Antidepresan

Antidepresan
Antidepresan
Kelas obat-obatan
Pengenal kelas
Penggunaan	Gangguan depresi
Kode ATC	N06A
Data klinis
Drugs.com	Drug Classes
Consumer Reports	Best Buy Drugs
WebMD	MedicineNet RxList
Pranala luar
MeSH	D000928
	Dalam Wikidata

Antidepresan adalah sebuah obat yang digunakan untuk mengobati gangguan depresi mayor, beberapa gangguan kecemasan, beberapa kondisi nyeri kronis, dan untuk membantu mengelola beberapa kecanduan.^[1] Efek samping umum dari antidepresan termasuk mulut kering, penambahan berat badan, pusing, sakit kepala, dan disfungsi seksual.^[2]^[3]^[4]^[5]^[6]

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)

Dihentikan/ditarik:

Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs)

Serotonin–norepinephrine–dopamine reuptake inhibitors (SNDRIs)

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_2A
Viloksazin – juga merupakan antagonis reseptor 5-HT_2B dan agonis reseptor 5-5-HT_2C

Hanya di luar label:

Atomoksetin^[8]^[9]^[10]^[11]

Norepinephrine–dopamine reuptake inhibitors (NDRIs)

Bupropion – juga merupakan antagonis non-kompetitif reseptor asetilkolin nikotinat^[12]

Hanya di luar label:

Amfetamin – sebenarnya agen pelepas norepinefrin-dopamin (NDRA)^[13]^[11]
Metilfenidat^[14]^[15]
Modafinil – sebenarnya penghambat pengambilan kembali dopamin selektif ditambah tindakan lainnya^[16]^[17]^[18]^[19]

Dihentikan/ditarik:

Antidepresan trisiklik

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

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

Monoamine Oxidase Inhibitors (MAOIs)

Tidak dapat diubah

Nonselektif

Dihentikan/ditarik:

Selektif untuk MAO-B

Selegilin

Dapat diubah

Nonselektif

Dihentikan/ditarik:

Karoksazon

Selektif untuk MAO-A

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

Dihentikan/ditarik:

Dicampur

Nonselektif

Bifemelan – RIMA, penghambat MAO-B yang tidak dapat diubah, dan NRI lemah

Antipsikotik atipikal

Amisulprid – disetujui dalam dosis rendah sebagai monoterapi untuk 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_2C dan agonis reseptor MT₁ dan MT₂
Allopregnanolon – Modulator alosterik positif reseptor GABA_A – disetujui untuk depresi pascapersalinan
Esketamin – antagonis reseptor NMDA non-kompetitif, tindakan lain^[20]
Gepiron – Agonis parsial reseptor 5-HT_1A dan antagonis reseptor α₂-adrenergik
Opipramol — Agonis reseptor σ₁, tindakan lain
Tianeptin – agonis reseptor μ-opioid yang lemah dan atipikal, tindakan lain

Hanya di luar label

Ketamin – antagonis reseptor NMDA non-kompetitif^[21]
Pramipeksol - Agonis reseptor dopamin D2, D3, dan D4^[22]
- Agonis dopamin tidak dianjurkan karena kecenderungannya memfasilitasi perkembangan kecanduan bahkan pada individu yang tidak memiliki riwayat perilaku tersebut.

Dihentikan/ditarik

α-Metiltriptamin [αMT] – agonis reseptor serotonin non-selektif, agen pelepas serotonin-norepinefrin-dopamin (SNDRA), dan RIMA lemah
Etriptamin [α-Etiltriptamin (αET)] – 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_2A dan 5-HT_2C
Oksaflozan – Agonis reseptor 5-HT_1A, 5-HT_2A, dan 5-HT_2C
Pivagabin – mekanisme kerjanya tidak diketahui/tidak jelas

Dijual bebas

Antidepresan berikut tersedia dengan resep dokter dan dijual bebas:

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

Perawatan tambahan

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 σ₁, SNRI, NDRI, tindakan lainnya

Referensi

^ Jennings, Leigh (2018). "Chapter 4: Antidepressants". Dalam Grossberg, George T.; Kinsella, Laurence J. Clinical psychopharmacology for neurologists: a practical guide. Springer. hlm. 45–71. doi:10.1007/978-3-319-74604-3_4. ISBN 978-3-319-74602-9.
^ Healy D, Noury LJ, Manginb D (May 2018). "Enduring sexual dysfunction after treatment with antidepressants, 5α-reductase inhibitors and isotretinoin: 300 cases". International Journal of Risk & Safety in Medicine. 29 (3): 125–134. doi:10.3233/JRS-180744. PMC 6004900 . PMID 29733030.
^ Bahrick AS (2008). "Persistence of Sexual Dysfunction Side Effects after Discontinuation of Antidepressant Medications: Emerging Evidence". The Open Psychology Journal. 1: 42–50. doi:10.2174/1874350100801010042.
^ Taylor MJ, Rudkin L, Bullemor-Day P, Lubin J, Chukwujekwu C, Hawton K (May 2013). "Strategies for managing sexual dysfunction induced by antidepressant medication". The Cochrane Database of Systematic Reviews. 5 (5): CD003382. doi:10.1002/14651858.CD003382.pub3. PMID 23728643.
^ Kennedy SH, Rizvi S (April 2009). "Sexual dysfunction, depression, and the impact of antidepressants". Journal of Clinical Psychopharmacology. 29 (2): 157–64. doi:10.1097/jcp.0b013e31819c76e9. PMID 19512977.
^ 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)
^ Tatsumi M, Groshan K, Blakely RD, Richelson E (December 1997). "Pharmacological profile of antidepressants and related compounds at human monoamine transporters". European Journal of Pharmacology. 340 (2-3): 249–258. doi:10.1016/s0014-2999(97)01393-9. PMID 9537821.
^ Fedder D, Patel H, Saadabadi A (March 2023). "Atomoxetine". StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. PMID 29630286.
^ Dell'Osso B, Palazzo MC, Oldani L, Altamura AC (December 2011). "The noradrenergic action in antidepressant treatments: pharmacological and clinical aspects". CNS Neurosci Ther. 17 (6): 723–32. doi:10.1111/j.1755-5949.2010.00217.x. PMC 6493872 . PMID 21155988.
^ Fleurence R, Williamson R, Jing Y, Kim E, Tran QV, Pikalov AS, Thase ME (2009). "A systematic review of augmentation strategies for patients with major depressive disorder". Psychopharmacol Bull. 42 (3): 57–90. PMID 19752841.
^ ^a ^b Corp SA, Gitlin MJ, Altshuler LL (September 2014). "A review of the use of stimulants and stimulant alternatives in treating bipolar depression and major depressive disorder". J Clin Psychiatry. 75 (9): 1010–8. doi:10.4088/JCP.13r08851. PMID 25295426.
^ Arias HR, Santamaría A, Ali SF (2009). "Pharmacological and neurotoxicological actions mediated by bupropion and diethylpropion". Int. Rev. Neurobiol. International Review of Neurobiology. 88: 223–55. doi:10.1016/S0074-7742(09)88009-4. ISBN 9780123745040. PMID 19897080.
^ Dale E, Bang-Andersen B, Sánchez C (2015). "Emerging mechanisms and treatments for depression beyond SSRIs and SNRIs". Biochem. Pharmacol. 95 (2): 81–97. doi:10.1016/j.bcp.2015.03.011 . PMID 25813654.
^ Challman TD, Lipsky JJ (2000). "Methylphenidate: its pharmacology and uses". Mayo Clin. Proc. 75 (7): 711–21. doi:10.4065/75.7.711 . PMID 10907387.
^ Prommer E (2012). "Methylphenidate: established and expanding roles in symptom management". Am J Hosp Palliat Care. 29 (6): 483–90. doi:10.1177/1049909111427029. PMID 22144657.
^ Urban AE, Cubała WJ (February 2020). "The role of eugeroics in the treatment of affective disorders". Psychiatr Pol. 54 (1): 21–33. doi:10.12740/PP/OnlineFirst/90687 . PMID 32447354.
^ Kleeblatt J, Betzler F, Kilarski LL, Bschor T, Köhler S (May 2017). "Efficacy of off-label augmentation in unipolar depression: A systematic review of the evidence". Eur Neuropsychopharmacol. 27 (5): 423–441. doi:10.1016/j.euroneuro.2017.03.003. PMID 28318897.
^ 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 (March 2020). "Efficacy and tolerability of adjunctive modafinil/armodafinil in bipolar depression: A meta-analysis of randomized controlled trials". Bipolar Disord. 22 (2): 109–120. doi:10.1111/bdi.12859 . PMID 31643130.
^ Szmulewicz AG, Angriman F, Samamé C, Ferraris A, Vigo D, Strejilevich SA (June 2017). "Dopaminergic agents in the treatment of bipolar depression: a systematic review and meta-analysis". Acta Psychiatr Scand. 135 (6): 527–538. doi:10.1111/acps.12712. PMID 28256707.
^ "SPRAVATO™ (esketamine) nasal spray FDA label" (PDF). Food and Drug Administration. 5 March 2019. Diakses tanggal 6 March 2019.
^ Zhang MW, Harris KM, Ho RC (2016). "Is off-label repeat prescription of ketamine as a rapid antidepressant safe? Controversies, ethical concerns, and legal implications". BMC Med Ethics. 17: 4. doi:10.1186/s12910-016-0087-3 . PMC 4714497 . PMID 26768892.
^ Tundo A, Betro' S, de Filippis R, Marchetti F, Nacca D, Necci R, Iommi M (April 2023). "Pramipexole Augmentation for Treatment-Resistant Unipolar and Bipolar Depression in the Real World: A Systematic Review and Meta-Analysis". Life. 13 (4): 1043. Bibcode:2023Life...13.1043T. doi:10.3390/life13041043 . PMC 10141126  Periksa nilai |pmc= (bantuan). PMID 37109571 Periksa nilai |pmid= (bantuan).

Pranala luar

Media tentang Antidepressants di Wikimedia Commons

Artikel bertopik farmasi ini adalah sebuah rintisan. Anda dapat membantu Wikipedia dengan mengembangkannya.

Artikel bertopik kedokteran atau medis ini adalah sebuah rintisan. Anda dapat membantu Wikipedia dengan mengembangkannya.

[Jennings2018-1] Jennings, Leigh (2018). "Chapter 4: Antidepressants". Dalam Grossberg, George T.; Kinsella, Laurence J. Clinical psychopharmacology for neurologists: a practical guide. Springer. hlm. 45–71. doi:10.1007/978-3-319-74604-3_4. ISBN 978-3-319-74602-9.

[2] Healy D, Noury LJ, Manginb D (May 2018). "Enduring sexual dysfunction after treatment with antidepressants, 5α-reductase inhibitors and isotretinoin: 300 cases". International Journal of Risk & Safety in Medicine. 29 (3): 125–134. doi:10.3233/JRS-180744. PMC 6004900 . PMID 29733030.

[Bahrick-3] Bahrick AS (2008). "Persistence of Sexual Dysfunction Side Effects after Discontinuation of Antidepressant Medications: Emerging Evidence". The Open Psychology Journal. 1: 42–50. doi:10.2174/1874350100801010042.

[4] Taylor MJ, Rudkin L, Bullemor-Day P, Lubin J, Chukwujekwu C, Hawton K (May 2013). "Strategies for managing sexual dysfunction induced by antidepressant medication". The Cochrane Database of Systematic Reviews. 5 (5): CD003382. doi:10.1002/14651858.CD003382.pub3. PMID 23728643.

[5] Kennedy SH, Rizvi S (April 2009). "Sexual dysfunction, depression, and the impact of antidepressants". Journal of Clinical Psychopharmacology. 29 (2): 157–64. doi:10.1097/jcp.0b013e31819c76e9. PMID 19512977.

[6] 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)

[Tatsumi1997-7] Tatsumi M, Groshan K, Blakely RD, Richelson E (December 1997). "Pharmacological profile of antidepressants and related compounds at human monoamine transporters". European Journal of Pharmacology. 340 (2-3): 249–258. doi:10.1016/s0014-2999(97)01393-9. PMID 9537821.

[pmid29630286-8] Fedder D, Patel H, Saadabadi A (March 2023). "Atomoxetine". StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. PMID 29630286.

[pmid21155988-9] Dell'Osso B, Palazzo MC, Oldani L, Altamura AC (December 2011). "The noradrenergic action in antidepressant treatments: pharmacological and clinical aspects". CNS Neurosci Ther. 17 (6): 723–32. doi:10.1111/j.1755-5949.2010.00217.x. PMC 6493872 . PMID 21155988.

[pmid19752841-10] Fleurence R, Williamson R, Jing Y, Kim E, Tran QV, Pikalov AS, Thase ME (2009). "A systematic review of augmentation strategies for patients with major depressive disorder". Psychopharmacol Bull. 42 (3): 57–90. PMID 19752841.

[pmid25295426-11] Corp SA, Gitlin MJ, Altshuler LL (September 2014). "A review of the use of stimulants and stimulant alternatives in treating bipolar depression and major depressive disorder". J Clin Psychiatry. 75 (9): 1010–8. doi:10.4088/JCP.13r08851. PMID 25295426.

[pmid19897080-12] Arias HR, Santamaría A, Ali SF (2009). "Pharmacological and neurotoxicological actions mediated by bupropion and diethylpropion". Int. Rev. Neurobiol. International Review of Neurobiology. 88: 223–55. doi:10.1016/S0074-7742(09)88009-4. ISBN 9780123745040. PMID 19897080.

[pmid25813654-13] Dale E, Bang-Andersen B, Sánchez C (2015). "Emerging mechanisms and treatments for depression beyond SSRIs and SNRIs". Biochem. Pharmacol. 95 (2): 81–97. doi:10.1016/j.bcp.2015.03.011 . PMID 25813654.

[pmid10907387-14] Challman TD, Lipsky JJ (2000). "Methylphenidate: its pharmacology and uses". Mayo Clin. Proc. 75 (7): 711–21. doi:10.4065/75.7.711 . PMID 10907387.

[pmid22144657-15] Prommer E (2012). "Methylphenidate: established and expanding roles in symptom management". Am J Hosp Palliat Care. 29 (6): 483–90. doi:10.1177/1049909111427029. PMID 22144657.

[pmid32447354-16] Urban AE, Cubała WJ (February 2020). "The role of eugeroics in the treatment of affective disorders". Psychiatr Pol. 54 (1): 21–33. doi:10.12740/PP/OnlineFirst/90687 . PMID 32447354.

[pmid28318897-17] Kleeblatt J, Betzler F, Kilarski LL, Bschor T, Köhler S (May 2017). "Efficacy of off-label augmentation in unipolar depression: A systematic review of the evidence". Eur Neuropsychopharmacol. 27 (5): 423–441. doi:10.1016/j.euroneuro.2017.03.003. PMID 28318897.

[pmid31643130-18] 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 (March 2020). "Efficacy and tolerability of adjunctive modafinil/armodafinil in bipolar depression: A meta-analysis of randomized controlled trials". Bipolar Disord. 22 (2): 109–120. doi:10.1111/bdi.12859 . PMID 31643130.

[pmid28256707-19] Szmulewicz AG, Angriman F, Samamé C, Ferraris A, Vigo D, Strejilevich SA (June 2017). "Dopaminergic agents in the treatment of bipolar depression: a systematic review and meta-analysis". Acta Psychiatr Scand. 135 (6): 527–538. doi:10.1111/acps.12712. PMID 28256707.

[SpravatoLabel-20] "SPRAVATO™ (esketamine) nasal spray FDA label" (PDF). Food and Drug Administration. 5 March 2019. Diakses tanggal 6 March 2019.

[pmid26768892-21] Zhang MW, Harris KM, Ho RC (2016). "Is off-label repeat prescription of ketamine as a rapid antidepressant safe? Controversies, ethical concerns, and legal implications". BMC Med Ethics. 17: 4. doi:10.1186/s12910-016-0087-3 . PMC 4714497 . PMID 26768892.

[22] Tundo A, Betro' S, de Filippis R, Marchetti F, Nacca D, Necci R, Iommi M (April 2023). "Pramipexole Augmentation for Treatment-Resistant Unipolar and Bipolar Depression in the Real World: A Systematic Review and Meta-Analysis". Life. 13 (4): 1043. Bibcode:2023Life...13.1043T. doi:10.3390/life13041043 . PMC 10141126  Periksa nilai |pmc= (bantuan). PMID 37109571 Periksa nilai |pmid= (bantuan).

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