Antidepressants Flashcards
Phenelzine (Nardil) Class
MAOI
Phenelzine (Nardil) MOA
Irreversibly inhibit both MAOa and MAOb, Prevent breakdown of DA
Phenelzine (Nardil) Therpeutics
Depression, anxiety, PTSD, chronic pain, enuresis, bulimia, alcoholism
Phenelzine (Naardil) SE
- Hypertensive crisis (with tyramine-rich foods); serotonin syndrome (MAOI + SSRI); agitation (rare), delerium –> seizures
- Anticholinergic, orthostatic hypotension, sexual dysfunction, weight gain, sedation
Desipramine (Norpramin) CLass
TCA
Desipramine (Norpramin) MOA
Block reuptake of NE or 5-HT at varying potencies and selectivity; also variably block muscarinic, a-adrenergic, dopamine, and histamine receptors
Desipramine (Norpramin) Therapeutics
Depression, anxiety, PTSD, chronic pain, enuresis, bulimia, alcoholism
Desipramine (Norpramine) SE
- Sympathomimetic (cardiac arrhythmias and conduction defects, especially at OD)
- Antimuscarinic, orthostatic hypotension, sedation (additive with alcohol), seizures
Desipramine (Norpramine) MIsc
Not very safe; rarely used anymore
Imipramine (Tofranil) Class
TCA
Imipramine (Tofranil) MOA
Block reuptake of NE or 5-HT at varying potencies and selectivity; also variably block muscarinic, a-adrenergic, dopamine, and histamine receptors
Imipramine (Tofranil) Therapeutics
Depression, anxiety, PTSD, chronic pain, enuresis, bulimia, alcoholism
Imipramine (Tofranil) SE
- Sympathomimetic (cardiac arrhythmias and conduction defects, especially at OD)
- Antimuscarinic, orthostatic hypotension, sedation (additive with alcohol), seizures
Imipramine (Tofranil) Misc
Not very safe; rarely used anymore; forms active metabolite (desipramine)
Amitriptyline (Elavil) Class
TCA
Amitriptyline (Elavil) MOA
Block reuptake of NE or 5-HT at varying potencies and selectivity; also variably block muscarinic, a-adrenergic, dopamine, and histamine receptors
Amitriptyline (Elavil) Therapeutics
Depression, anxiety, PTSD, chronic pain, enuresis, bulimia, alcoholism; prevention of tension headaches, migraines
Amytriptyline (elavil) SE
- Sympathomimetic (cardiac arrhythmias and conduction defects, especially at OD)
- Antimuscarinic, orthostatic hypotension, sedation (additive with alcohol), seizures
Amytriptyline (Elavil) Misc
Not very safe; rarely used anymore; forms active metabolite (nortriptyline)
Nortriptyline (Pamelor) Class
TCA
Nortriptyline (Pamelor) MOA
Block reuptake of NE or 5-HT at varying potencies and selectivity; also variably block muscarinic, a-adrenergic, dopamine, and histamine receptors
Nortriptyline (Pamelor) Therapeutics
Depression, anxiety, PTSD, chronic pain, enuresis, bulimia, alcoholism
Nortriptyline (Pamleor) SE
- Sympathomimetic (cardiac arrhythmias and conduction defects, especially at OD)
- Antimuscarinic, orthostatic hypotension, sedation (additive with alcohol), seizures
Nortriptyline (Pamelor) Misc
Not very safe; rarely used anymore
Fluoxetine (Prozac) Class
SSRI
Fluoxetine (Prozac) MOA
Inhibit reuptake of 5-HT (and NE to lesser extent)
Fluoxetine (Prozac) Therpeutics
Depression, anxiety, PTSD, chronic pain, enuresis, bulimia, alcoholism; pre-menstrual dystrophic disorder
Fluoxetine (Prozac) SE
- Serotonin syndrome (with MAOIs)
2. Fewer than tricyclics; mostly nausea, decreased sexual function
Fluoxetine (Prozac) Misc
Potent P450 inhibitor; forms active metabolite (norfluoxetine)
Paroxetine (Paxil) Class
SSRI
Paroxetine (Paxil) MOA
Inhibit reuptake of 5-HT (and NE to lesser extent)
Paroxetine (Paxil) Therapeutics
Depression, anxiety, PTSD, chronic pain, enuresis, bulimia, alcoholism
Paroxetine (Paxil) SE
- Serotonin syndrome (with MAOIs)
2. Fewer than tricyclics; mostly nausea, decreased sexual function
Paroxetine (Paxil) Misc
Potent P450 inhibitor
Sertraline (Zoloft) Class
SSRI
Sertraline (Zoloft) MOA
Inhibit reuptake of 5-HT (and NE to lesser extent)
Sertraline (Zoloft) Therapeutics
Depression, anxiety, PTSD, chronic pain, enuresis, bulimia, alcoholism
Sertraline (Zoloft) SE
- Serotonin syndrome (with MAOIs)
2. Fewer than tricyclics; mostly nausea, decreased sexual function
Escitalopram (Lexapro) Class
SSRI
Escitalopram (Lexapro) MOA
Inhibit reuptake of 5-HT (and NE to lesser extent)
Escitalopram (Lexapro) Therapeutics
Depression, anxiety, PTSD, chronic pain, enuresis, bulimia, alcoholism
Escitalopram (Lexapro) SE
- Serotonin syndrome (with MAOIs)
2. Fewer than tricyclics; mostly nausea, decreased sexual function
Citalopram (Celexa) Class
SSRI
Citalopram (Celexa) MOA
Inhibit reuptake of 5-HT (and NE to lesser extent)
Citalopram (Celexa) Therapeutics
Depression, anxiety, PTSD, chronic pain, enuresis, bulimia, alcoholism
Citalopram (Celexa) SE
- Serotonin syndrome (with MAOIs)
2. Fewer than tricyclics; mostly nausea, decreased sexual function
Duloxetine (Cymbalta) Class
SNRI
Duloxetine (Cymbalta) MOA
Inhibits reuptake of 5-HT and NE
Duloxetine (Cymbalta) Therapeutics
Depression, anxiety, PTSD, chronic pain, enuresis, bulimia, alcoholism
Venlafaxine (Effexor) CLass
SNRI
Venlafaxine (Effexor) MOA
Inhibits reuptake of 5-HT and NE
Venlafaxine (Effexor) Therapeutics
Depression, anxiety, PTSD, chronic pain, enuresis, bulimia, alcoholism
Bupropion (Wellbutrin) Class
Atypical
Bupropion (Wellbutrin) MOA
Blocks DA and NE reuptake
Bupropion (Wellbutrin) Therapeutics
Depression, anxiety, PTSD, chronic pain, enuresis, bulimia, alcoholism; maintain nicotine abstinence in quitting smokers
Bupropion (Wellbutrin) SE
Lowers seizure threshold
Mirtazapine (Remeron) Class
Atypical
Mirtazapine (Remeron) MOA
5HT2a antagonists; also inhibit 5HT reuptake
Mirtazapine (Remeron) THerapeutics
Depression, anxiety, PTSD, chronic pain, enuresis, bulimia, alcoholism
Lithium MOA
Unknown; lithium depletes secondary messengers IP3 and DAG, important in a-adrenergic and muscarinic-cholinergic transmission
Lithium Therapeutics
Anti-manic/mood-stabilizing (bipolar); long-term cluster headache prevention
Lithium SE
- If elevated levels: neurotoxicity, cardiac toxicity, renal dysfunction
- Drowsiness, weight gain, tremor, polydipsia, polyuria
Lithium Misc
Nausea and vomiting early sign of lithium OD; indomethacin and Na-depleting diuretics should be avoided (increase [Li])