Drugs for Central Noradrenergic and Serotonergic Systems Flashcards
reserpine
Monoamine theory of depression: Catecholamine theory
- dec NE
- induce depression-like syndrome (but good antihypertensive drug)
amphetamine
Monoamine theory of depression: Catecholamine theory
- inc NE
- reduces depression
iproniazid
Monoamine theory of depression: Catecholamine theory
- inc NE
- reduces depression
fluoxetine
Monoamine theory of depression: Monoamine theory
- inc 5HT
- reduces depression
imipramine
Tricyclic non selective reuptake inhibitors NSRIs: tricyclic antidepressants TCAs
- have 3-C rings
- dec NE and 5HT reuptake into axon terminals in CNS –> inc both concentration and effect in synaptic gap in CNS
- use: unipolar depression, bipolar disorder (depresive phases/episodes), enuresis (nighttime bedwetting), eating disorders, chronic pain, phobias & panic attacks, obsessive compulsive disorders
- side effect: parasympathetic nervous system (dry mouth, constipation), symp ns (vasodilation, tachycaria), CNS-based(weight gain [sexual dysfunction, sedation])
desimipramine
Tricyclic non selective reuptake inhibitors NSRIs: tricyclic antidepressants TCAs
- have 3-C rings
- dec NE and 5HT reuptake into axon terminals in CNS –> inc both concentration and effect in synaptic gap in CNS
- use: unipolar depression, bipolar disorder (depresive phases/episodes), enuresis (nighttime bedwetting), eating disorders, chronic pain, phobias & panic attacks, obsessive compulsive disorders
- side effect: parasympathetic nervous system (dry mouth, constipation), symp ns (vasodilation, tachycaria), CNS-based(weight gain [sexual dysfunction, sedation])
amytriptyline
Tricyclic non selective reuptake inhibitors NSRIs: tricyclic antidepressants TCAs
- have 3-C rings
- dec NE and 5HT reuptake into axon terminals in CNS –> inc both concentration and effect in synaptic gap in CNS
- use: unipolar depression, bipolar disorder (depresive phases/episodes), enuresis (nighttime bedwetting), eating disorders, chronic pain, phobias & panic attacks, obsessive compulsive disorders
- side effect: parasympathetic nervous system (dry mouth, constipation), symp ns (vasodilation, tachycaria), CNS-based(weight gain [sexual dysfunction, sedation])
aortryptyline
Tricyclic non selective reuptake inhibitors NSRIs: tricyclic antidepressants TCAs
- have 3-C rings
- dec NE and 5HT reuptake into axon terminals in CNS –> inc both concentration and effect in synaptic gap in CNS
- use: unipolar depression, bipolar disorder (depresive phases/episodes), enuresis (nighttime bedwetting), eating disorders, chronic pain, phobias & panic attacks, obsessive compulsive disorders
- side effect: parasympathetic nervous system (dry mouth, constipation), symp ns (vasodilation, tachycaria), CNS-based(weight gain [sexual dysfunction, sedation])
clomipramine
Tricyclic non selective reuptake inhibitors NSRIs: tricyclic antidepressants TCAs
- have 3-C rings
- dec NE and 5HT reuptake into axon terminals in CNS –> inc both concentration and effect in synaptic gap in CNS
- use: unipolar depression, bipolar disorder (depresive phases/episodes), enuresis (nighttime bedwetting), eating disorders, chronic pain, phobias & panic attacks, obsessive compulsive disorders
- side effect: parasympathetic nervous system (dry mouth, constipation), symp ns (vasodilation, tachycaria), CNS-based(weight gain [sexual dysfunction, sedation])
duloxetine
Non tricyclic non selective reuptake inhibitors
-same as TCA (side effects less intense), but not chemically
venlaxafine
Non tricyclic non selective reuptake inhibitors
-same as TCA (side effects less intense), but not chemically
isocarboxazid
MAO inhibitor
- dec NE and 2HT degradation in axon terminals in CNS –> inc both vesicular storage –> inc both release and receptor activation and effect
- use: only as antidepressant (when patient is refractory to other drugs)
- side effect from food and drug interactions: inc NE release (dietary amines are indirect sympathomimetics), cardiac effect lethal (combination of dietary amine induced NE release and MAOI induced ind of stored/released NE causes massive release of NE into synaptic gap)
- food: cheese, wine, chocolate
phenelzine
MAO inhibitor
- dec NE and 2HT degradation in axon terminals in CNS –> inc both vesicular storage –> inc both release and receptor activation and effect
- use: only as antidepressant (when patient is refractory to other drugs)
- side effect from food and drug interactions: inc NE release (dietary amines are indirect sympathomimetics), cardiac effect lethal (combination of dietary amine induced NE release and MAOI induced ind of stored/released NE causes massive release of NE into synaptic gap)
- food: cheese, wine, chocolate
tranylcypromine
MAO inhibitor
- dec NE and 2HT degradation in axon terminals in CNS –> inc both vesicular storage –> inc both release and receptor activation and effect
- use: only as antidepressant (when patient is refractory to other drugs)
- side effect from food and drug interactions: inc NE release (dietary amines are indirect sympathomimetics), cardiac effect lethal (combination of dietary amine induced NE release and MAOI induced ind of stored/released NE causes massive release of NE into synaptic gap)
- food: cheese, wine, chocolate
fluoxetine
Serotonin specific reuptake inhibitors SSRIs
- inhibition of 5HT reuptake
- uses: unipolar depression, bipolar disorder (depressive phase), chronic pain, eating disorders, anxiety disorders, obsessive compulsive disorders
- side effect: CHRONIC not overdose: major decrease of sexual libido & satisfaction, ACUTE/CHRONIC overdose: “serotonin syndrome”, confusion, hallucinations, tachycardia, palpitations, hyperreflexia
- use: PROZAC for depression, SARAFEM for premenstrual dysphoria