depression Flashcards
What is the primary mechanism of action of sertraline?
- Inhibition of serotonin reuptake results in serotonin accumulation
- Serotonin affects mood, personality and wakefulness
What is the drug target of sertraline?
Serotonin transporter
What is the main side effect of sertraline?
- GI effects (nausea, diarrhoea)
- Sexual dysfunction
- Anxiety
- Insomnia
How does sertraline affect dopamine?
Mild inhibition of dopamine transporter
What must be considered when discontinuing sertraline?
Must be gradually decreased
What is the primary mechanism of action of citalopram?
Inhibition of serotonin reuptake results in accumulation of serotonin
What is the drug target of citalopram?
Serotonin transporter
What are the main side effects of citalopram?
- GI effects (nausea, diarrhoea)
- Sexual dysfunction
- Anxiety
- Insomnia
- QT prolongation
What else can citalopram act as?
Mild antagonist of muscarinic and histamine (H1) receptors
What must be considered when discontinuing citalopram?
Must be gradually decreased
What is citalopram metabolised by?
CYP2C19
What is the primary mechanism of action of fluoxetine?
Inhibition of serotonin reuptake results in serotonin accumulation
What is the drug target of fluoxetine?
Serotonin transporter
What are the ain side effects of fluoxetine?
- GI effects (nausea, diarrhoea)
- Sexual dysfunction
- Anxiety
- Insomnia
What else does fluoxetine act as?
- Mild antagonist of 5HT2A and 5HT2C receptors
- Complete inhibition of CYP2D6 and significant inhibition of CYP2C19 (caution with warfarin)
What is the primary mechanism of action of venlafaxine?
- More potent inhibitor of serotonin reuptake than noradrenaline reuptake
- Noradrenaline is involved in regulation of emotion and cognition
What are the drug targets of venlafaxine?
- Serotonin transporter
- Noradrenaline transporter
What are the main side effects of venlafaxine?
- GI effects (nausea, diarrhoea)
- Sexual dysfunction
- Anxiety
- Insomnia
- Hypertension (at higher doses)
What must be considered when discontinuing venlafaxine?
Must be gradually decreased
What is the primary mechanism of action of mirtazapine?
- Antagonises central presynaptic alpha-2-adrenergic receptors
- Causes an increased release of serotonin and noradrenaline
- Antagonises central 5HT2 receptors, leaving 5HT1 receptors unopposed causing anti-depressant effects
What are the drug targets of mirtazapine?
- Alpha-2 receptor
- 5HT2 receptor
What are the main side effects of mirtazapine?
- Weight gain
- Sedation
What less common side effects are there of mirtazapine?
- Low probability of sexual dysfunction
- May exacerbate REM sleep behaviour disorder
