Drugs Used to Treat Depression

Pharmacotherapy for Neurological Disorders
Depression is a neurological disorder that is treatable by pharmacotherapy. However, treatment for depression does not always solely rely on drugs and interventions can include counseling or approaches such as cognitive behavioral therapy to help patients suffering from depression who also have behavior issues that factor into their treatment plan. This paper will describe the types of drugs that would be prescribed to patients to treat symptoms associated with depression and it will also reflect on how behavior factors might impact the effects of prescribed drugs along with measures a nurse practitioner might take to help reduce negative side effects.
There are numerous drugs available to treat depression. These include Zoloft, Prozac, Celexa, Wellbutrin XL, Cymbalta, Lexapro, Xanax, Paxil, and dozens of others. Many drugs that are used to treat depression are classified in the following categories: selective serotonin reuptake inhibitors (SSRIs), serotonin and norpinephrine reuptake inhibitors (SNRIs), tricyclic antidepressants (TCAs), tetracyclic antidepressants, and dopamine reuptake blockers. Because of the side effects of some of these drugs, patients suffering from depression who also show signs of having or harboring aggressive feelings have to be monitored closely to prevent a sudden outbreak of violence from occurring either against the patient’s own self via suicide or against others in the patient’s environment (Gupta, Gersing, Erkanli & Burt, 2016).
SSRIs are the most common type of pharmacotherapy used to treat patients with depression as it is believed that a serotonin imbalance is what causes the neurological disorder of depression. Drugs like Zoloft, Prozac, Celexa, Paxil, and Lexapro decrease the serotonin reuptake in the brain which allows serotonin to stay working in the brain and staving off the feelings of depression. Typical side effects that accompany the use of SSRIs include nervousness, nausea, and in some cases aggression. Molero, Lichtenstein, Zetterqvist, Gumpert and Fazel (2015) found that violence and violent crime associated with the use of SSRIs varies according to the factor of age group and the types of behaviors that the individuals are engaged in.
Behavior is a factor that might impact the effects of prescribed drugs like Zoloft or Paxil as the patient’s mood is altered by these drugs because of their affect on serotonin levels in the brain. A patient whose behavior indicates impulsiveness, aggression, hostility, or who shows signs of anxiety or a desire to hurt others may need to be monitored closely in order to mitigate the risks associated with these drugs and their effect on depressed persons. As Gupta et al. (2016) and Molero et al. (2015) show, there is a need to better understand how these drugs impact persons who have aggressive behavioral tendencies.
To mitigate the risk of these drugs having an adverse effect on the patient’s behavior, a patient whose behavior tends towards the criminal, who displays signs of suicide ideation, demonstrates an aggressive demeanor, or who has a history of violence should consider the risks associate with the pharmacotherapy options associated with treating depression. Many individuals who successfully treat depression combine pharmacotherapy with behavioral therapy to empower the patient to be more self-efficacious. A nurse should therefore consider recommending that patients whose behavior might be a negative factor while suffering from depression couple their pharmacotherapy with cognitive behavioral therapy, in order to facilitate a positive behavioral experience.
References
Gupta, S., Gersing, K. R., Erkanli, A., & Burt, T. (2016). Antidepressant regulatory
warnings, prescription patterns, suicidality and other aggressive behaviors in major depressive disorder and anxiety disorders. Psychiatric Quarterly, 87(2), 329-342.
Molero, Y., Lichtenstein, P., Zetterqvist, J., Gumpert, C. H., & Fazel, S. (2015). Selective
serotonin reuptake inhibitors and violent crime: a cohort study. PLoS Medicine, 12(9), e1001875.