antidepressants (test 3) Flashcards
Name 5 examples of Tricyclics (TCA)?
amitriptyline, nortriptyline, clomipramine, desipramine, imipramine
What do TCAs do?
boost serotonin and norepinephrine
What are the clinical uses of TCAs?
depression, neuropathic and chronic pain, migraine prevention, may help primary insomnia
What are side effects of TCAs?
weight gain, dry mouth, constipation, urinary retention, sexual side effects, cardiac adverse effects; may be LETHAL in OD
Notes on TCA amitriptyline?
dosing = 25 mg QHS initially, target dose 50-150 mg/day
Notes on TCA clomipramine?
the most serotoninergic TCA, as such works for OCD
Notes on TCA desipramine?
fewer anticholinergic side effects compared to other TCAs
Notes on TCA imipramine?
also approved for enuresis
Notes on TCA nortriptyline?
plasma levels well studied and may be used to monitor compliance and metabolism
What two suffixes do TCAs generally end with?
-iptyline or -ipramine
What two suffixes do TCAs generally end with?
-iptyline or -ipramine
Name 4 examples of SSRIs and the mnemonic to remember they with.
Fluoxetine, Paroxetine, Sertraline, Citalopram; FLashbacks PARalyze SEnior CITizens
What do SSRIs do?
boost mostly serotonin
What are clinical uses of SSRIs?
depression, premenstrual dysphoric disorder, generalized anxiety disorder, OCD, PTSD
What are adverse effects of SSRIs?
GI side effects initially, sexual side effects
Notes on SSRI citalopram?
dosing = 20 mg QD initially, may increase to 40 mg QD. At higher doses may cause QT prolongation
Notes on SSRI fluoxetine?
also FDA approved for bulimia nervosa, panic disorders, and bipolar depression – in conjunction with olanzapine
Notes on SSRI Paroxetine?
can cause constipation, dry mouth, and sedation
Notes on SSRI Sertraline?
has some ability to block dopamine reuptake, which may lead to activation or increased energy
Notes on SSRI Sertraline?
has some ability to block dopamine reuptake, which may lead to activation or increased energy
Name 2 Serotonin Norepinephrine reuptake inhibitors (SNRIs).
Venlafaxine and Duloxetine
What do SNRIs do?
boost serotonin and norepinephrine
What are adverse effects of SNRIs?
GI side effects initially; sexual side effects
Notes on SNRI venlafaxine?
watch for blood pressure increases; may cause withdrawal syndrome
Notes on SNRI duloxetine?
also used for diabetic peripheral neuropathic pain and fibromyalgia
Name one Monoamine oxidase inhibitor (MAOI).
selegiline
What are MAOIs used for?
recommended for atypical depression and treatment resistant depression. MAOIs are rarely used today due to dietary restrictions.
Notes on MAOI selegiline?
transdermal approach for depression, oral for Parkinson disease
Name 4 atypical antidepressants (don’t fit in the other categories).
bupropion, mirtazapine, trazodone, nefazodone
What are the clinical uses of bupropion?
depression, seasonal affective disorder, SMOKING CESSATION; may be added to SSRI to reverse or alleviate sexual side effects
What are the two antidepressants that don’t have sexual side effects?
bupropion and mirtazapine
What are some problems with mirtazapine?
can cause sedation and increased appetite.. BUT its unlikely to cause sexual side effects so that’s a bonus
What are some problems with mirtazapine?
can cause sedation and increased appetite.. BUT it’s unlikely to cause sexual side effects so that’s a bonus
What are some side effects with trazodone?
sedation but with low weight gain. PRIAPISM (long-lasting, painful erection) is a rare but important adverse effect to consider.
Why is nefazodone rarely used?
VERY HEPATOTOXIC!!!
