Antidepressants Flashcards
What are the 3 big classes of side effects of TCAs?
Antihistaminic
Anticholinergic
Antiadrenergic
What antihistaminic side effects are there of TCAs?
Sedation
Weight gain
What anticholinergic SEs are there?
Dry mouth
Dry eyes
Constipation
What antiadrenergic SE are there?
Orthostatic hypotension
Sexual dysfunction
How do TCAs work?
Side chains that bind to serotonin receptors
What are examples of TCAs?
Amitrytiline
Clomipramine
Imipramine
Doxepin
Heart SE of TCAs?
QT prolongation
What are secondary TCAs?
Metabolites of TCAs
Primarily block noradrenaline
How do monoamine oxidase inhibtors work?
Bind irreversibly to monoamine oxidase
Prevent inactivation of amines
What amines are stopped from being deactivated by MAOIs?
Dopamine
Serotonin
Norepinephrine
What happens with these non-inactivated amines?
They don’t get broken down in the gut and get absorbed to increase levels
Side effects of MAOIs?
Orthostatic hypotension
Sexual dysfunction
Sleep disturbance
Sedation
HYPERTENSIVE CRISIS
SEROTONIN SYNDROME
What causes a hypertensive crisis with MAOIs?
When consumed with tyrosine rich foods
Why does tyrosine cause a hypertensive crisis with MAOIs?
Is also an amine that is sympathomimetic
What must be done when switching an SSRI to a MAOI because of serotonin syndrome?
Must wait 2 - 3 weeks depending on SSRI halflife