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Anesthetic Considerations for Patients on Antidepressant Therapy—Part I
Mana Saraghi DMD,
 Leonard R. Golden MD, and
 Elliot V. Hersh DMD, MS, PhD
Article Category: Other
Volume/Issue: Volume 64: Issue 4
Online Publication Date: Jan 01, 2017
DOI: 10.2344/anpr-64-04-14
Page Range: 253 – 261

Millions of patients take antidepressant medications in the United States. The 2013 National Ambulatory Medical Care Survey revealed that antidepressants represented the third most frequently prescribed class of medications, following analgesics and lipid-lowering agents, in outpatient office visits. 1 Antidepressants are indicated for the treatment of depression or anxiety disorders. Anxiety disorders include conditions such as generalized anxiety disorder, obsessive-compulsive disorder, panic disorders, phobias, and posttraumatic stress

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Figure 1.  ; Antidepressant medications within the 4 therapeutic drug classes.
Mana Saraghi,
 Leonard R. Golden, and
 Elliot V. Hersh
<bold>Figure 1. </bold>
Figure 1. 

Antidepressant medications within the 4 therapeutic drug classes.

Figure 2.  ; Vasoconstrictor interaction with tricyclic antidepressants and serotonin-norepinephrine reuptake inhibitors.
Mana Saraghi,
 Leonard R. Golden, and
 Elliot V. Hersh
<bold>Figure 2. </bold>
Figure 2. 

Vasoconstrictor interaction with tricyclic antidepressants and serotonin-norepinephrine reuptake inhibitors.

Anesthetic Considerations for Patients on Antidepressant Therapy – Part II
Mana Saraghi DMD,
 Leonard Golden MD, and
 Elliot V. Hersh DMD, MS, PhD
Article Category: Other
Volume/Issue: Volume 65: Issue 1
Online Publication Date: Jan 01, 2018
DOI: 10.2344/anpr-65-01-10
Page Range: 60 – 65

Part I of this series discussed antidepressant pharmacology and interactions with adrenergic agonists. In part II, we will focus on Sedation and General Anesthetic Drug Interactions, Serotonin Syndrome, and other anesthetic concerns with antidepressants. SEDATION AND GENERAL ANESTHETIC DRUG INTERACTIONS Tricyclic Antidepressants (TCAs) and Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs) As noted in part I, both the TCAs and the SNRIs inhibit the reuptake of both serotonin and

Figure 1 ; Patient partitioning. Data were excluded from analyses if patients had eaten 1 hour prior to saliva collection, were scheduled for intravenous sedation, had been diagnosed with xerostomia, were taking beta-blockers, or were taking antidepressant and/or antipsychotic medications.
Kevin C. Lee and
 Jennifer P. Bassiur
<bold>Figure 1</bold>
Figure 1

Patient partitioning. Data were excluded from analyses if patients had eaten 1 hour prior to saliva collection, were scheduled for intravenous sedation, had been diagnosed with xerostomia, were taking beta-blockers, or were taking antidepressant and/or antipsychotic medications.

Figure 3.  ; (A) Naïve nerve terminal. (B) Nerve terminal plus a monoamine oxidase inhibitor. (C) Nerve terminal with epinephrine. (D) Nerve terminal with ephedrine.
Mana Saraghi,
 Leonard R. Golden, and
 Elliot V. Hersh
<bold>Figure 3. </bold>
Figure 3. 

(A) Naïve nerve terminal. (B) Nerve terminal plus a monoamine oxidase inhibitor. (C) Nerve terminal with epinephrine. (D) Nerve terminal with ephedrine.

Figure 4.  ; Lack of vasoconstrictor interaction with selective serotonin reuptake inhibitors.
Mana Saraghi,
 Leonard R. Golden, and
 Elliot V. Hersh
<bold>Figure 4. </bold>
Figure 4. 

Lack of vasoconstrictor interaction with selective serotonin reuptake inhibitors.

Psychotropic Drugs: Implications For Dental Practice
Daniel E. Becker DDS
Article Category: Research Article
Volume/Issue: Volume 55: Issue 3
Online Publication Date: Jan 01, 2008
DOI: 10.2344/0003-3006-55.3.89
Page Range: 89 – 99

agents used to treat psychiatric disorders. They include sedative-anxiolytics, antipsychotics, antidepressants, and the antimanic agents. While these drugs all act in some manner to alter the activity of neurotransmitters, psychiatric illness cannot be explained entirely on biochemical defects. Indeed, one cannot overlook the importance of psychological and social factors in both the pathophysiology of mental illness, and its response to specific pharmacotherapeutic agents. 2 Sedative-Anxiolytics Drugs in this particular class have the

Subject Index
Article Category: Research Article
Volume/Issue: Volume 64: Issue 4
Online Publication Date: Jan 01, 2017
DOI: 10.2344/0003-3006-64.4.267
Page Range: 267 – 267

Addiction, 178 Adhesive patch, 73 Adrenaline, 165 Airway, 168 Airway management, 153 Ala of nose, 104 Allergic disease, 173 Alpha amylase, 22 Analgesic, 178 Adrenergic, 253 Anesthesia, 33 Anesthetic management, 244 Antidepressants, 253 Antidiabetic medication, 39 Arrhythmia, 165 Articaine, 80, 203 Atrioventricular node, 165 Belching, 244 Benzocaine, 73 Blood loss, 3

Pain Management Part II: Pharmacologic Management of Chronic Orofacial Pain
Steven Ganzberg DMD, MS
Article Category: Research Article
Volume/Issue: Volume 57: Issue 3
Online Publication Date: Jan 01, 2010
DOI: 10.2344/0003-3006-57.3.114
Page Range: 114 – 119

classes are commonly used as analgesics for chronic pains versus acute pain. These include antidepressants, particularly the tricyclic antidepressants (TCAs) 1 , 2 and the selective serotonin-norepinephrine reuptake inhibitors (SNRIs), 3 – 5 nonsteroidal anti-inflammatory agents (NSAIDs) when an inflammatory component is present, and the opioids. The latter 2 groups were discussed in the previous article, “Pain Management: Part I: Managing Acute and Postoperative Dental Pain.” 6 Only relevant issues associated with the use of these medications in chronic pain versus