diphenhydramine shows some antidepressant-like properties. 3-Phenoxy-3-phenylpropylamine, a compound structurally similar to diphenhydramine, was taken as a starting point, and Molloy synthesized dozens of its derivatives.
Testing the physiological effects of these compounds in mice resulted in nisoxetine, a selective norepinephrine reuptake inhibitor currently widely used in biochemical experiments.
Later, hoping to find a derivative inhibiting only serotonin reuptake, Wong proposed to re-test the series for the in-vitro reuptake of serotonin, norepinephrine and dopamine.
This test, carried out by Jong-Sir Horng in May 1972, showed the compound later named fluoxetine to be the most potent and selective inhibitor of serotonin reuptake of the series.
A controversy ensued after Lilly researchers published a paper entitled \"Prozac (fluoxetine, Lilly 110140), the first selective serotonin uptake inhibitor and an antidepressant drug\" implicitly claiming fluoxetine to be the first selective serotonin reuptake inhibitor (SSRI).
Two years later they had to issue a correction, admitting that the first SSRI was zimelidine developed by Arvid Carlsson and colleagues.
(However, unlike its successful cousin, zimelidine was banned worldwide because of serious side effects.) Fluoxetine was the third SSRI on the market. Fluvoxamine (Luvox) had been marketed in Europe since 1983.
Fluoxetine made its appearance on the Belgian market in 1986 and was approved for use by the Food and Drug Administration (FDA) in the United States in December 1987.
Eli Lilly's patent on Prozac (fluoxetine) expired in August, 2001, prompting an influx of generic drugs onto the market.
Escitalopram was developed in a close cooperation between Lundbeck and Forest Laboratories.
Its development was initiated in the summer of 1997, and the resulting new drug application was submitted to the FDA in March 2001.
The short time (3.5 years) it took to develop escitalopram can be attributed to the previous extensive experience of Lundbeck and Forest with citalopram, which has similar pharmacology.
The FDA issued the approval of escitalopram for major depression in August 2002 and for generalized anxiety disorder in December 2003.
Escitalopram can be considered an example of \"lifecycle management\" - the strategy pharmaceutical companies use in order to extend the lifetime of a drug, in this case of the citalopram franchise.
Escitalopram is an enantiomer of citalopram, used for the same indication, and for that reason it required less investment and less time to develop.
Two years after escitalopram's launch, when the patent on citalopram expired, the escitalopram sales successfully made up for the loss.
On May 23, 2006, the FDA approved a generic version of escitalopram by Teva.
However, on July 14th, 2006 the US District Court of Delaware decided in favor of Lundbeck regarding the patent infringement dispute and ruled the patent on escitalopram valid.
Despite the drug's similarity, preclinical as well as various clinical studies (including double-blinded studies—considered the gold standard of clinical evidence) have shown differentiated effects of citalopram and escitalopram as well as a clinical superiority compared to a variety of other SSRIs, such as paroxetine especially in severely depressed patients and sertraline.
Compared to newer serotonin-norepinephrine reuptake inhibitors such as venlafaxine and duloxetine escitalopram was shown to be at least as effective.
You are about to enter the iCAN community, which means that Cipralex has been prescribed for you by your doctor to treat a depression.
The iCAN website is an interactive support tool.
It is designed to specifically provide patients being treated for depression with:
*support in between visits to your doctor
*information about depression and anxiety
*tools to monitor your progress, including a self rating scale and a private diary
*tips sent to you to help you along the way
*online interaction opportunities with other people on the road to recovery
*access to an independent panel of experts who will answer your questions
*the option to share your experiences with the iCAN community
*anonymity which is protected by a user name and pass word of your choice at registration
Cipralex is licenced in the UK for treating depression, panic disorder, social phobia and generalised anxiety disorder.
It may be a few weeks after beginning treatment with Cipralex that you feel any improvement. Continue to take Cipralex even if it is some time before you start to feel better.
Likewise, if you begin to feel better, continue to take Cipralex as prescribed by your doctor.
Do not make any changes without first consulting your doctor.
Experts in the field of treating depression have designed this service and many of them have contributed with good advice from many years of experience in counselling patients.
We wish you a successful journey on the road to recovery.
Monoamine oxidase inhibitors (MAOIs) are a class of powerful antidepressant drugs prescribed for the treatment of depression.
They are particularly effective in treating atypical depression, and have also shown efficacy in helping smokers to quit.
Due to potentially lethal dietary and drug interactions, MAOIs had been reserved as a last line of defense, used only when other classes of antidepressant drugs (for example selective serotonin reuptake inhibitors and tricyclic antidepressants) have been tried unsuccessfully.
Recently, however, a patch form of the drug selegiline, called Emsam, was developed.
It was approved for use by the FDA on February 28, 2006.
When applied transdermally the drug does not enter the gastro-intestinal system as it does when taken orally, thereby decreasing the dangers of dietary interactions associated with MAOI pills.
In the past they were prescribed for those resistant to tricyclic antidepressant therapy, but newer MAOIs are now sometimes used as first-line therapy.
They are also used for treating agoraphobia and social anxiety. Currently, the availability of selegiline and moclobemide provides a safer alternative, although not always as effective as the old types.
MAO inhibitors can also be used in the treatment of Parkinson's disease (by affecting dopaminergic neurons), as well as an alternative for migraine prophylaxis.
Generic drug names are listed first with trade names in brackets.
Anti-depressant drugs may be augmented in the treatment of depression or other mood disorders by non-antidepressant drugs (such as lithium carbonate) which have been shown to boost the antidepressant effect of a main antidepressant treatment.