MNI Antidepressants Antipsychotics Anxiolytics Hypnotics Antiepileptics Parkinsons Flashcards
Isocarboxazid
MAOI; Antidepressant
Hydrazine derivative
AE: Drowsiness, Insomnia, Nausea, Ortho hypotension, weight gain, muscle pain, sex dysfunction. Serotonin Syndrome in combination with 5-HT agent. Cheese reaction in presence of tyramine containing food.
Phenelzine
MAOI; Antidepressant
Hydrazine derivative
AE: Drowsiness, Insomnia, Nausea, Ortho hypotension, weight gain, muscle pain, sex dysfunction. Serotonin Syndrome in combination with 5-HT agent. Cheese reaction in presence of tyramine containing food.
Tranylcypromine
MAOI; Antidepressant
Non-hydrazine
AE: Drowsiness, Insomnia, Nausea, Ortho hypotension, weight gain, muscle pain, sex dysfunction. Serotonin Syndrome in combination with 5-HT agent. Cheese reaction in presence of tyramine containing food.
Selegiline
MAOI; Antidepressant; Parkinson’s Medication
Non-hydrazine.
Parkinson’s Disease: Selective & irreversible MAO-B inhibition= selectively reduces dopamine breakdown in the brain. Used as adjunct to Levodopa.
AE: Drowsiness, Insomnia (is metabolized to amphetamine & methamphetamine), Nausea, Ortho hypotension, weight gain, muscle pain, sex dysfunction. Serotonin Syndrome in combination with 5-HT agent.
Transdermal formulation- Unlikely to cause Cheese Reaction
Cyproheptadine
5-HT Antagonist
Used to manage Serotonin Syndrome
Pseudoephedrine
alpha agonist
Contraindicated in patients taking MAOI
Phenylpropanolamine
alpha agonist
Contraindicated in patients taking MAOI
Amitriptyline
Tricyclic Antidepressant
Blocks SERT, NET, a-adrenergics, Muscarinics, Histamine, Cardiac Fast Na Channels
AE: Ortho hypotension, reflex tachy (a-blockade). Blurred vision, xerostomia, urinary retention, constipation, aggravation of glaucoma (M-blockade). Sedation, Weight-Gain (H-blockade). Fatal arrhythmias (Cardiac Na blockade)
Clomipramine
Tricyclic Antidepressant
Blocks SERT (more selective!), NET, a-adrenergics, Muscarinics, Histamine, Cardiac Fast Na Channels
AE: Ortho hypotension, reflex tachy (a-blockade). Blurred vision, xerostomia, urinary retention, constipation, aggravation of glaucoma (M-blockade). Sedation, Weight-Gain (H-blockade). Fatal arrhythmias (Cardiac Na blockade)
Desipramine
Tricyclic Antidepressant
Blocks SERT, NET (more selective!), a-adrenergics, Muscarinics, Histamine, Cardiac Fast Na Channels
AE: Ortho hypotension, reflex tachy (a-blockade). Blurred vision, xerostomia, urinary retention, constipation, aggravation of glaucoma (M-blockade). Sedation, Weight-Gain (H-blockade). Fatal arrhythmias (Cardiac Na blockade)
Imipramine
Tricyclic Antidepressant
Blocks SERT, NET, a-adrenergics, Muscarinics, Histamine, Cardiac Fast Na Channels
AE: Ortho hypotension, reflex tachy (a-blockade). Blurred vision, xerostomia, urinary retention, constipation, aggravation of glaucoma (M-blockade). Sedation, Weight-Gain (H-blockade). Fatal arrhythmias (Cardiac Na blockade)
Nortriptyline
Tricyclic Antidepressant
Blocks SERT, NET (more selective!), a-adrenergics, Muscarinics, Histamine, Cardiac Fast Na Channels
AE: Ortho hypotension, reflex tachy (a-blockade). Blurred vision, xerostomia, urinary retention, constipation, aggravation of glaucoma (M-blockade). Sedation, Weight-Gain (H-blockade). Fatal arrhythmias (Cardiac Na blockade)
Sodium Bicarbonate
Reverse conduction block in TCA induced arrhythmia
Citalopram
SSRI Antidepressant
Block SERT (5-HT reuptake).
AE: Nausea, GI Upset, Diarrhea, sex dysfunction, weight gain. Serotonin Syndrome possible.
Low potential for interactions.
Escitalopram
SSRI Antidepressant
Block SERT (5-HT reuptake).
AE: Nausea, GI Upset, Diarrhea, sex dysfunction, weight gain. Serotonin Syndrome possible.
Low potential for interactions.
Sertaline
SSRI Antidepressant
Block SERT (5-HT reuptake).
AE: Nausea, GI Upset, Diarrhea, sex dysfunction, weight gain. Serotonin Syndrome possible.
Low potential for interactions.
Fluoxetine
SSRI Antidepressant
Block SERT (5-HT reuptake).
AE: Nausea, GI Upset, Diarrhea, sex dysfunction, weight gain. Serotonin Syndrome possible.
Blocks CYP2D6, high interaction potential.
Longer half-life, less likely to have discontinuation syndrome.
Paroxetine
SSRI Antidepressant
Block SERT (5-HT reuptake).
AE: Nausea, GI Upset, Diarrhea, sex dysfunction, weight gain. Serotonin Syndrome possible.
Blocks CYP2D6, high interaction potential.
Short half-life, more likely to have discontinuation syndrome.
Fluvoxamine
SSRI Antidepressant
Block SERT (5-HT reuptake).
AE: Nausea, GI Upset, Diarrhea, sex dysfunction, weight gain. Serotonin Syndrome possible.
Blocks CYP1A2 CYP2C19 CYP3A4; high interaction potential.
Nefazodone
SARI Antidepressant
Block SERT (5HT reuptake) (weakly). Also 5HT2 antagonists (potent).
Hepatotoxic, no longer commonly prescribed.
Trazodone
SARI Antidepressant
Block SERT (5HT reuptake) (weakly). Also 5HT2 antagonists (potent).
Also H1 and a1 blockage. Extremely sedating (main use is hypnotic), and causes priapism.
Venlafaxine
SNRI Antidepressant
Blocks SERT and NET (5-HT and NEpi reuptake)
Potent SERT blocker, needs higher doses to block NET, also inhibits dopamine reuptake weakly.
Fewer CYP450 interactions than SSRI.
Short half-life, discontinuation syndrome more likely.
Used for patients where SSRIs were not effective. Also, Chronic Pain.
Duloxetine
SNRI Antidepressant
Blocks SERT and NET (5-HT and NEpi reuptake) at all doses.
Fewer CYP450 interactions than SSRI.
Used for patients where SSRIs were not effective. Also, Chronic Pain.
Bupropion
NDRI Antidepressant
Inhibits NEpi & Dopamine reuptake. Increases release of both.
AE: Seizures. No sexual dysfunction.
Less effective for anxiety than other Antidepressants. Approved for smoking cessation.