Drugs - Misc 2nd Gen Antidepressants

Question 1

Which are the miscellaneous second-generation antidepressants?

Answer 1

• Maprotiline (Ludiomil)
• Amoxapine (Ascendin)
• Trazodone (Desyrel)
• Nefazodone (Serzone)
• Clomipramine (Anafranil)

Question 2

What are the characteristics of maprotiline?

Answer 2

• True serotonin selective reuptake inhibitor
• the worst for causing seizures (BAM-C)
• potent H1 blocker so sedating

Question 3

What are the characteristics of amoxapine?

Answer 3

• When metabolize that can block the D2 receptor and therefore has a potential for EPS
• higher incidence of seizures (BAM-C)
• NE > 5HT reuptake blocker

Question 4

What are the characteristics of trazodone?

Answer 4

• Significant sedation and orthostasis (often used in PM) -> used to counteract SSRI induced insomnia
• priapism due to a alpha-2 blockade by parent drug
• questionable efficacy in the treatment of more severe depression
• mechanism of action and depression is likely due to its ability to block 5HT2A receptors; also is a partial agonist at 5HT1A receptors (more efficacy than buspirone)
• minimal weight gain (activates 5HT2C)

Question 5

What are the characteristics of nefazodone?

Answer 5

• Discontinued due to severe hepatotoxicity
• potent blockade of 5HT2A/2C receptors (decreased sexual dysfunction and is anxiolytic)
• a mild SNRI
• potent CYP3A4 blocker

Question 6

What are the characteristics of clomipramine?

Answer 6

• Used for panic attacks and OCD not as an antidepressant
• has adverse side effects of both SSRI and TCA
• high incidence of seizures (BAM-C)
• potent anti-cholinergic