MedicalToday

Definition
Depression, also known as depressive disorders or unipolar depression, is a mental illness characterized by a profound and persistent feeling of sadness or despair and/or a loss of interest in things that once were pleasurable. Disturbance in sleep, appetite, and mental processes are a common accompaniment.

Pharmacology.

Fluoxetine is a bicyclic antidepressant that is a selective and potent inhibitor of presynaptic reuptake of serotonin (an SSRI). It does not affect re-uptake of norepinephrine or dopamine and has a relative lack of affinity for muscarinic, histamine,

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1- and

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2-adrenergic, and serotonin receptors.

Administration and Adult Dosage.

Pharmacology.
Alprazolam is a triazolobenzodiazepine that is equal in efficacy to other benzodiazepines for generalized anxiety disorder but more effective in the treatment of panic disorder. Although alprazolam has some efficacy in major depression, it is less effective than heterocyclic antidepressants.

Pharmacology.
Venlafaxine is a potent reuptake inhibitor of serotonin and norepinephrine, like many TCAs, but lacks effects on muscarinic,

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-adrenergic, or histamine receptors.

Administration and Adult Dosage.
PO for depression (immediate-release) 75mg bid or tid initially, increasing q 4-7 days to an effective antidepressant dosage of 225-375 mg/day in 2 or 3 divided doses; (sustained-release) 75 mg once daily initially, increasing in increments of up to 75 mg/day at intervals of 4 or more days to a maximum of 225 mg/day. The sustained-release preparation does not reduce side effects but allows once-daily administration.
PO for generalized anxiety disorder 75-225 mg/day in 2-3 divided doses. Patients with renal impairment or on hemodialysis require a 25-50% dosage reduction.

Pharmacology.
Sertraline is an SSRI similar to fluoxetine, which indirectly results in a downregulation of -adrenergic receptors. It has no clinically important effect on noradrenergic or histamine receptors and no effect on MAO. It lacks stimulant, cardiovascular, anticholinergic, and convulsant effects. Sertraline has antidepressant effects equal to TCAs and fluoxetine and might have anorectic effects and efficacy in OCD.