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Antidepressants are psychotropic medications prescribed to alleviate symptoms of mood disorders like depression and anxiety. They work by addressing chemical imbalances of neurotransmitters in the brain. Different types of antidepressants target different neurotransmitters; for example, selective serotonin reuptake inhibitors (SSRIs) increase the availability of serotonin, while serotonin-norepinephrine reuptake inhibitors (SNRIs) elevate the levels of both serotonin and norepinephrine. Common SSRIs include Prozac and Zoloft, while tricyclics include Tofranil and Elavil.

Antidepressants

Selective serotonin reuptake inhibitors (SSRIs) are a class of drugs used to treat conditions like depression, which is often associated with low serotonin levels. Unlike agonists or antagonists that bind to receptors, SSRIs work by blocking the reuptake process. This action prevents unused serotonin from being reabsorbed by the presynaptic neuron, allowing it to remain in the synaptic cleft for a longer period. The extended presence of serotonin enhances its interaction with postsynaptic receptors, thereby strengthening its overall effect. Common examples of SSRIs include Prozac, Paxil, and Zoloft.

SSRIs and SNRIs

Tricyclic (or heterocyclic) antidepressants inhibit the reuptake of serotonin and/or norepinephrine, and are thus called due to their three (or more)-ring chemical structure. Some examples include:

- Amitriptyline (Elavil) 
- Nortriptyline (Aventyl)
- Maprotiline hydrochloride (Ludiomil)
- Desipramine hydrochloride (Norpramin)
- Clomipramine (Anafranil)

A similar drug is Bupropion (Wellbutrin), which is an aminoketone that weakly blocks norepinephrine, serotonin, and dopamine reuptake.

Tricyclic Antidepressants

MAOIs inhibit the breakdown of the enzyme that breaks down monoamine neurotransmitters. Some MAOIs have antidepressant effects, including:

- Phenelzine (Nardil)
- Isocarboxazid (Marplan)
- Tranylcypromine (Parnate)

Monoamine Oxidase Inhibitors (MAOIs)

Reference for Side Effects of Antidepressants

Side effects of SSRIs: 
* Headache
* Nausea
* Weight gain
* Drowsiness
* Reduced sex drive

Side effects of Tricyclics:
* Dry mouth
* Constipation
* Blurred vision
* Drowsiness
* Reduced sex drive
* Increased risk of suicide

Side Effects of Antidepressants

A clinician is considering two different types of medication for a patient. Medication A primarily works by increasing the amount of serotonin available between nerve cells. Medication B works by increasing the availability of both serotonin and norepinephrine. Which of the following statements accurately distinguishes between the mechanisms of these two medications?

References for Long-Term Use of Antidepressants

In past years, the overall use of antidepressants has increased. This could be from a mixture of increased "new" users or longer durations of use. Long-term is defined as 12 months or more of consistent medication use. Prevalence and incidence have increased SSRI use specifically. Treatments typically are as follows:

treatment of acute phase: 4-6 weeks
treatment for prevention of relapses: 4 to 12 months
treatment for prevention of recurrence: maintenance treatment (2-5 years)

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