Antidepressants

Question 1

What are the four main classes of Antidepressants?

Answer 1

Selective Serotonin Reuptake Inhibitors (SSRIs),

Serotonin Norepinephrine Reuptake Inhibitors (SNRIs),

Tricyclic Antidepressants (TCAs),

Monoamine Oxidase Inhibitors (MAOIs)

Question 2

How do SSRIs work?

Answer 2

They block serotonin transporters in presynaptic neurons to prevent reuptake and increase the amount of serotonin in the synaptic cleft

Question 3

What are some common SSRIs?

Answer 3

Fluoxetine
Paroxetine
Sertraline
Citalopram
Escitalopram

Question 4

How do SNRIs work?

Answer 4

They block serotonin and norepinephrine transporters in presynaptic neurons to prevent reuptake and increase the amount of those neurotransmitters in the synaptic cleft

Question 5

What are some common SNRIs?

Answer 5

Venlafaxine
Duloxetine
Desvenlafaxine

Question 6

What are some side effects of SSRIs and SNRIs?

Answer 6

Nausea
Diarrhoea
Anxiety and restlessness
Loss of appetite and weight loss
Sleep disturbance
Cardiovascular disturbances
Sexual dysfunction

Question 7

How do TCAs work?

Answer 7

They block serotonin and noradrenaline transporters and acetylcholine and histamine receptors

Question 8

What are some common TCAs?

Answer 8

Amitryptaline
Clomipramine
Nortriptyline

Question 9

What are some side effects of TCAs?

Answer 9

Cardiac disturbances
* QTC Prolongation
* Arrythmias
* Sinus tachycardia

Anticholinergic effects
* Orthostatic hypotension
* Dry mouth
* Constipation
* Blurred vision
* Urinary Retention

CNS Disturbance
* Confusion
* Drowsiness
* Nightmares

Lowered seizure threshold

Question 10

How do MAOIs work?

Answer 10

Monoamine Oxidase (MAO) Breaks down monoamines like dopamine and seratonin, decreasing the amount of neurotransmitter present. MAOIs inhibit MAO activity, preventing this breakdown

Question 11

What are some considerations for patients taking a MAOI?

Answer 11

Monoamine oxidase breaks down tyramine from food, and excess tyramine caused by MAO inhibition can cause severe blood pressure elevation

Tyramine rich foods should be avoided (Pickled, fermented, smoked, or aged foods).

Avoid sympathomimetic medications
* Common cold and flu meds
* Decongestants
* Hay fever and allergy medicines
* Weight reduction or appetite suppressants