抗うつ薬

Antidepressants

三環系抗うつ薬は抗コリン，抗アドレナリンα₁，抗ヒスタミンH₁作用，また過量服薬での危険性により患者のQOLに影響を及ぼすために，新規抗うつ薬が開発された。選択的セロトニン再取込み阻害薬はセロトニンを選択的に取り込み，非鎮静系薬で不安症にも効果を発揮する。消化器系副作用が見られ，性機能障害や出血傾向に注意する。セロトニン・ノルアドレナリン再取込み阻害薬は意欲向上が期待される非鎮静系薬である。慢性疼痛に効果的だが，消化器症状に加え，頻脈，血圧上昇に留意する。ミルタザピンは鎮静系薬で，食欲不振や不眠を呈する例に用いられる。ただ眠気，そして体重増加に留意する。ボルチオキセチンは非鎮静系薬で，不眠や性機能障害が少ないものの，胃腸症状は認められる。

Abstract

Tricyclic antidepressants possess anticholinergic, alpha 1 anti-adrenergic, and H1 antihistaminic properties, and an overdose affects patients' quality of life, which has led to the development of novel antidepressant drugs. Selective serotonin reuptake inhibitors (SSRIs) are non-sedating drugs that selectively reuptake serotonin and are effective against anxiety. Adverse effects of SSRIs include gastrointestinal disturbances, sexual dysfunction, and bleeding tendency. Serotonin noradrenaline reuptake inhibitors (SNRIs) are non-sedating agents that are expected to improve volition. SNRIs are effective against chronic pain, although they are associated with gastrointestinal symptoms, tachycardia, and elevated blood pressure. Mirtazapine is a sedative drug used in patients with anorexia and insomnia. However, drowsiness and weight gain are known adverse effects of this medication. Vortioxetine is a non-sedative drug associated with gastrointestinal symptoms; however, insomnia and sexual dysfunction are less common.