Newer Antidepressants
Second- and later-generation agents — SSRIs, SNRIs, atypical receptor-modulators & the rapid-acting drugs
Past RGUHS + DNB + MPMSU + MUHS · 13
MPMSUJan '25
RGUHSJun '24
RGUHSNov '22
MPMSUAug '21
DNBDec '21
RGUHSNov '20
RGUHSNov '19
MPMSU2015
DNBDec '15
MPMSU2014
MUHSWinter '14
DNBDec '12
RGUHSSep '06
Introduction
- Definition — Antidepressants elevate mood in depressive illness; practically all act on monoaminergic (5HT, NE, ± DA) transmission in the brain.
- "Newer" = second-generation+ — The post-TCA/post-MAOI agents developed from the 1980s to overcome three TCA limitations — frequent anticholinergic/cardiovascular/neurological effects, low safety margin (overdose lethality), and incomplete response.
- Two pivotal classes — SSRIs and SNRIs selectively block SERT (SSRIs) or SERT + NET (SNRIs) with no direct action on cholinergic/adrenergic/histaminergic receptors → improved tolerability and overdose safety.
- Newest wave — Mechanistically distinct rapid-acting agents — the NMDA antagonists (ketamine/esketamine) and the neurosteroid GABA_A modulator brexanolone — called "the first mechanistically distinct antidepressants approved in decades."
- Indian framing (KDT) — SSRIs and SNRIs are first-line; TCAs are now only alternatives in non-responsive cases or those not tolerating second-generation agents.
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Newer Antidepressants
PharmaNotes Pro · LAQ
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