Depression Flashcards
Drugs
Setraline Citalopram Fluoxetine Venlafaxine Mirtazapine
Setraline action
Inhibition of serotonin reuptake results in an accumulation of serotonin. Serotonin in the central nervous system plays a role in the regulation of mood, personality, and wakefulness.
Sertraline target
Serotonin transporter
Sertraline side effects
GI effects (nausea, diarrhoea), sexual dysfunction, anxiety, insomnia
Sertraline other
Mild inhibition of dopamine transporter
Must be gradually decreased on discontinuation. Partial inhibition of CYP2D6 at high doses (150 mg).
In 2020 – Sertraline was the 16th most commonly prescribed drug in West London area
Citalopram action
Inhibition of serotonin reuptake results in an accumulation of serotonin. Serotonin in the central nervous system plays a role in the regulation of mood, personality, and wakefulness.
Citalopram target
Serotonin transporter
Citalopram side effects
GI effects (nausea, diarrhoea), sexual dysfunction, anxiety, insomnia
Citalopram other
Mild antagonism of muscarinic and histamine (H1) receptors
Must be gradually decreased on discontinuation. Metabolized by CYP2C19.
In 2020 – Citalopram was the 27th most commonly prescribed drug in West London area
Fluoxetine action
Inhibition of serotonin reuptake results in an accumulation of serotonin. Serotonin in the central nervous system plays a role in the regulation of mood, personality, and wakefulness.
Fluoxetine target
Serotonin transporter
Fluoxetine side effects
GI effects (nausea, diarrhoea), sexual dysfunction, anxiety, insomnia
Fluoxetine other
Mild antagonism of 5HT2A and 5HT2C receptors
Complete inhibition of CYP2D6 and significant inhibition of CYP2C19 (caution with warfarin).
In 2020 – Fluoxetine was the 68th most commonly prescribed drug in West London area
Venlafaxine action
Venlafaxine is a more potent inhibitor of serotonin reuptake than norepinephrine reuptake.
Noradrenaline in the central nervous system is implicated in the regulation of emotions and cognition.
Venlafaxine target
Serotonin transporter
Noradrenaline transporter
Venlafaxine side effects
GI effects (nausea, diarrhoea), sexual dysfunction, anxiety, insomnia, hypertension (at higher doses)
Venlafaxine other
Must be gradually decreased on discontinuation
In 2020 – Venlafaxine was the 83rd most commonly prescribed drug in West London area
Mirtazapine action
Antagonises central presynaptic alpha-2-adrenergic receptors, which causes an increased release of serotonin and norepinephrine.
Antagonises central 5HT2 receptors, which leaves 5HT1 receptors unopposed causing anti-depressant effects.
Mirtazapine target
Alpha-2 receptor
5-HT2 receptor
Mirtazapine side effects
Weight gain
Sedation
Mirtazapine other
Low probability of sexual dysfunction. May exacerbate REM sleep behaviour disorder
In 2020 – Mirtazapine was the 30th most commonly prescribed drug in West London area
