Depression: It Matters!
Pp. 3-24 (22)
Ana María Sánchez Peralta
It is well documented in the literature that there is high prevalence of
depression in various diseases and is also a risk factor for the development of certain
diseases, such as cardiovascular disease or diabetes. Depression can delay the
convalescence and may have effects on treatment states. Pharmacological treatments for
depression are based on increasing activity of neurotransmitters which are normally
diminished in this disease. Various intrinsic or extrinsic factors play role for the
development of depression. Treatments vary according to the type of depression. Hence,
diagnosing the exact cause of depression is very important. The adverse effects of
antidepressant drugs on other disease conditions in a depressed patient should be
considered, particularly on the central nervous system and the cardiovascular system.
The interactions of various antidepressants may cause the "Serotonin Syndrome" by
synergy effect. There are also interactions with other drugs at the kinetic level due to the
role of cytochrome P450 (CYP450) in the metabolism of antidepressants and many
others (drugs or molecules). These interactions can be competitive or non-competitive
with a result of agonism (synergies) or antagonism, with the change of relative effects
of each one. Because antidepresant effect is at long term, the quick substitution of one
antidepressant with other usually gives mixed effects of both and interactions at the
beginning. Withdrawal should be gradual otherwise, it may cause discontinuation
syndrome. The symptoms of this syndrome should not be confused with the patient's
symptoms. The worsening of other ailments and enlargement of convalescence can be
diminished with right type of antidepressant treatment.
Antidepressants, depression, disease, interactions, risk factor.
University of Pharmacy, Department of Food Science and Physical Chemistry, La Cartuja, Granada, Spain.