Assignment:
Respond to one student. Posts are a minimum of 250 words, scholarly written, APA formatted (with some exceptions due to limitations in the D2L editor), and a minimum of 2 references (which may include the course textbook).
Student's post:
Antidepressants act mainly as monoamine agonists by interfering with serotonergic, noradrenergic, and/or dopaminergic systems, thereby reducing depression. They can be broadly divided into five major classes, each with different side effects and clinical considerations.
Selective Serotonin Reuptake Inhibitors (SSRIs) like fluoxetine and sertraline act on serotonin reuptake, which leads to an increase in the amount of serotonin in the synapses. They are first-line agents because of their safety and tolerability. Side effects are nausea, insomnia, sexual dysfunction and headaches. Clinicians should be vigilant for serotonin syndrome and follow the black-box warning for heightened suicidal ideation in individuals less than 25 years old (Chu & Wadhwa, 2023). Need Assignment Help?
Venlafaxine and duloxetine are both in a class of medications called serotonin-norepinephrine reuptake inhibitors (SNRIs), which block the reabsorption of both serotonin and norepinephrine. Common side effects are high blood pressure, nausea, dizziness and sexual dysfunction. It is important to avoid abrupt discontinuation of this medication because of the possibility of withdrawal syndrome and to monitor cardiovascular status (Gao et al., 2025).
Tricyclic Antidepressants (TCAs) like amitriptyline are serotonin and norepinephrine reuptake inhibitors with anticholinergic effects. Side effects are dry mouth, urinary retention, constipation, sedation and cardiac arrhythmias. The use of TCAs is contraindicated in overdose and should be used with caution in older adults and cardiac patients (Kamp et al., 2024).
Monoamine Oxidase Inhibitors (MAOIs), such as phenelzine, irreversibly inhibit monoamine oxidase, which increases serotonin, norepinephrine, and dopamine. Side effects are orthostatic hypotension, insomnia and weight gain. One of the key factors is the potential for hypertensive crisis due to tyramine-rich food and with drug interactions (Gao et al., 2025).
Atypical Antidepressants, such as bupropion and mirtazapine, target dopamine/norepinephrine and histamine/serotonin receptors, respectively. Bupropion has a lowering effect on seizure threshold, and mirtazapine is sedating and can lead to much weight gain. Both are employed in low-tolerance of other classes (Chu & Wadhwa, 2023).
Knowing the differences in pharmacology, side effects, and clinical application of each antidepressant class is crucial to safe individualised patient care.
References:
Chu, A., & Wadhwa, R. (2023). Selective serotonin reuptake inhibitors. In StatPearls [internet]. StatPearls Publishing.
Kamp, C. B., Petersen, J. J., Faltermeier, P., Juul, S., Siddiqui, F., Barbateskovic, M., ... & Jakobsen, J. C. (2024). Beneficial and harmful effects of tricyclic antidepressants for adults with major depressive disorder: a systematic review with meta-analysis and trial sequential analysis. BMJ mental health, 27(1).
Gao, K., Oruc, E. B., & Koparal, B. (2025). Pharmacological monotherapy for depressive disorders: current and future-a narrative review. Medicina, 61(4), 558.