Nursing Guide: Drugs Affecting the Central Nervous System

When most people hear about mood disorders they mostly think about antidepressants but there are many other drugs on the market to treat various types of emotional and mood disorders. These types of drugs affect the central nervous system in various ways.

A client who is diagnosed with depression is usually placed on an antidepressant drug; depression is associated with an imbalance of the neurotransmitters of the brain. The antidepressant drug increases the action of certain neurotransmitters to relieve the symptoms of depressions.

There are 4 classes of antidepressants:

Tricyclic antidepressants - This type of antidepressant inhibit the reuptake of nonrepinephrine and serotonin. Because of their long half lives they have an increased risk of side effects. (Also called TCA drugs) Examples of Tricyclic antidepressants: Elavil, Ascendin and Tofranil

Serotonin-reuptake inhibitors - These are drugs that slow the reuptake of serotonin. These are the drugs of choice to treat depression. These drugs were developed to treat depression with fewer side effects than TCA drugs. Clients are encouraged to take these drugs in the AM. Most common side effects to SSRI drugs are sexual dysfunctions. Examples of Serotonin-Reuptake Inhibitors: Paxil, Zoloft and Celexa.

Monoamine oxidase inhibitors (MAO inhibitors)- these drugs work by inhibiting the enzyme monoamine oxidase, this type of MAO enzyme prevents noepinephrine, epinephrine and serotonin from working (Chemical imbalance). MAOI's permit these agents to be released, lessoning the signs and symptoms of depression. MAOI's carry many drug and food interactions including liver toxicity. These drugs are reserved for those who are not responding to other drugs.

Patient teaching is very important for a patient who is taking MAO inhibitor drug's you will need to teach your patient that hypertensive crisis can occur with alcoholic beverages, processed meats, chocolate, aged cheese, eggplant, nuts, soy, and avocados.

Atypical antidepressants - These are your newer type antidepressant drugs. These are the type of drugs that do not fit well into any other category and work differently than other type of antidepressants. Examples of Atypical antidepressants: Wellbutrin, Cymbalta, Remeron, and Effexor. Some of these medications have been used to treat Bi-Polar disorder effectively.

There are drugs used for ADHD that are used to stimulate the areas of the brain related to focusing and alertness. Many of these drugs are controlled substances. Depending on the types of drugs that are prescribed and the needs of the client these medications may need to be taken at certain times of the day for examples at least 6 hours before bedtime so that the effectiveness is used during peak time. Examples of ADHD drugs: Adderall, Strattera and Ritalin