Antidepressants Flashcards
what are the TCAs
amitriptyline, nortriptyline, imipramine, clomipramine, desipramine, trimipramine, protriptyline,
what are the indications for TCAs
major depression, pain, anxiety disorders, ADHD, nocturnal enuresis, and schizophrenia
what are the adverse effects of the TCAs
orthostatic hypotension due to alpha 2 blockade, anti cholinergic effects, sedation, weight gain, sexual problems, acidosis. arrhythmias, delirium, and seizures,
what hypertension medication can TCAs block
clonidine
what are the other potential drug interactions with TCAs
competition for protein binding, CYP2D6, and other agents that increase seratonin
what are the pharmacokinetics of TCAs
they are highly protein bound and lipid soluble
amoxamine
D2 blocker and NET>SERT=DAT blocker used for psychosis with depression
maprotiline
selective NE re-uptake inhibitor with increased seizure risk
trazodone
5-HT2a antagonist and 5-HT1a partial agonist. used for depression with anxiety and sleep problems. CYP3A4.
mirtazepine
alpha 2 and 5-HT2 antagonist. increased NE and 5-HT. it is sedating due to potent anti histamine effects and it has worse weight gain. It has less GI and sexual problems
bupropion
weak blocker of DAT, SERT, and NET. Its metabolite is an NRI. it causes sympathetic side effects and can be used for smoking cessation. It can cause seizures
what are the SNRIs
duloxetine and venlafaxine
what are the issues with duloxetine
it is highly protein bound and it is metabolized by CYP2D6 and 1A2
vortioxetine
I don’t even care to type out all the shit that it does
what are the SSRIs
sertraline, paroxetine, fluoxetine, and citalopram
which of the SSRIs can cause birth defects
paroxetine
which of the CYPs can TCAs inhibit
2C19 and 2D6
what are the adverse effects of SSRIs
nausea and sexual side effects
what is serotonin syndrome
when you have multiple drugs on board that all increase serotonin, the 5-HT1a receptors in the midbrain become overstimulated
what are the MAOIs
tranylcypromine, isocarboxazid, and phenelzine
what is the indication for MAOIs
used for depression when nothing else will work and for panic disorder and agoaphobia
what are the drug interactions for MAOIs
anything that has tyramine in it, anything that will increase serotonin, and symapathetico mimetics
