CPTP 3.3 Anti-depressants Flashcards
Fluoxetine
+ clinical use + significant side effects (if any)
SSRI
Clinical use:
Depression (first line), Bulimia, OCD
Side effects:
usual SSRI, no significant
Note: Long half life
Citalopram
+ clinical use + significant side effects (if any)
SSRI
Clinical use:
Depression, panic disorder
Significantly more affinity for 5-HT than NA –> more useful for patients who don’t like NA side effects
Significant side effects:
- bleeding risk
- QT prolongation
- Mania
Sertraline
+ clinical use + significant side effects (if any)
SSRI
Clinical use:
Depression
Side effects:
usual SSRI, no significant
Paroxetine
+ clinical use + significant side effects (if any)
SSRI
Clinical use:
Depression
Side effects:
usual SSRI, no significant
Trazodone
+ clinical use + significant side effects (if any)
SSRI
Clinical use:
Depression
Side effects:
usual SSRI, no significant
Escitalopram
+ clinical use + significant side effects (if any)
SSRI
Clinical use:
Depression
Side effects:
usual SSRI, no significant
Venlafaxine
+ clinical use + significant side effects (if any)
SNRI
Clinical use:
Depression, Generalised Anxiety Disorder, Social Anxiety Disorder
Side effects:
usual SNRI,
(contraindicated with arrhythmia)
Duloxetine
+ clinical use + significant side effects (if any)
SNRI
Clinical use:
Depression, Generalised Anxiety Disorder, Social Anxiety Disorder
Side effects:
usual SNRI,
(contraindicated with arrhythmia)
Reboxetine
+ clinical use + significant side effects (if any)
NARI
Clinical use:
Depression
Side effects:
none significant
Desipramine
+ clinical use + significant side effects (if any)
NARI
Clinical use:
Depression
Side effects:
none significant
Amitriptyline
+ clinical use + significant side effects (if any)
TCA
Clinical use:
Severe, treatment resistant depression
Side effects:
Cardiotoxic (potentially fatal in overdose)
Imipramine
+ clinical use + significant side effects (if any)
TCA
Clinical use:
Severe, treatment resistant depression
Side effects:
Cardiotoxic (potentially fatal in overdose)
Lofepramine
+ clinical use + significant side effects (if any)
TCA
Clinical use:
Severe, treatment resistant depression
Side effects:
Cardiotoxic (potentially fatal in overdose)
Desipramine
+ clinical use + significant side effects (if any)
TCA
Clinical use:
Severe, treatment resistant depression
Side effects:
Cardiotoxic (potentially fatal in overdose)
Buproprion
Dopamine reuptake inhibitor
Phenelzine
+ clinical use + significant side effects (if any)
Old MAOI:
-MAO-A inhibition: less breakdown of 5HT/NA
-MAO-B inhibition: less breakdown of dopamine
Clinical use:
Panic, Social Phobia, Agoraphobia
Side effects:
Overdose risk due to stimulant effect (from increased dopamine)
Tranylcypramine
+ clinical use + significant side effects (if any)
Old MAOI:
-MAO-A inhibition: less breakdown of 5HT/NA
-MAO-B inhibition: less breakdown of dopamine
Clinical use:
Panic, Social Phobia, Agoraphobia
Side effects:
Overdose risk due to stimulant effect (from increased dopamine)
Moclopemide
+ clinical use + significant side effects/interactions (if any)
New MAOI:
-MAO-A inhibition: less breakdown of 5HT/NA
Clinical use:
Panic, Social Phobia, Agoraphobia
Side effects
- interactions with SSRI (hyperthermia, confusion, hypertensive crisis)
- high absorption of dietary amines –> leads to hypertensive crisis
Mirtazepine
+ pharmacodynamics
+ clinical use + significant side effects/interactions (if any)
Atypical antidepressant
Pharmacodynamics:
high affinity for H1 receptor
presynaptic alpha2 receptor antagonist
Clinical use:
Depression (second most commonly prescribed after fluox)
Side effects:
- Sedation, weight gain
- Contraindicated in those with cardiac problems, blood disorders (e.g. anaemia)
Nefazodone
+ pharmacodynamics
+ clinical use + significant side effects/interactions (if any)
Atypical antidepressant
Pharmacodynamics:
High affinity for 5HT(2A) receptor
Clinical use:
Depression
Side effects:
Affects slow wave sleep
Mianserin
+ pharmacodynamics
+ clinical use + significant side effects/interactions (if any)
Atypical antidepressant
Pharmacodynamics:
High affinity for H1 & 5HT(2A) receptor
Clinical use:
Depression
Side effects:
- Sedation, weight gain
- Affects slow wave sleep
Sodium valproate
Pharmacodynamics
+ clinical use
+ side effects
Pharmacodynamics:
Blocks voltage gated Na channels
Increases GABA levels
Clinical use:
Mania, bipolar, epilepsy
Side effects:
COMMON: nausea, abdominal pain, weight gain, thrombocytopenia, thinning hair
UNCOMMON: agitation, ataxia, tremor
Lithium
+ clinical use
+ side effects
+ risks
Clinical use: (mood stabiliser)
Recurrent depression, Mania, bipolar
Side effects:
COMMON: thirst, polyuria, weight gain, tremor
UNCOMMON: V&D, abdominal pain, ataxia, drowsiness
Risks:
- thyroid dysfunciton
- renal impairment
- toxicity
- relapse if stopped suddenly
- requires regular blood tests