Depression Flashcards
Describe the mechanism of action for Setraline, citalopram flouxetine?
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.
What is the drug target of setraline, citalopram, flouxetine?
Serotonin transporter
What are the side effects of Setraline, flouxetine and citalopram?
GI effects (nausea, diarrhoea), sexual dysfunction, anxiety, insomnia
What is important to consider when discontinuing Setraline and citalopram?
Must be gradually decreased on discontinuation. Partial inhibition of CYP2D6 at high doses (150 mg).
What other receptor is citalopram an antagonist for?
Mild antagonism of muscarinic and histamine (H1) receptors
What other receptoris flouxetine an antagponist for?
Mild antagonism of 5HT2A and 5HT2C receptors
Complete inhibition of CYP2D6 and significant inhibition of CYP2C19 (caution with warfarin).
Which drugs are SSRI’s?
Setraline
Citalopram
Fluoxetine
Venlafaxine
Mirtazapine
What is the mechanism of action of Mirtazapine?
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.
What are the drug targets of Mirtazapine?
Alpha - 2 receptor
5 - HT2 Receptor
What are the side effects of Mirtazapine?
Weight gain, sedation
What is the effect of Mirtazapine on sleep?
May exacerbate REM sleep behaviour disorder
Why is mirtazapine preffered over oher SSRI’s?
Low probability of sexual dysfunction.
What is the mechanism of action for venlafaxine?
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.
Which receptors does Venlafaxine act on?
Serotonin transporter
Noradrenaline transporter
What are the side effects of Venlafaxine?
GI effects (nausea, diarrhoea), sexual dysfunction, anxiety, insomnia, hypertension (at higher doses)
