Antidepressant

Question 1

MAO-A and MAO-B breaks down what?

Answer 1

MAO-A: breaks down NE, 5-HT, dopamine

MAO-B: NE, dopamine

Question 2

Phenelzine
SE
DDI

Answer 2

irreversible, non selective maoi
- postural hypotension, restless, insomnia
due to accumulation of dopamine in neck ganglia causing sympathetic block. due to CNS stimulation.
- serotoninergic drugs –> hyperexcitability, loss of consciousness, increase muscular tone, myoclonus (jerking)
-cheese, yeast –> acute HTN, throbbing HA, intracranial hemorrhage

Question 3

name 4 TCA drugs.

what is the moa of TCA

Answer 3

desipramine (selective for NA - transporter)
imipramine (non selective)
amitriptyline (non selective)
nortriptyline (non selective)
Clomipramine (anxiolytic)
MOA: inhibit MAO reuptake, by binding to serotonin transporter and NA transporter

Question 4

TCA
SE
DDI

Answer 4

anti-cholinergic
sedation (H1 antagonism) –> tolerance to sedation develop in 1-2 wks
Postural hypotension (a1 antagonism)

+plasma protein bound
+cyp inducer/inhibitor

Question 5

list as many SSRI drugs as you can

Answer 5

fluoxetine
citalopram
sertraline
paroxetine

Question 6

SSRI
SE
DDI

Answer 6

N (5-HT3), insomnia
sexual dysfunction (5-HT2)

+ serotoninergic drugs –> serotonin syndrome

Question 7

what is the function of cyproheptadine

Answer 7

it is a 5-HT2 blocker –> block binding of SSRI onto 5-HT2 to prevent SSRI-induced sexual dysfunction

Question 8

venlafaxine
desvenlafaxine
duloxetine
SE
DDI

Answer 8

they are SNRI (also bind to serotonin and NA transporter –> same as TCA, but diff structures)
SE: N, insomnia sexual dysfunction
** but SNRI withdrawal sx more than SSRI and TCA
+ serotoninergic drugs –> serotonin syndrome

Question 9

Reboxetine

SE

Answer 9

it is a NARI (NA)
anticholinergic
tachycardia, insomnia (due to increase in NA, stimulate CNS)

Question 10

what is Mirtazapine

Answer 10

NA and specific serotonin
a2-adrenergic antagonist
5-HT2 receptor antagonist (instead of agonist –> so reverse sexual dysfunction!)

Question 11

what is Ketamine and its 2 uses

Answer 11

antidepressant and anesthetic as it is a glutamate NMDA receptor antagonist

Question 12

What is bupropion

Answer 12

a NA-dopamine reuptake inhibitor

Question 13

what is agomelatine and its 2 uses

Answer 13

MT1 and MT2 receptor agonist

Antidepressant and help with sleeping disorder