Psychiatric Mental Health Nursing lab Antidepressant Drugs 

Outlines  Introduction of antidepressant drugs.  Definition of antidepressant drugs.  Types of antidepressant drugs.  Side effect  Indication of each type  Contraindication of each type  Treatment of toxicity  Nursing role 

Introduction 

Antidepressant drugs are primarily used in the treatment of major depressive illness, anxiety disorders, the depressed phase of bipolar disorder, and psychotic depression. Off-label uses of antidepressants include the treatment of chronic pain, migraine headaches, peripheral and diabetic neuropathies; sleep apnea, dermatologic disorders, panic disorder, and eating disorders. 

Types of antidepressants 

1. Tricyclic antidepressants medications:

 • Side Effects: • Dizziness -Orthostatic hypotension • Tachycardia -Sedation • Headache -Tremor • Blurred vision -Constipation • Dry mouth and throat -Weight gain • Urinary hesitancy

2-Monoamine Oxidase Inhibitors (MAOIs) 

. MAOIs is used infrequently because of potentially fatal side effects as hypertensive crisis

• Hypertensive crisis Symptoms are occipital headache, hypertension, nausea, vomiting , chills, sweating, restlessness, nuchal rigidity, dilated pupils, fever, and motor agitation. These can lead to hyperpyrexia, cerebral hemorrhage and death

 Side effects:

 • Drowsiness -Dry mouth • Over activity -Insomnia • Nausea -Anorexia • Constipation -Urinary retention • Orthostatic hypotension 

3- Selective serotonin reuptake inhibitors (SSRIs): 

• SSRIs are effective and safer for children and older adults ,these drugs produce few sedating, anticholinergic, and cardiovascular side effects  Adverse effect of (SSRIs):Serotonin syndrome 

 Symptoms of serotonin syndrome include 

• Change in mental state: confusion, agitation • Neuromuscular excitement: muscle rigidity, weakness, tremors, collapse, muscle paralysis • Autonomic abnormalities: hyperthermia, tachycardia 

General nursing care and instructions for patients receiving antidepressant drug 

 Monitor vital signs, especially pulse and blood pressure, especially when initiating treatment. (Tricyclic may cause ortho static hypotension). 

 Avoid abrupt changes in position. 

 Administer accurately. Give TCAs at bedtime to aid in sleep and minimize daytime drowsiness. 

 Monitor blood pressure for patient taking MAOIS, to avoid hypertensive crisis, a life-threatening condition that can result when a client taking MAOIs ingests Tyramine -containing foods and fluids or other medications. Observe for signs and symptoms of improved mood, keeping in mind that it may take 2 to 4 weeks to achieve therapeutic effectiveness. Monitor fluid intake and output. Ensure client safety. (Dizziness caused by postural hypotension increases the risk of fall injuries.) Avoid driving or performing hazardous activities until blood pressure is stabilized and effects of the drug are known.