Drugs For Mood Disorders Flashcards
Depression definition
Sad,despondent mood
Types of Depression
Major depressive disorder (MDD) Situational Dysthymia or persistant depressive dis. Postpartum depression (PPD) Premenstrual dysphoric disorder (PDD) Seasonal affective disorder (SAD) Psychotic
Non-drug approaches(depression)
- Cognitive behavioral therapy
- Electroconvulsive therapy (ECT)
- Repetitive transcranial magnetic stimulation (rTMS)
Neurotransmitters to Depr./Strategy
Block breakdown of NE/ uptake of 5HT
SSRI- block 5HT reuptake
SNRI- block 5HT and NE reuptake
TCA- block 5HT and NE reuptake
MAOI- block NE/DA degradation
*all are efficacious
Neurotransmitter Safety
SSRI>SNRI>TCA>MAOI
SSRI Drugs/MoA
Citalopram (Celexa) Escitalopram(lexapro) Fluoxetine (prozac) Paroxetine(paxil) Setraline(zoloft)
Antagonize SERT to block reuptake of 5HT
Side effects: most common is sexual dysfunction
Atypicals (incl. SNRIs) Drugs
Duloxetine(cymbalta) Venlafaxine(effexor) Trazodone(oleptro, desyrel) Bupropion (wellbutin) Vortioxetine (brintellix)
Duloxetine(cymbalta) moa
5HT and NE reuptake inhibitor/SNRI
(-) NET and SERT
Venlafaxine(effexor) moa
5HT and NE reuptake inhibitor/SNRI
(-) NET and SERT
Trazodone(oleptro, desyrel) moa
(-)5HT2 -counterintuitive
(-)alpha 1 adrenergic receptorsi
Bupropion (wellbutin) moa
(-) NET amd DAT / may stimulate NE and DA release
Side effects:
alpha 1 antagonism-hypotension
Dysrhythmias
Vortioxetine (brintellix) moa
Complex moa
(-)SERT
Partial agonist of 5HT 1a/1b
(-) 5HT 1d, 3, 7
Some ppl have mutation in SERT and antidepressants do not work for them
Tricyclics drug/ moa
Amitriptyline (elavil)
(-) NET and SERT
Side effects:
H1 receptor antagonist- drowsiness
Anticholinergic effects
“Dirty drug”
MAOI drugs/moa
Phenelzine( nardil)
Inhibit MAO-inhibit metabolism of NE, Epi, and dopamine
Inhibit breakdown of tyramine which can lead to hypertensive crisis bc mimics NE
Bipolar Disorder
Alternating episodes of mania and depression
Bipolar 1- one manic episode
Bipolar 2- one major depressive + one hypomanic episode
Cyclothia-low level depressive and hypomania
Mood Stabilizers (Bipolar) drugs
Lithium (eskalith)
Lithium (eskalith) moa
Modulates celluar metabolism and signal transduction-> suppresses neuronal activity
Narrow Ti and side effects include weight gain or tremors
*first line tx for bipolar 1
Atypical Antipsychotics (Bipolar) Drugs
Aripriprazole (abilify)
Risperdone (risperdol)
Aripriprazole (abilify) moa
Dopamine D2 receptor antagonism
-5HT 2a weak partial (+)
Risperdone (risperdol) moa
(-) D2 receptors and (-) 5HT2a receptors
Antiseizure (Bipolar) drugs/moa
Carbamazepine (tegretol)-na+ desens
Lamotrigine (lamictal) na+ desens
Valporic acid (depakene, depakote) na+ channel desens and (+) GABA / (-) Ca+ channel
ADHD
Hyperactive and Attention defec.
Stimulants (ADHD)
- mainly CNS stimulants
Methylphenidate (ritalin, concerta)
Amphetamine (adderall)
Methamphetamine (desoxyn)
Methylphenidate (ritalin, concerta) moa
Blocks DA, 5HT, NE reuptake
Schedule 2
Amphetamine (adderall) moa
Inc DA, 5HT and NE neurotransmission
Methamphetamine (desoxyn) moa
Enhances release of DA, 5HT, and NE
Non-Stimulant (ADHD) drug/moa
Atomoxotine (stratterta)
Selectively inhibits NE reuptake in prefrontal cortex-> calming effect
