ANTIDEPRESSANTS Flashcards
ANTIDEPRESSANTS
Tricyclic AD SSRI SNRI Serotonin Receptor Antagonists Heterocyclic AD MAO Inhibitors
TRICYCLIC ANTIDEPRESSANT
Imipramine Clomipramine Desipramine Amitryptyline Nortryptiline Doxepin Protriptyline Trimipramine
SSRI
Fluoxetine Paroxetine Citalopram Escitalopram Sertraline Fluvoxamine Vilazodone
SNRI
Venlafaxine
Duloxetine
Desvenlafaxine
Milnacipran
Serotonin Antagonist
Trazodone
Nefazodone
Vortioxetine
TETRACYCLIC ANTIDEPRESSANT
Amoxapine
Maprotiline
Mirtazapine
UNICYCLIC AMINOKETONE
Bupropion
MAO INHIBITORS
Phenelzine
Tranylcypromine
Isocarboxazid
Selegiline
3Cs of TCA Overdose
Coma
Convulsions
Cardiotoxicity
Toxic dose of Tricyclic Antidepressant
7mg/kg
Lethal dose of Tricyclic Antidepressant
15mg/kg
What would you give to reverse cardiotoxicity due to tricyclic antidepressant overdose?
QRS duration>100 msec or ventricular arrhythmias
Bicarbonate
Drugs that can cause Serotonin Syndrome
MAOi TCA Dextromethorphan Meperidine St. John's Wort MDMA (ecstasy)
Manifestation of Serotonin Syndrome
FAT CHD
Fever Agitation Tremor
Clonus Hyperreflexia Diaphoresis
MOA: TCA
blocks NE and 5-HT transporters (prevents reuptake)
plus
blockade of ANS and histamine receptors
very useful for patients with psychomotor retardation, sleep disturbance, poor appetite and weight loss
TCA
AE: TCA
anticholinergic - dry mouth
alpha blockade - orthostatic hypotension
histamine blockade - weight gain and excessive sweating
TCA used for OCD
Clopiramine
MOA: SSRI
inhibits neuronal reuptake of serotonin by inhibiting Serotonin Transporter (SERT)
DOC for Major Depressive Disorder
SSRIs
SSRI for OCD
Fluvoxamine
Discontinuation Syndrome is caused by which SSRIs
Paroxetine and Sertraline
Causes QT prolongation and cardiac septal defects (teratogen)
Citalopram