Antidepressants Flashcards
Antidepressant having stimulant effects similar to SSRI’s and can increase blood pressure
Venlafaxine
Antidepressant inhibiting norepinephrine, serotonin, and dopamine reuptake
Venlafaxine
Sedation is a common side effect of these drugs, they lower seizure threshold, uses include BAD, acute panic attacks, phobias, enuresis, and chronic pain and their overdose can be deadly
Tricyclic antidepressants (TCA)
Antidepressant also used for sleep that causes priapism
Trazodone
Agents having higher sedation and antimuscarinic effects than other TCA’s
Tertiary amines
Well-tolerated and are first-line antidepressants
SSRI’s, bupropion, and venlafaxine
All antidepressants have roughly the same efficacy in treating depression, agents are chosen based on these criterion
Side-effect profile and prior pt response
MAOI should not be administered with SSRI’s or potent TCA’s due to development of this condition
Serotonin syndrome
Some of SSRIs’ therapeutic effects beside depression
Panic attacks, social phobias, bulimia nervosa, and PMDD premenstrual dysphoric disorder), OCD
Secondary amines that have less sedation and more excitation effect
Nortriptyline, Desipramine
Neurotransmitters affected by the action of antidepressants
Norepinephrine and serotonin
Antidepressant which is inhibitor of CYP450 enzymes and may be associated with hepatic failure
Nefazodone
Most useful in patients with significant anxiety, phobic features, hypochondriasis, and resistant depression
Monamine oxidase inhibitors
Antidepressant with MOA as alpha 2 antagonist, has effects on both 5-HT and NE, blocks histamine receptors, and is sedating
Mirtazapine
Antidepressant associated with seizures and cardiotoxicity
Maprotiline
SE of mirtazapine
Liver toxicity, increased serum cholesterol
TCA used in chronic pain, enuresis, and OCD
Imipramine
Condition will result from in combination of MAOI with tyramine containing foods (ex. wine, cheese, and pickled meats)
Hypertensive crisis
SSRI indicated for premenstrual dysphoric disorder
Fluoxetine (Sarafem)
SSRI with long T1/2 and can be administered once weekly for maintenance, not acute tx
Fluoxetine
SSRI’s less likely to cause a withdrawal syndrome
Fluoxetine
Population group especially sensitive to side effects of antidepressants
Elderly patients
TCA with greatest sedation of this group, and marked antimuscarinic effects, used for sleep
Doxepin
Three C’s associated with TCA toxicity
Coma, Convulsions, Cardiac problems (arrhythmias and wide QRS)
Example of three antidepressants that are indicated for obsessive compulsive disorder
Clomipramine, fluoxetine and fluvoxamine
TCA used in obsessive compulsive disorder (OCD), most significant of TCA’s for risk of seizure, weight gain, and neuropsychiatric signs and symptoms
Clomipramine
Except for these agents all SSRI have significant inhibition of CytP450 enzymes
Citalopram and its metabolite escitalopram
Unicyclic antidepressant least likely to affect sexual performance, used for management of nicotine withdrawal, SE’s include dizziness, dry mouth, aggravation of psychosis, and seizures
Bupropion
Antidepressant associated with neuroleptic malignant syndrome
Amoxapine
TCA used in chronic pain, a hypnotic, and has marked antimuscarinic effects
Amitriptyline
Usual time needed for full effect of antidepressant therapy
2 to 3 weeks
