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Behavioral Science > Anti-Depressants > Flashcards

Anti-Depressants Flashcards

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1
Q

Tricyclic: Tertiary Amines

A 
Doxepine
Imipramine
Trimipramine
Amitriptyline
Clomipramine

*Low therapeutic index (lethal dose is close to therapeutic dose)

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2
Q

Tricyclic: Secondary Amines

A

Nortriptyline
Desipramine
Protriptyline

*Low therapeutic index (lethal dose is close to therapeutic dose)

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3
Q

Tetracyclic

A

Amoxapine

*Low therapeutic index (lethal dose is close to therapeutic dose)

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4
Q

MAOI: Classical

A

Phenelzine

Tranylcypromine

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5
Q

MAOI: Selective

A

Selegeline

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6
Q

SSRI

A 
Fluvoxamine (Luvox)
Paroxetine (Paxil)
Sertraline (Zoloft)
Citalopram (Celexa)
Escitalopram (Lexapro)
Fluoxetine (Prozac)
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7
Q

Atypical

A

Bupropion
Trazadone
Mirtazapine

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8
Q

SNRI

A

Venlafaxine
Duloxetine

*work most rapidly

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9
Q

NRI

A

Reboxitine

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10
Q

Tricyclic: General side effects/Problems

A 
Anticholinergic
Antihistaminic
Anti-alpha1
Sexual side effects
Overdose and lethality (most associated w/ completed suicide)
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11
Q

SSRI: General Side Effects/Problems

A 
Weight gain
sexual side effects (40%)
GI problems
Drug interactions
effects on sleep
Serotonin syndrome
Withdrawal/Serotonin discontinuation syndrome
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12
Q

Serotonin Syndrome

A

Build up of serotonin
agitation, confusion, dilated pupils, muscle twitching/loss of muscle coordination, diarrhea, heavy sweating, headache, shivering, goose bumps
high fever, seizure, unconsciousness, irregular heartbeat
Mimics NMS, but missing rigidity and antipsychotics

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13
Q

Serotonin Discontinuation syndrome

A

usually with high dosage, short acting SSRIs

poor sleep, jittery, nervous, flu-like

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14
Q

Doxepine

A

Tricyclic Tertiary Amine
antidepressant
blocks re-uptake of all NTs (NE, 5HT, DA). Blocks postsynaptic M1, A1, H1 receptors
Most anti-cholinergic of the TCAs

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15
Q

Imipramine

A 
Tricyclic Tertiary Amine
antidepressant, treats bedwetting
blocks re-uptake of all NTs (NE, 5HT, DA). Blocks postsynaptic M1, A1, H1 receptors
Fatal in overdose
up to a month to take effect
Reliable blood levels
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16
Q

Trimipramine

A

Tricyclic Tertiary Amine
antidepressant
blocks re-uptake of all NTs (NE, 5HT, DA). Blocks postsynaptic M1, A1, H1 receptors

17
Q

Amitriptyline

A 
Tricyclic Tertiary Amine
antidepressant
blocks re-uptake of all NTs (NE, 5HT, DA). Blocks postsynaptic M1, A1, H1 receptors
Very sedating
commonly used
helpful w/ neurologic/non-specific pain
18
Q

Clomipramine

A

Tricyclic Tertiary Amine
antidepressant
blocks re-uptake of all NTs (NE, 5HT, DA). Blocks postsynaptic M1, A1, H1 receptors
Most SSRI-like of TCAs

19
Q

Nortriptyline

A

Tricyclic Secondary Amine
Antidepressant
Blocks re-uptake of all NTs (NE, 5HT, DA)
Blocks postsynaptic M1, A1, H1 receptors
Least anti-cholinergic of TCAs
Therapeutic window (not useful below or above a certain dose)
Least problem with hypotension (least anti-alpha 1)
Good for elderly
Reliable blood levels

20
Q

Desipramine

A 
Tricyclic Secondary Amine
Antidepressant
Blocks re-uptake of all NTs (NE, 5HT, DA)
Blocks postsynaptic M1, A1, H1 receptors
Least anticholinergic
least anti-alpha 1
reliable blood levels
21
Q

Protriptyline

A

Tricyclic Secondary Amine
Antidepressant
Blocks re-uptake of all NTs (NE, 5HT, DA)
Blocks postsynaptic M1, A1, H1 receptors

22
Q

Amoxapine

A 
Tetracyclic
antidepressant, antipsychotic
Blocks re-uptake of all NTs (NE, 5HT, DA)
Blocks postsynaptic M1, A1, H1 receptors
Also blocks postsynaptic D2 receptor
Risk of EPS, TD, NMS
May cause gynecomastia
Low therapeutic index (lethal dose is close to therapeutic dose)
23
Q

Phenelzine

A 
Classical MAO Inhibitor
Antidepressant
Irreversible inhibition of MAO-A and MAO-B(A is for serotonin, B is for dopamine)
Can block Alpha-1 receptors
Hypotension (Alpha-1 block)
anticholinergic
Weight gain
Avoid meals w/ tyramine
Serotonin syndrome
Hypertensive crisis (BP >200)
sexual dysfunction
24
Q

Tranylcypromine

A 
Classical MAO Inhibitor
Antidepressant
Irreversible inhibition of MAO-A and MAO-B(A is for serotonin, B is for dopamine)
Can block Alpha-1 receptors
Hypotension (Alpha-1 block)
anticholinergic
Weight gain
Avoid meals w/ tyramine
Serotonin syndrome
Hypertensive crisis (BP >200)
sexual dysfunction
25
Q

Selegiline

A

Selective MAO Inhibitor
Antidepressant
Selective inhibition for MAO-B (degrades dopamine)
Does not run the risk of serotonin syndrome or hypertensive crisis, unless there is a drug-drug interaction that causes loss of selectivity for MAO-B (some contraceptives)

26
Q

Fluvoxamine (Luvox)

A

1/2 life = 17 hours (shortest of SSRIs)
Antidepressant, first med approved for OCD
Blocks re-uptake of serotonin
blocks phase one metabolism of other drugs (leads to toxicity)
Worst Rx-Rx interactions
Headaches and migraines

27
Q

Paroxetine (Paxil)

A 
1/2 life = 21 hours
Antidepressant
Blocks re-uptake of serotonin
blocks phase one metabolism of other drugs (leads to toxicity)
Some sedation (anti-H1)
significant weight gain
most anticholinergic
increased risk of EPS with Antipsychotics
not lethal in overdose
28
Q

Sertraline (Zoloft)

A 
Antidepressant
Blocks re-uptake of serotonin
blocks phase one metabolism of other drugs (leads to toxicity)
GI problems
not much drug interaction
29
Q

Citalopram (Celexa)

A 
Antidepressant
Blocks re-uptake of serotonin
blocks phase one metabolism of other drugs (leads to toxicity)
least amount of drug interactions
little/no weight gain
30
Q

Escitalopram (Lexapro)

A

Antidepressant
Blocks re-uptake of serotonin
blocks phase one metabolism of other drugs (leads to toxicity)
Most potent portion of citalopram molecule

31
Q

Fluoxetine (Prozac)

A 
1/2 life > 70 hours
Antidepressant
Blocks re-uptake of serotonin
blocks phase one metabolism of other drugs (leads to toxicity)
no weight gain (some weight loss)
Most activating (give in the morning)
May boost anxiety
May prevent 5HT discontinuation syndrome
32
Q

Bupropion

A 
Atypical
Antidepressant, anxiolytic, aid to smoking cessation, ADHD
Blocks re-uptake of NE and dopamine
RIsk of psychosis
risk of seizures in people with eating disorders
some drug interactions
no weight gain 
no sexual side effects
33
Q

Trazodone

A 
Atypical
Antidepressant, hypnotic
Blocks re-uptake of NE and dopamine
major anti-histaminic
heavily sedating
priapism 
not addictive
34
Q

Mirtazapine

A 
Atypical
Antidepressant
heavily anti-histaminic (sedation and weight gain)
No sexual side effects
slight risk of agranulocytosis (0.3%)
35
Q

Venlafaxine

A

SNRI
antidepressant
blocks re-uptake of NE (mostly), 5HT and DA
Hypertension (6-13%) because of NE re-uptake blockage
short 1/2 life
serotonin discontinuation syndrome

36
Q

Duloxetine

A 
SNRI
Antidepressant
Blocks re-uptake of NE and 5HT
little weight gain
short 1/2 life
37
Q

Reboxitine

A

Antidepressant

blocks re-uptake of NE

38
Q

Tricyclics With Reliable Blood Levels

A

Desipramine
Imipramine
Nortriptyline

Behavioral Science (9 decks)

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