Lihat sumber Antidepresan

{{Infobox drug class
| Image= File:Venlafaxine structure.svg
| Alt= 225px
| Caption= 
| Pronounce=
| Synonyms=
<!-- Class identifiers -->
| Use=Gangguan depresi
| ATC_prefix=N06A
| Mode_of_action=
| Mechanism_of_action=
| Biological_target=
| Chemical_class=
<!-- Clinical data -->
| Drugs.com={{Drugs.com|drug-class|antidepressants}}
| MedlinePlus=antidepressants
| Consumer_Reports= antidepressants
| medicinenet= antidepressants
| rxlist=100734
<!-- Pranala luar -->
| MeshID=D000928
}}

'''Antidepresan''' adalah sebuah [[obat]] yang digunakan untuk mengobati [[gangguan depresi mayor]], beberapa [[gangguan kecemasan]], beberapa kondisi [[nyeri kronis]], dan untuk membantu mengelola beberapa [[kecanduan]].<ref name="Jennings2018">{{cite book|title=Clinical psychopharmacology for neurologists: a practical guide|last1=Jennings|first1=Leigh|date=2018|publisher=Springer|isbn=978-3-319-74602-9|editor1-last=Grossberg|editor1-first=George T.|pages=45–71|chapter=Chapter 4: Antidepressants|doi=10.1007/978-3-319-74604-3_4|editor2-last=Kinsella|editor2-first=Laurence J.}}</ref> [[Efek samping]] umum dari antidepresan termasuk [[Xerostomia|mulut kering]], [[penambahan berat badan]], [[pusing]], [[sakit kepala]], dan [[disfungsi seksual]].<ref>{{cite journal | vauthors = Healy D, Noury LJ, Manginb D | title = Enduring sexual dysfunction after treatment with antidepressants, 5α-reductase inhibitors and isotretinoin: 300 cases | journal = International Journal of Risk & Safety in Medicine | volume = 29 | issue = 3 | pages = 125–134 | date = May 2018 | pmid = 29733030 | pmc = 6004900 | doi = 10.3233/JRS-180744 }}</ref><ref name="Bahrick">{{cite journal |doi=10.2174/1874350100801010042 |title=Persistence of Sexual Dysfunction Side Effects after Discontinuation of Antidepressant Medications: Emerging Evidence |journal=The Open Psychology Journal |volume=1 |pages=42–50 |year=2008 |last1=Bahrick |first1=Audrey S. | name-list-format = vanc }}</ref><ref>{{cite journal | vauthors = Taylor MJ, Rudkin L, Bullemor-Day P, Lubin J, Chukwujekwu C, Hawton K | title = Strategies for managing sexual dysfunction induced by antidepressant medication | journal = The Cochrane Database of Systematic Reviews | volume = 5 | issue = 5 | pages = CD003382 | date = May 2013 | pmid = 23728643 | doi = 10.1002/14651858.CD003382.pub3 | url = https://kclpure.kcl.ac.uk/portal/en/publications/strategies-for-managing-sexual-dysfunction-induced-by-antidepressant-medication(5f0f0033-e139-42cc-9590-d3b5cad1bb25).html }}</ref><ref>{{cite journal | vauthors = Kennedy SH, Rizvi S | title = Sexual dysfunction, depression, and the impact of antidepressants | journal = Journal of Clinical Psychopharmacology | volume = 29 | issue = 2 | pages = 157–64 | date = April 2009 | pmid = 19512977 | doi = 10.1097/jcp.0b013e31819c76e9 }}</ref><ref>[https://www.ema.europa.eu/en/documents/other/new-product-information-wording-extracts-prac-recommendations-signals-adopted-13-16-may-2019-prac_en.pdf Serotonin and noradrenaline reuptake inhibitors (SNRI); selective serotonin reuptake inhibitors (SSRI) – Persistent sexual dysfunction after drug withdrawal ](EPITT no 19277), 11 June 20191, EMA/PRAC/265221/2019, Pharmacovigilance Risk Assessment Committee (PRAC)</ref>

Sebagian besar jenis antidepresan biasanya aman dikonsumsi, tetapi dapat menyebabkan meningkatnya pikiran untuk bunuh diri ketika dikonsumsi oleh anak-anak, remaja, dan dewasa muda. Sindrom penghentian dapat terjadi setelah menghentikan antidepresan yang menyerupai depresi berulang.

== Jenis ==
Berikut merupakan jenis obat antidepresan:
===''Selective Serotonin Re-uptake Inhibitor'' (SSRIs)===
* [[Citalopram]] 
* [[Escitalopram]] 
* [[Fluoksetin]] 
* [[Fluvoksamin]] 
* [[Paroksetin]] 
* [[Sertralin]] 

Dihentikan/ditarik:
* [[Indalpin]] 
* [[Zimelidin]]

===''Serotonin and Norepinephrine Reuptake Inhibitors'' (SNRIs)===
* [[Desvenlafaksin]] 
* [[Duloksetin]] 
* [[Levomilnacipran]] 
* [[Milnacipran]] 
* [[Venlafaksin]]

===''Serotonin–norepinephrine–dopamine reuptake inhibitors'' (SNDRIs)===
* [[Toludesvenlafaksin]]
* [[Nefazodon]]<ref name="Tatsumi1997">{{cite journal | vauthors = Tatsumi M, Groshan K, Blakely RD, Richelson E | title = Pharmacological profile of antidepressants and related compounds at human monoamine transporters | journal = European Journal of Pharmacology | volume = 340 | issue = 2-3 | pages = 249–258 | date = December 1997 | pmid = 9537821 | doi = 10.1016/s0014-2999(97)01393-9 }}</ref>

===''Serotonin modulators and stimulators'' (SMSs)===
===''Serotonin antagonist and reuptake inhibitors'' (SARIs)===
* [[Nefazodon]] (Dihentikan/ditarik di banyak negara)
* [[Trazodon]] 

Dihentikan/ditarik:
* [[Etoperidon]]

===''Norepinephrine reuptake inhibitors'' (NRIs)===
* [[Reboksetin]] 
* [[Teniloksazin]] – juga merupakan antagonis reseptor 5-HT<sub>2A</sub>
* [[Viloksazin]] – juga merupakan antagonis reseptor 5-HT<sub>2B</sub> dan agonis reseptor 5-5-HT<sub>2C</sub>
Hanya di luar label:
* [[Atomoksetin]]<ref name="pmid29630286">{{cite book | vauthors = Fedder D, Patel H, Saadabadi A | chapter = Atomoxetine | chapter-url = https://www.ncbi.nlm.nih.gov/books/NBK493234/ | date = March 2023 | title = StatPearls [Internet] | location = Treasure Island (FL) | publisher = StatPearls Publishing | pmid = 29630286 }}</ref><ref name="pmid21155988">{{cite journal | vauthors = Dell'Osso B, Palazzo MC, Oldani L, Altamura AC | title = The noradrenergic action in antidepressant treatments: pharmacological and clinical aspects | journal = CNS Neurosci Ther | volume = 17 | issue = 6 | pages = 723–32 | date = December 2011 | pmid = 21155988 | pmc = 6493872 | doi = 10.1111/j.1755-5949.2010.00217.x | url = }}</ref><ref name="pmid19752841">{{cite journal | vauthors = Fleurence R, Williamson R, Jing Y, Kim E, Tran QV, Pikalov AS, Thase ME | title = A systematic review of augmentation strategies for patients with major depressive disorder | journal = Psychopharmacol Bull | volume = 42 | issue = 3 | pages = 57–90 | date = 2009 | pmid = 19752841 | doi = | url = }}</ref><ref name="pmid25295426">{{cite journal | vauthors = Corp SA, Gitlin MJ, Altshuler LL | title = A review of the use of stimulants and stimulant alternatives in treating bipolar depression and major depressive disorder | journal = J Clin Psychiatry | volume = 75 | issue = 9 | pages = 1010–8 | date = September 2014 | pmid = 25295426 | doi = 10.4088/JCP.13r08851 | url = }}</ref>

===''Norepinephrine–dopamine reuptake inhibitors'' (NDRIs)===
* [[Bupropion]] – juga merupakan antagonis non-kompetitif reseptor asetilkolin nikotinat<ref name="pmid19897080">{{cite journal | vauthors = Arias HR, Santamaría A, Ali SF | title = Pharmacological and neurotoxicological actions mediated by bupropion and diethylpropion | journal = Int. Rev. Neurobiol. | volume = 88 | pages = 223–55 | year = 2009 | pmid = 19897080 | doi = 10.1016/S0074-7742(09)88009-4 | series = International Review of Neurobiology | isbn = 9780123745040 }}</ref>

Hanya di luar label:
* [[Amfetamin]] – sebenarnya agen pelepas norepinefrin-dopamin (NDRA)<ref name="pmid25813654">{{cite journal | vauthors = Dale E, Bang-Andersen B, Sánchez C | title = Emerging mechanisms and treatments for depression beyond SSRIs and SNRIs | journal = Biochem. Pharmacol. | volume = 95 | issue = 2 | pages = 81–97 | year = 2015 | pmid = 25813654 | doi = 10.1016/j.bcp.2015.03.011 | url = | doi-access = free }}</ref><ref name="pmid25295426" />
* [[Metilfenidat]]<ref name="pmid10907387">{{cite journal | vauthors = Challman TD, Lipsky JJ | title = Methylphenidate: its pharmacology and uses | journal = Mayo Clin. Proc. | volume = 75 | issue = 7 | pages = 711–21 | year = 2000 | pmid = 10907387 | doi = 10.4065/75.7.711 | url = | doi-access = free }}</ref><ref name="pmid22144657">{{cite journal | vauthors = Prommer E | title = Methylphenidate: established and expanding roles in symptom management | journal = Am J Hosp Palliat Care | volume = 29 | issue = 6 | pages = 483–90 | year = 2012 | pmid = 22144657 | doi = 10.1177/1049909111427029 | s2cid = 21384037 | url = }}</ref>
* [[Modafinil]] – sebenarnya penghambat pengambilan kembali dopamin selektif ditambah tindakan lainnya<ref name="pmid32447354">{{cite journal | vauthors = Urban AE, Cubała WJ | title = The role of eugeroics in the treatment of affective disorders | journal = Psychiatr Pol | volume = 54 | issue = 1 | pages = 21–33 | date = February 2020 | pmid = 32447354 | doi = 10.12740/PP/OnlineFirst/90687 | url = | doi-access = free }}</ref><ref name="pmid28318897">{{cite journal | vauthors = Kleeblatt J, Betzler F, Kilarski LL, Bschor T, Köhler S | title = Efficacy of off-label augmentation in unipolar depression: A systematic review of the evidence | journal = Eur Neuropsychopharmacol | volume = 27 | issue = 5 | pages = 423–441 | date = May 2017 | pmid = 28318897 | doi = 10.1016/j.euroneuro.2017.03.003 | s2cid = 3740987 | url = }}</ref><ref name="pmid31643130">{{cite journal | vauthors = Nunez NA, Singh B, Romo-Nava F, Joseph B, Veldic M, Cuellar-Barboza A, Cabello Arreola A, Vande Voort JL, Croarkin P, Moore KM, Biernacka J, McElroy SL, Frye MA | title = Efficacy and tolerability of adjunctive modafinil/armodafinil in bipolar depression: A meta-analysis of randomized controlled trials | journal = Bipolar Disord | volume = 22 | issue = 2 | pages = 109–120 | date = March 2020 | pmid = 31643130 | doi = 10.1111/bdi.12859 | url = | doi-access = free }}</ref><ref name="pmid28256707">{{cite journal | vauthors = Szmulewicz AG, Angriman F, Samamé C, Ferraris A, Vigo D, Strejilevich SA | title = Dopaminergic agents in the treatment of bipolar depression: a systematic review and meta-analysis | journal = Acta Psychiatr Scand | volume = 135 | issue = 6 | pages = 527–538 | date = June 2017 | pmid = 28256707 | doi = 10.1111/acps.12712 | s2cid = 3712257 | url = }}</ref>

Dihentikan/ditarik:
* [[Amineptin]] 
* [[Nomifensin]]

===Antidepresan trisiklik===
* [[Amitriptilin]] 
* [[Amitriptilinoksida]] 
* [[Desipramin]] 
* [[Dibenzepin]] 
* [[Dimetakrin]] 
* [[Dosulepin]] 
* [[Doksepin]] 
* [[Imipramin]] 
* [[Klomipramin]] 
* [[Lofepramin]] 
* [[Melitrasen]] 
* [[Nitroksazepin]] 
* [[Nortriptilin]] 
* [[Noksiptilin]] 
* [[Pipofezin]] 
* [[Protriptilin]] 
* [[Trimipramin]] 

[[Opipramol]], [[tianeptin]], dan [[amineptin]] (dihentikan) secara kimiawi adalah TCA tetapi secara [[farmakodinamika]] atipikal, dan oleh karena itu dikelompokkan di tempat lain.

Dihentikan/ditarik:
* [[Butriptilin]] 
* [[Demeksiptilin]]
* [[Fluasizin]] 
* [[Imipraminoksida]] 
* [[Iprindol]] 
* [[Metapramin]] 
* [[Propizepin]] 
* [[Kuinupramin]] 
* [[Tiazesim]] – sebenarnya bukan TCA tapi antidepresan mirip trisiklik
* [[Tofenasin]] – sebenarnya bukan TCA tapi antidepresan mirip trisiklik

===Antidepresan tetrasiklik===
* [[Amoksapin]] 
* [[Maprotilin]] 
* [[Mianserin]] 
* [[Mirtazapin]] 
* [[Setiptilin]] 

Mianserin, mirtazapin, dan setiptilin juga kadang-kadang digambarkan sebagai antidepresan noradrenergik dan serotonergik spesifik (NaSSA).

===''Monoamine Oxidase Inhibitors'' (MAOIs)===
====Tidak dapat diubah====

;Nonselektif
* [[Fenelzin]] 
* [[Isokarboksazid]]
* [[Tranilsipromin]] 

Dihentikan/ditarik:

* [[Benmoksin]] 
* [[Feniprazin]] 
* [[Fenoksipropazin]] 
* [[Iproklozid]] 
* [[Iproniazid]] 
* [[Mebanazin]] 
* [[Nialamida]] 
* [[Oktamoksin]] 
* [[Pivhidrazin]] 
* [[Safrazin]]

;Selektif untuk MAO-B
* [[Selegilin]]

====Dapat diubah====

;Nonselektif

Dihentikan/ditarik:

* [[Karoksazon]] 
;Selektif untuk MAO-A
* [[Metralindol]] 
* [[Moklobemid]] 
* [[Pirlindol]] 

Obat-obatan ini kadang-kadang digambarkan sebagai penghambat MAO-A yang dapat diubah (RIMA).

Dihentikan/ditarik:

* [[Eprobemid]] 
* [[Minaprin]] 
* [[Toloksaton]]

====Dicampur====

;Nonselektif
* [[Bifemelan]] – RIMA, penghambat MAO-B yang tidak dapat diubah, dan NRI lemah

===Antipsikotik atipikal===
* [[Amisulprid]] – disetujui dalam dosis rendah sebagai monoterapi untuk [[Distimia|depresi persisten]]
* [[Kuetiapin]] – disetujui sebagai monoterapi untuk depresi bipolar
* [[Lumateperon]] – disetujui sebagai monoterapi untuk depresi bipolar
* [[Lurasidon]] – disetujui sebagai monoterapi untuk depresi bipolar

===Lainnya===
====Dipasarkan====
* [[Agomelatin]] – [[Antagonis reseptor]] 5-HT<sub>2C</sub> dan agonis reseptor MT<sub>1</sub> dan MT<sub>2</sub>
* [[Allopregnanolon]] – Modulator alosterik positif reseptor GABA<sub>A</sub> – disetujui untuk [[depresi pascapersalinan]]
* [[Esketamin]] – antagonis reseptor NMDA non-kompetitif, tindakan lain<ref name="SpravatoLabel">{{cite web | title = SPRAVATO™ (esketamine) nasal spray FDA label | publisher = [[Food and Drug Administration]] | date = 5 March 2019 | url = https://www.accessdata.fda.gov/drugsatfda_docs/label/2019/211243lbl.pdf | access-date = 6 March 2019}}</ref>
* [[Gepiron]] – Agonis parsial reseptor 5-HT<sub>1A</sub> dan antagonis reseptor α<sub>2</sub>-adrenergik
* [[Opipramol]] — Agonis reseptor σ<sub>1</sub>, tindakan lain
* [[Tianeptin]] – agonis reseptor μ-opioid yang lemah dan atipikal, tindakan lain

====Hanya di luar label====
* [[Ketamin]] – antagonis reseptor NMDA non-kompetitif<ref name="pmid26768892">{{cite journal | vauthors = Zhang MW, Harris KM, Ho RC | title = Is off-label repeat prescription of ketamine as a rapid antidepressant safe? Controversies, ethical concerns, and legal implications | journal = BMC Med Ethics | volume = 17 | pages = 4 | year = 2016 | pmid = 26768892 | pmc = 4714497 | doi = 10.1186/s12910-016-0087-3 | doi-access = free }}</ref>
* [[Pramipeksol]] - Agonis [[Reseptor (biokimia)|reseptor]] dopamin D2, D3, dan D4<ref>{{cite journal | vauthors = Tundo A, Betro' S, de Filippis R, Marchetti F, Nacca D, Necci R, Iommi M | title = Pramipexole Augmentation for Treatment-Resistant Unipolar and Bipolar Depression in the Real World: A Systematic Review and Meta-Analysis | journal = Life | volume = 13 | issue = 4 | pages = 1043 | date = April 2023 | pmid = 37109571 | pmc = 10141126 | doi = 10.3390/life13041043 | doi-access = free | bibcode = 2023Life...13.1043T }}</ref>
** Agonis dopamin tidak dianjurkan karena kecenderungannya memfasilitasi perkembangan kecanduan bahkan pada individu yang tidak memiliki riwayat perilaku tersebut.

====Dihentikan/ditarik====
* [[α-Metiltriptamin]] <nowiki>[</nowiki>αMT<nowiki>]</nowiki> – agonis reseptor serotonin non-selektif, agen pelepas serotonin-norepinefrin-dopamin (SNDRA), dan RIMA lemah
* [[Etriptamin]] <nowiki>[</nowiki>α-Etiltriptamin<nowiki> (αET)]</nowiki> – agonis reseptor serotonin non-selektif, SNDRA, dan RIMA lemah
* [[Indeloksazin]] – agen pelepas serotonin (SRA), NRI, dan antagonis reseptor NMDA
* [[Medifoksamin]] – penghambat penhambilan kembali serotonin-dopamin (SDRI) yang lemah dan antagonis reseptor 5-HT<sub>2A</sub> dan 5-HT<sub>2C</sub>
* [[Oksaflozan]] – Agonis reseptor 5-HT<sub>1A</sub>, 5-HT<sub>2A</sub>, dan 5-HT<sub>2C</sub>
* [[Pivagabin]] – [[Mekanisme aksi|mekanisme kerja]]nya tidak diketahui/tidak jelas

====Dijual bebas====
Antidepresan berikut tersedia dengan [[resep dokter]] dan dijual bebas:

* [[Ademetionin]] <nowiki>[</nowiki>''S''-Adenosil-<small>L</small>-metionin (SAMe)<nowiki>]</nowiki> – [[kofaktor (biokimia)|kofaktor]] dalam [[biosintesis]] neurotransmitter monoamin
* ''[[Hypericum perforatum]]'' <nowiki>[</nowiki>''St. John's Wort''<nowiki>]</nowiki> (Jarsin, Kira, Movina) – Aktivator TRPC6, dan berbagai tindakan lainnya
* [[Oksitriptan]] <nowiki>[</nowiki>5-Hidroksitriptofan (5-HTP)<nowiki>]</nowiki> – [[Prekursor (kimia)|prekursor]] dalam biosintesis [[serotonin]]
* [[Triptofan]] – prekursor dalam biosintesis serotonin

===Perawatan tambahan===
====Antipsikotik atipikal====
* [[Aripiprazol]] – disetujui sebagai tambahan antidepresan untuk depresi berat
* [[Brekspiprazol]] – disetujui sebagai tambahan antidepresan untuk depresi berat
* [[Lumateperon]] – disetujui sebagai tambahan untuk penstabil suasana hati untuk depresi bipolar
* [[Lurasidon]] – disetujui sebagai tambahan untuk penstabil suasana hati untuk depresi bipolar
* [[Olanzapin]] – disetujui sebagai tambahan antidepresan untuk depresi berat
* [[Kuetiapin]] – disetujui sebagai tambahan antidepresan atau penstabil suasana hati untuk depresi berat dan depresi bipolar

;Hanya di luar label
* [[Risperidon]]

====Antipsikotik tipikal====
;Hanya di luar label
* [[Trifluoperazin]]<ref
name="pmid27514300">{{cite journal | vauthors = Thase ME | title = Adverse Effects of Second-Generation Antipsychotics as Adjuncts to Antidepressants: Are the Risks Worth the Benefits? | journal = Psychiatr. Clin. North Am. | volume = 39 | issue = 3 | pages = 477–86 | year = 2016 | pmid = 27514300 | doi = 10.1016/j.psc.2016.04.008 }}</ref>

====Lainnya====

;Hanya di luar label
* [[Buspiron]] – Agonis parsial reseptor 5-HT<sub>1A</sub>
* [[Litium (pengobatan)|Litium]] – penstabil suasana hati (mekanisme aksi tidak diketahui/tidak jelas)
* [[Levotiroksin]] (T<sub>4</sub>) – [[hormon tiroid]] (agonis reseptor hormon tiroid)
* [[Triiodotironina]] (T<sub>3</sub>) – hormon tiroid (agonis reseptor hormon tiroid)

===Obat kombinasi===
* [[Amitriptilin/klordiazepoksid]] – Kombinasi TCA dan [[benzodiazepin]]
* [[Amitriptilin/perfenazin]] – TCA dan kombinasi antipsikotik tipikal
* [[Flupentiksol/melitrasen]] – TCA dan kombinasi antipsikotik tipikal
* [[Olanzapin/fluoksetin]] – Kombinasi SSRI dan antipsikotik atipikal – disetujui sebagai monoterapi untuk depresi bipolar dan depresi yang resistan terhadap pengobatan
* [[Tranilsipromin/trifluoperazin]] – MAOI dan kombinasi antipsikotik tipikal
* [[Bupropion/dekstrometorfan]] – antagonis reseptor NMDA non-kompetitif, agonis reseptor σ<sub>1</sub>, SNRI, NDRI, tindakan lainnya

== Referensi ==
{{reflist}}

== Pranala luar ==
{{Wiktionary|antidepressant}}
*{{Commons category-inline|Antidepressants}}

[[Kategori:Farmakologi]]


{{Farmasi-stub}}{{kedokteran-stub}}
[[Kategori:Farmasi]]