Antidepressants

Question 1

Tricyclic antidepressants

Answer 1

TCA
Blocks reuptake receptors at noradrenergic synapse
Dibenzazepines (imipramine)
Dibenzcycloheptenes (amitryptyline)
Drowsiness, constipation, dizziness
Road admin
Quick absorbance
Interacts with cyt p450, alcohol, anaesthetics, MAOI
toxic in overdose

Question 2

Monoamine oxidase inhibitors

Answer 2

MAOI
Inhibits breakdown of reuptaken NA so it’s available for release via leak
1st gen: non selective non reversible (phenelzine)
2nd gen: selective, mostly non reversible (chlorgyline)
Moclonamine: selective and reversible
Benzene ring structure
Effects last longer than the MAOI stays in the blood
Therefore cannot use plasma conc. to see effects
Washout
The cheese effect
Sexual dysfunction (compliance issue)

Question 3

Selective serotonin reuptake inhibitors

Answer 3

SSRI
Blocks reuptake of serotonin so there’s more available in the synapse
Paroxetine: most potent
Citalopram: most selective
Fluoxetine has active metabolite
Nausea, vomiting, diarrhoea
Neurological, vascular, GIT
Interacts with alcohol and grapefruit juice

Question 4

Serotonin reuptake enhancers

Answer 4

Opposite of SSRI
TIENEPTINE
Only in france

Question 5

Dual acting Antidepressants

Answer 5

NA and 5-HT
Selective reuptake (moreso for one than the other usually)
Venlafaxine

NA and DA
Buproprione

Question 6

Melatonergic

Answer 6

Agomelatine
Agonise melatonin receptors
MDD
Anxiolytic
Short half life and bioavailability