ic12 depression medication moa and side effects

Question 1

list of TCAs and their classification

differences in classification

Answer 1

3rd degree amines
- amitriptyline
- clomiPRAMINE

2nd degree amine
- nortriptyline
- desiPRAMINE

2nd degree amine TCAs have less anticholinergic, sedation, and cardiotoxic side effects

Question 2

MOA and side effects of TCA

Answer 2

GI
sexual dysfunction

weight gain, sedation, orthostatic hypotension, arrhythmia (QTC conduction abnormalities), seizure risk

Question 3

what TCA used for OCD

Answer 3

clomipramine

Question 4

list of SSRIs

Answer 4

fluoxetine
fluvoxamine
sertraline
escitalopram/citalopram
paroxetine

Question 5

which SSRI has the longest half life and how long

Answer 5

fluoxetine (t1/2 4-6 days)
extended if norfluoxetine (4-16 days)

Question 6

MOA of SSRI

Answer 6

selectively inhibits serotonin reuptake autoreceptors in the presynapse

Question 7

SE of SSRIs

Answer 7

GI and sexual dysfunction

headache, transient nervousness during initiation

hyponatremia (SIADH)

bleeding risk, EPSE

Question 8

which SSRI has the most sedating and weight gain effects (+ additional properties)

Answer 8

paroxetine
- most anticholinergic and sedating

it also has short half life = withdrawal risk.

Question 9

which SSRI has risk of QTC prolongation if high doses in elderly

Answer 9

escitalopram
citalopram

Question 10

which SSRI has risk of insomnia

Answer 10

fluoxetine

Question 11

other indication of fluoxetine

Answer 11

eating disorders

Question 12

list of SNRI and their MOA

Answer 12

venlafaxine (and desvenlafexine)
duloxetine

selective inhibitor of NE and 5HT

Question 13

additional indication of SNRI

Answer 13

use in chornic pain MSK, diabetic peripheral neuropathy, fibromyalgia..

Question 14

SE of SNRI

Answer 14

similar to SSRI

Question 15

which SNRI has BP increase

Answer 15

venlafaxine

Question 16

which SNRI might cause urinary hesitation

Answer 16

duloxetine

Question 17

MOA of mirtazapine (name the drug class)

Answer 17

NaSSA
Noradrenaline and specific serotonin antagonist

alpha2, 5ht2,3, histamine antagonisms
also increase NE

Question 18

SE of mirtazapine (and special counselling)

Answer 18

somnolence (useful for insomnia)
weight gain
increased appetite

can reverse the GI and sexual side effects of SSRI/SNRI

Question 19

what is bupropion and its mOA

Answer 19

NDRI
NE and Dopamine reuptake inhibitor

less sexual side effect compared to SSRI/SNRI

Question 20

SE of bupropion and special counselling

Answer 20

insomnia
seizrue
psychosis

NOT SUITABLE FOR EATING DISORDERS

Question 21

another indication for bupropion

Answer 21

smoking cessation aid

Question 22

what is moclobemide

Answer 22

MAOI
safest among MAOis

Question 23

trazodone MOA, SE, indications

Answer 23

BLOCKS 5HT reuptake
antagonises 5HT2, H1 and alpha1

SE
same as SSRI + sedation + orthostatic hypotension
- rare: priapism

used for insomnia instead of depression

Question 24

agomelatine MOA, SE, contraindications

Answer 24

melatonin MT1, 2 agonist
5ht2c antagonist

increase DA and NE

causes GI SE and increases LFTs

c/I: fluvoxamine, ciprofloxacin.