Category: Nursing Essay

Abstract

This paper explores the pharmacological effects of anti-depressants in their treatment of depressive and related disorders, including ADHD, OCD, anti-social disorders, eating/sleeping disorders, and clinical depression. The constructivism of this work is in its substantial literature review, discussion section, and nursing implication sections where the author reveals both effectiveness and side effects of psychic drugs to cure depression. Nurse practical advice is given for those who work in clinics to reduce side effects and prevent worsening of the situation with patients.

 

Depression and related disorders have been treated by many generations of medications that are reported to have more or fewer effects on treatment. Specifically, they are all related to activating neural centers in the human brain and helping to transport serotonin and dopamine chemical structures between different brain centers. For this task, it is good to apply anti-depressants as stimulators of the brain activity in relation to their use irrespective of some side effects that may be significant for the brain structures.

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Chemically, anti-depressants may differ by the structure of the compound in their atomic nature. For example, there are tricyclic anti-depressants with three atoms in the structure and there are tetracyclic compounds with the four-based compound structure. By effectiveness, selective and serotonin-norepinephrine reuptake inhibitors can be used apart from the major side effects, when regulated by other medications, and in the careful use with other psychic drugs. Noradrenergic and monoamine oxidase inhibitors belong to the new generation of psychic drugs that are used in depressive disorders treatment.

The aim of this paper is to provide an overview of medications of the anti-depressant type and discuss the benefits and side effects of each type of drugs. The Nursing Implication part will highlight consequences, which a nurse should take into account when treating a patient experiencing ADHD, OCD, clinical depression, eating/sleeping disorders, chronic pain, anxiety disorder, antisocial disorder, etc. In this relation, it would be useful to compare and contrast different types of medications in relevance to the nursing implications when they are all related to both benefits and side effects. Nurses should take into account all complexities and hard situations when treating patients with depressive disorders and, by the way, they should be all enlisted in the highly accessible database of clinical reviews and trials like this have been made in some attempts in the Cochrane Library by a number of research experts.

Discussion

Tricyclic Antidepressant Amitriptyline

Tricyclic antidepressant amitriptyline has been tested experimentally and clinically since the 1950s. This medication has shown positive results in the treatment of clinical depressive disorders, ADHD, suicide attempts, schizophrenic disorders, and eating disorders. This medication belongs to tricyclic compounds due to its specific chemical structure as its compounds have been united into triplets.

The superiority to the placebo effect of amitriptyline has been observed by researchers of the Cochrane Collaboration that have recently performed a background systematic review of substantial clinical trials of the tricyclic antidepressants. The effectiveness of this publication can be assessed by the amount of clinical trials data that go well along with the side effects of tricyclic antidepressants. The researchers have pointed out that their side effects are significant, as well as their impact on the organism. For instance, it has been revealed that amitriptyline may cause heart failure, hypertension, sexual dysfunction, vomiting, etc., specifically if the overdose has been applied to a patient. Overdose may even cause a lethal effect.

Selective Serotonin Reuptake Inhibitors

The medical use of selective serotonin reuptake inhibitors is the following: the chemical formula allows reactivating specific dopamine transporters in the organism. In this way, serotonin is easier transported in a patient and helps in the treatment of clinical depression, obsessive-compulsive disorders, eating and sleeping disorders, etc. The medication has been activated when it is bound up with postsynaptic receptors with the available level of serotonin within the synaptic cleft. However, the efficacy of the SSRIs in the clinical depression treatment may be doubtful for during some researches practitioners provide examples when this type of medication appears to be ineffective. On the contrary, Fournier et al. (2010) have provided a meta-analysis and clinical review research that has helped to generate major objectives of the depression treatment in cases of interest when there are observed outside sources reviewed along with practical results of the clinical medication treatment. The discussion of applying the SSRIs as dopamine transporting catalyzers has been on the rise nowadays due to the appearance of the next generation of antidepressants that are designed to get relief for the patients with a low dose of serotonin in the blood.

Serotonin-norepinephrine Reuptake Inhibitors (SNRIs)

Serotonin-norepinephrine reuptake inhibitors (SNRIs) are medications that are relevantly used to treat OCD, depression, attention deficit disorders, chronic pain, and other mood disorders, including ADHD and menopausal syndromes that belong to the group of dopamine and serotonin transmissions disorders. This type of medication belongs to potentially active and useful inhibitors of serotonin and norepinephrine reactions. They catalyze and stimulate other related medications, which is why they should be used carefully in correlation with other ways to treat depression, including natural herbal medications. In any case, improved tolerability and updates in safety profile should be used as applicable to patients who belong to the group of risk as indicated with respect to the correct dosage and in relation to the need to control for the allergic reaction of the organism to the SNRIs and deliverables. As for the forthcoming chemical reaction, it would be useful to provide the correct testing in relation to all types of such medications when they are prescribed and used with a view to ensuring corrections in dosages. The SNRIs ensuring “balanced dual inhibition of monoamine reuptake” can offer an easy way to use this type of medications for curing a wide range of symptoms, as related to clinical depression in all of its aspects, including OCD, ADHD, eating/sleeping disorders, and other clinical extrapolations of medication-required reactions. In some cases, patients are agreed to be cured by this type of antidepressants, but in other cases there is a need for extra care in relation to risky situations of suicidal reactions that may be either side effects of the SNRIs use or just may belong to the extra use of other medications that are left beyond the controllable measures.

The types of SNRIs are different as per dosage that during the initial stages of treatment starts with 300 mg/day is not recommended unless there are no significant reactions to the medication observed. The medications used at the initial stage of treatment are commonly from the following list: Venlafaxine (Effexor), Desvenlafaxine (Pristiq), Duloxetine (Yentreve, Cymbalta), Milnacipran (Ixel, Savills, Dalcipran), Levomilnacipran (Fetzima), etc. In relevance to different generations of medications, there is a variety of them being approved by the FDA as applicable in treatment of depressive disorders. In 1993, Venlafaxine was approved by the FDA, and in the progressive schedule in 1998 the FDA approved Sibutramine, in 2005 – Duloxetine, and in 2008 – Desvenlafaxine. Finally, as per medication of the new forthcoming generations, the Milnacipran was approved by the FDA in 2009 and has been actively tested clinically and used for the treatment of depressive disorders since then. A comparative analysis with other medications has been provided by the Cochrane society and it has been revealed that different SNRIs applied as medications of high-end generations can be effective in treatment of the clinical depression and related disorders if prescribed in the right dosages that are calculated depending on the severity of the disorder, possible allergic reactions, BMI (body mass index), and other health parameters. Apart from the side effects of the SNRIs, they are reported to be effective as per overall relief parameters when applied both in-home treatment and for forecasting of the forthcoming therapeutic effect in the clinical depressive syndromes treatment.

Psychoactive properties of the serotonin transmission catalyzers have been first discovered and tested on tuberculosis patients as the prehistory of treatment depression relating to the state of exhaust in the overall health rates of patients. Serotonin is an active substance that should be actively transmitted between activated centers so that the health parameters of patients can be tested as normal or positive in reactions with other fluids in the organism. Relevantly, the activity of dopamine and serotonin transmissions can be actively related to the progressive disorders since they are formulated in the number of researches from the Cochrane Library. For instance, Benedict, Arellano, De Cock, and Baird (2010) have provided substantial research on the effect of the economic evaluation in the form of a comparative analysis of duloxetine and serotonin selective reuptake inhibitors in treating MDD in relevance to Scotland. The economic evaluation of serotonin transmissions between neural centers appears to be effective as a part of the research.