Anti-depressants

Question 1

Selgeline

Answer 1

MAO inhibitor
Trans-dermal patch
Does not block gut metabolism of tyramine

Question 2

Imipramine

Tricyclic AD

Answer 2

Serotonin/NE reuptake inhibitor (non-selective)
prototype
structurally similar to anti-psychotics
1st pass liver metabolism

Question 3

Amoxapine

Tricyclic AD

Answer 3

2nd generation Serotonin/NE reuptake inhibitor
fewer side effects - dyskinesia, Parkinsonism
weight gain, heart, skeletal, CNS

Question 4

Venlafaxine

Tricyclic AD

Answer 4

Non-selective uptake inhibitor

no cardiac conduction side effects

Question 5

Duloxetine

Tricyclic AD

Answer 5

Non-selective uptake inhibitor
indicated for diabetic polyneuropathy
PAIN

Question 6

Fluoxetine

SSRI

Answer 6

Prozac (prototype)
Selective Serotonin Reuptake Inhibitor
minimal side effects on ANS
absorbed orally
long plasma life (1 dose/day; bad for bipolar)
effective in children and adolescents

Question 7

SSRI

Answer 7

inhibits drug metabolizing enzymes
less effective than tricyclics for tx of depression associated with pain
decreased libido and sexual dysfxn

Question 8

Mirtazapine

Answer 8

Blockers of a2 adrenergic auto receptors
blocks negative feedback loop and increases NE release
does NOT inhibit reuptake
fewer side effects than tricyclics

Question 9

Augmenting drugs

Answer 9

Lithium: stabilizes mood
thyroid supplements
benzodiazepines: decrease insomnia and anxiety (cause memory loss, addictive)
risperidone: antipsychotic
valproic acid