Monoamine-Releasing Agents

Antidepressant and Antimanic Medications: Monoamine-Releasing Agents

Monoamine-releasing agents are also categorized as psychostimulants and primarily include amphetamine, methamphetamine, methylphenidate, and pemoline. They cause the release of and weakly block the reuptake of NE, DA, and serotonin. Amphetamine was available on an over-the-counter basis until the FDA reclassified it as a prescription drug in 1938 and further restricted its availability in 1951 due to widespread misuse and abuse.

The literature on the use of monoamine-releasing agents in the treatment of depression is surprisingly large and disappointingly poorly controlled given the beneficial effects usually reported. Almost all large, controlled trials were conducted before 1970, and different studies used different dosing strategies, diagnostic methods, and outcome measures. No long-term studies have been conducted. More recent studies have focused on medically ill or geriatric patients with MDE.

Monoamine-releasing agents are rapidly metabolized into inactive compounds and generally have relatively short half-lives (4-8 hours). The most common side effects are insomnia, drowsiness, restlessness, nausea, weight loss, weight gain, and hypertension. At high doses these agents can cause a characteristic paranoid psychosis. These drugs are generally well tolerated in the clinical dosage range (e.g., 5-30 mg/day dextroamphetamine), with most patients experiencing no side effects and with insomnia being the most common side effect reported.

Antidepressant and Antimanic Medications Introduction Diagnostic Indications and Contraindications

• Indications for Use of Antidepressant and Antimanic Medications
• Contraindications to Use of Antidepressant and Antimanic Medications
• General Treatment Guidelines Antidepressant Medications: Pharmacological Properties and Evidence for Acute-Phase Efficacy