Summary
Samenvatting Antidepressiva
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Samenvatting van 3 pagina's voor het vak Minor aan de HHS
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3. Antidepressivahypothese depressie:
tekort aan noradrenaline en serotonine in de hersenen
werking antidepressiva:
mogelijk door opheffen tekort aan noradrenaline en serotonine (= monoaminen)
in de hersenen
- blokkade van heropnamen
- remming van afbraak
antidepressiva indeling van het boek
- klassiek:
o tricyclische antidepressiva TCA’s
- modern:
o selectieve serotonine heropnameremmers SSRI’s
o serotonine-noradrenaline heropnameremmers SNRI’s
- overigen:
o monoamino-oxidaseremmers MAO-remmers
alle middelen remmen heropnamen alleen MAO-remmer remt afbraak
antidepressiva indicaties hulpgids:
- depressie
- paniekstoornis
- agorafobie
- obsessieve compulsie stoornis
- boulimia nervosa
opvallend: indicaties zowel depressie als angststoornissen
praktijk: vaak combinatie depressieve en angststoornissen
behandeling:
lichte depressie: afwachten, psychotherapie, 50% spontaan herstel binnen 3
maanden
matige of ernstige depressie: gebruik van antidepressivum
regel is: hoe ernstige de depressie, hoe zinvoller de behandeling met
antidepressivum
optreden van effect:
meeste effect tussen de derde en zesde week van de behandeling, de
concentratie van neurotransmitters is al snel verhoogd maar het effect treed pas
later op
TCA’s en SSRI’s zijn ongeveer even effectief
SSRI’s minder giftig en minder bijwerkingen
de huisarts geeft snel een SSRI’s terwijl er in de psychiatrie eerder naar een
klassiek middel dus een TCA wordt gegrepen.
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