4) Antidepressants Flashcards by Aqeel Nabijohn

What is the class for Tranylcypromine (Parnate)

MAOI

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What is the mechanism for Tranylcypromine (Parnate)

Irreversibly inhibit both MAOa and MAOb

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What are the therapeutics for Tranylcypromine (Parnate)

Depression, anxiety, PTSD, chronic pain, enuresis, bulimia, alcoholism

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What are the important side effects for Tranylcypromine (Parnate)

Hypertensive crisis (with tyramine-rich foods); serotonin syndrome (MAOI + SSRI); agitation (rare), delerium –> seizures

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What are the other side effects for Tranylcypromine (Parnate)

Anticholinergic, orthostatic hypotension, sexual dysfunction, weight gain, sedation

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What is the class for Phenelzine (Nardil)

MAOI

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What is the mechanism for Phenelzine (Nardil)

Irreversibly inhibit both MAOa and MAOb

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What are the therapeutics for Phenelzine (Nardil)

Depression, anxiety, PTSD, chronic pain, enuresis, bulimia, alcoholism

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What are the important side effects for Phenelzine (Nardil)

Hypertensive crisis (with tyramine-rich foods); serotonin syndrome (MAOI + SSRI); agitation (rare), delerium –> seizures

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What are the other side effects for Phenelzine (Nardil)

Anticholinergic, orthostatic hypotension, sexual dysfunction, weight gain, sedation

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What is the class for Desipramine (Norpramin)

Tricyclic

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What is the mechanism for Desipramine (Norpramin)

Block reuptake of NE or 5-HT at varying potencies and selectivity; also variably block muscarinic, a-adrenergic, dopamine, and histamine receptors

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What are the therapeutics for Desipramine (Norpramin)

Depression, anxiety, PTSD, chronic pain, enuresis, bulimia, alcoholism

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What are the important side effects for Desipramine (Norpramin)

Sympathomimetic (cardiac arrhythmias and conduction defects, especially at OD)

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What are the other side effects for Desipramine (Norpramin)

Antimuscarinic, orthostatic hypotension, sedation (additive with alcohol), seizures

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What are the miscellaneous for Desipramine (Norpramin)

Not very safe; rarely used anymore

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What is the class for Imipramine (Tofranil)

Tricyclic

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What is the mechanism for Imipramine (Tofranil)

Block reuptake of NE or 5-HT at varying potencies and selectivity; also variably block muscarinic, a-adrenergic, dopamine, and histamine receptors

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What are the therapeutics for Imipramine (Tofranil)

Depression, anxiety, PTSD, chronic pain, enuresis, bulimia, alcoholism

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What are the important side effects for Imipramine (Tofranil)

Sympathomimetic (cardiac arrhythmias and conduction defects, especially at OD)

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What are the other side effects for Imipramine (Tofranil)

Antimuscarinic, orthostatic hypotension, sedation (additive with alcohol), seizures

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What are the miscellaneous for Imipramine (Tofranil)

Not very safe; rarely used anymore; forms active metabolite (desipramine)

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What is the class for Amitriptyline (Elavil)

Tricyclic

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What is the mechanism for Amitriptyline (Elavil)

Block reuptake of NE or 5-HT at varying potencies and selectivity; also variably block muscarinic, a-adrenergic, dopamine, and histamine receptors

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What are the therapeutics for Amitriptyline (Elavil)

Depression, anxiety, PTSD, chronic pain, enuresis, bulimia, alcoholism; prevention of tension headaches, migraines

What are the important side effects for Amitriptyline (Elavil)

Sympathomimetic (cardiac arrhythmias and conduction defects, especially at OD)

What are the other side effects for Amitriptyline (Elavil)

Antimuscarinic, orthostatic hypotension, sedation (additive with alcohol), seizures

What are the miscellaneous for Amitriptyline (Elavil)

Not very safe; rarely used anymore; forms active metabolite (nortriptyline)

What is the class for Nortriptyline (Pamelor)

Tricyclic

What is the mechanism for Nortriptyline (Pamelor)

Block reuptake of NE or 5-HT at varying potencies and selectivity; also variably block muscarinic, a-adrenergic, dopamine, and histamine receptors

What are the therapeutics for Nortriptyline (Pamelor)

Depression, anxiety, PTSD, chronic pain, enuresis, bulimia, alcoholism

What are the important side effects for Nortriptyline (Pamelor)

Sympathomimetic (cardiac arrhythmias and conduction defects, especially at OD)

What are the other side effects for Nortriptyline (Pamelor)

Antimuscarinic, orthostatic hypotension, sedation (additive with alcohol), seizures

What are the miscellaneous for Nortriptyline (Pamelor)

Not very safe; rarely used anymore

What is the class for Fluoxetine (Prozac)

SSRI

What is the mechanism for Fluoxetine (Prozac)

Inhibit reuptake of 5-HT (and NE to lesser extent)

What are the therapeutics for Fluoxetine (Prozac)

Depression, anxiety, PTSD, chronic pain, enuresis, bulimia, alcoholism; pre-menstrual dystrophic disorder

What are the important side effects for Fluoxetine (Prozac)

Serotonin syndrom (with MAOIs)

What are the other side effects for Fluoxetine (Prozac)

Fewer than tricyclics; mostly nausea, decreased sexual function

What are the miscellaneous for Fluoxetine (Prozac)

Potent P450 inhibitor; forms active metabolite (norfluoxetine)

What is the class for Paroxetine (Paxil)

SSRI

What is the mechanism for Paroxetine (Paxil)

Inhibit reuptake of 5-HT (and NE to lesser extent)

What are the therapeutics for Paroxetine (Paxil)

Depression, anxiety, PTSD, chronic pain, enuresis, bulimia, alcoholism

What are the important side effects for Paroxetine (Paxil)

Serotonin syndrom (with MAOIs)

What are the other side effects for Paroxetine (Paxil)

Fewer than tricyclics; mostly nausea, decreased sexual function

What are the miscellaneous for Paroxetine (Paxil)

Potent P450 inhibitor

What is the class for Sertraline (Zoloft)

SSRI

What is the mechanism for Sertraline (Zoloft)

Inhibit reuptake of 5-HT (and NE to lesser extent)

What are the therapeutics for Sertraline (Zoloft)

Depression, anxiety, PTSD, chronic pain, enuresis, bulimia, alcoholism

What are the important side effects for Sertraline (Zoloft)

Serotonin syndrom (with MAOIs)

What are the other side effects for Sertraline (Zoloft)

Fewer than tricyclics; mostly nausea, decreased sexual function

What is the class for Escitalopram (Lexapro)

SSRI

What is the mechanism for Escitalopram (Lexapro)

Inhibit reuptake of 5-HT (and NE to lesser extent)

What are the therapeutics for Escitalopram (Lexapro)

Depression, anxiety, PTSD, chronic pain, enuresis, bulimia, alcoholism

What are the important side effects for Escitalopram (Lexapro)

Serotonin syndrom (with MAOIs)

What are the other side effects for Escitalopram (Lexapro)

Fewer than tricyclics; mostly nausea, decreased sexual function

What is the class for Citalopram (Celexa)

SSRI

What is the mechanism for Citalopram (Celexa)

Inhibit reuptake of 5-HT (and NE to lesser extent)

What are the therapeutics for Citalopram (Celexa)

Depression, anxiety, PTSD, chronic pain, enuresis, bulimia, alcoholism

What are the important side effects for Citalopram (Celexa)

Serotonin syndrom (with MAOIs)

What are the other side effects for Citalopram (Celexa)

Fewer than tricyclics; mostly nausea, decreased sexual function

What is the class for Duloxetine (Cymbalta)

SNRI

What is the mechanism for Duloxetine (Cymbalta)

Inhibits reuptake of 5-HT and NE

What are the therapeutics for Duloxetine (Cymbalta)

Depression, anxiety, PTSD, chronic pain, enuresis, bulimia, alcoholism

What is the class for Venlafaxine (Effexor)

SNRI

What is the mechanism for Venlafaxine (Effexor)

Inhibits reuptake of 5-HT and NE

What are the therapeutics for Venlafaxine (Effexor)

Depression, anxiety, PTSD, chronic pain, enuresis, bulimia, alcoholism

What is the class for Bupropion (Wellbutrin)

Atypical

What is the mechanism for Bupropion (Wellbutrin)

Blocks DA and NE reuptake

What are the therapeutics for Bupropion (Wellbutrin)

Depression, anxiety, PTSD, chronic pain, enuresis, bulimia, alcoholism; maintain nicotine abstinence in quitting smokers

What are the important side effects for Bupropion (Wellbutrin)

Lowers seizure threshold

What is the class for Mirtazapine (Remeron)

Atypical

What is the mechanism for Mirtazapine (Remeron)

5HT2a antagonists; also inhibit 5HT reuptake

What are the therapeutics for Mirtazapine (Remeron)

Depression, anxiety, PTSD, chronic pain, enuresis, bulimia, alcoholism

What is the mechanism for Lithium

Unknown; lithium depletes secondary messengers IP3 and DAG, important in a-adrenergic and muscarinic-cholinergic transmission

What are the therapeutics for Lithium

Anti-manic/mood-stabilizing (bipolar); long-term cluster headache prevention

What are the important side effects for Lithium

If elevated levels: neurotoxicity, cardiac toxicity, renal dysfunction

What are the other side effects for Lithium

Drowsiness, weight gain, tremor, polydipsia, polyuria

What are the miscellaneous for Lithium

Nausea and vomiting early sign of lithium OD; indomethacin and Na-depleting diuretics should be avoided (increase [Li])