Antidepressants Flashcards
Tricyclic antidepressants
TCAs
Block neuronal reuptake of NE and 5-HT
Work on NE and serotonin
Oldest class
Also used for: nerve pain, migraines, sleep
Orthostatic hypotension
Sedation
Anticholinergic effects: sweating, cardiac toxicity, seizures, suicide risk
Drug interactions: MAOI, anticholinergics, cns depressants
Selective serotonin reuptake inhibitors (SSRIs)
Block neuronal reuptake of serotonin Little effect on other NT Cns excitation vs sedation PKs differ among agents Fluoxetine half life >72 hrs Others 24hrs
Sexual dysfunction *weight gain * serotonin syndrome Withdrawal syndrome Dizzy, tremor, anxiety Anti-platelet activity leads to osteoporosis Drug interaction: CYP mediated Serotonergic
Serotonin/norepinephrine reuptake inhibitors (SNRIs)
Selective inhibition of both 5-HT and NE
Little effect on others
Sexual dysfunction, weight gain, serotonin syndrome
- CYP mediated
- serotonergic
Monoamine Oxidase Inhibitors (MAOI)
Inhibit the break down of NE, 5-HT and dopamine*
More NT available for release at the synapse and receptor binding
* irreversible inhibition after 2weeks
Old class
Reserved for last or cases of severe depression
Work well
Cns stimulation
Orthostasis
Serotonin syndrome
* dietary cautions
* dietary Tyramine: result of break down of tyrosine*
*Hypertensive crisis: severe headache, blurry vision, trouble thinking, stroke, seizure, chest pain, N/V, elevated BP and HR
Antidepressants
5 types
-prevent the reuptake of a NT at the neuron
Goal- make more NT available at the synapse
Trazadone
Other anti depressants Used a lot Moderate inhibition of 5-HT reuptake Used at bedtime (sedation) Mild anticholinergic effects Priapism
Bupropion
Other anti depressant
Used commonly for smoking cessation aide
Primarily effects DA
* no weight gain or sexual dysfunction
Altered consciousness, agitation, headache, dizzy
Mirtazapine (remeron)
Other anti depressants
Increases serotonin and NE release
Sedation and weight gain
Nefazodone (serzone)
Other anti depressants
Blocks reuptake of NE and 5-HT
Sedation, headache, dry mouth
Significant drug inx risks
Vilazodone ( vilbryd)
Other antidepressant
Selective inhibitor of 5-HT reuptake
Slow titration
Take with food
Imipramine Amiltriptyline Clomipramine Desipramine Nortriptyline Doxepin
Tricyclic antidepressants
Fluoxetine Citalopram Fluvoxamine Sertaline Paroxetine
Selective Serotonin Reupake inhibitors (SSRIs)
Venlafaxine Desvenlafaxine Duloxetine Milnacipran Levomilnacipran
Serotonin Norepinephrine Reuptake Inhibitors (SNRIs)
Rasagiline Selegiline Isocarboxazid Phenelzine Tranylcypromine
MAOIs
Bupropion Trazadone Nefazadone Vilazodone Mirtazapine
Other anti depressants
