Pharmacology - Antidepressants Flashcards
What are the different types of antidepressants?
- Selective serotonin reuptake inhibitors (SSRIs)
- Serotonin–norepinephrine reuptake inhibitors (SNRIs)
- Tricyclic antidepressants (TCAs)
- Tetracyclic antidepressants (TeCAs)
- Monoamine oxidase inhibitors (MAOIs)
List some examples of SSRIs
- Citalopram
- Fluoxetine
- Sertraline
- Paroxetine
List some examples of SNRIs
- Duloxetine
- Venlafaxine
- Escitalopram
List some examples of TCAs
- Amitriptyline
- Clomipramine
- Opipramol
List some examples of TeCAs
- Mirtazapine
- Amoxapine
- Setiptiline
List some examples of MAOIs
Non-selective
- Isocarboxazid
MAO-B selective
- Selegiline
MAO-A selective
- MetrAlindole
What is the mechanism of action of SSRIs?
- Increase the extracellular level of serotonin
- Limiting its reabsorption (reuptake) into the presynaptic cell
- Increasing the level of serotonin in the synaptic cleft available to bind to the postsynaptic receptor.
What is the mechanism of action of SNRIs?
- Increase the extracellular level of noradrenaline and serotonin
- Limiting its reabsorption (reuptake) into the presynaptic cells
- Increasing the level of both in the synoptic cleft available to bind to the postsynaptic receptor.
What is the mechanism of action of TCAs?
- Blocking the serotonin transporter (SERT) and the norepinephrine transporter (NET), respectively
- Which results in an elevation of the synaptic concentrations of these neurotransmitters
- Therefore an enhancement of neurotransmission
What is the mechanism of action of TeCAs?
- Inhibit the noradrenaline reuptake
- More available in synaptic cleft
- More available to bind to postsynaptic receptors
Noradrenergic and specific serotonergic antidepressant
What is the mechanism of action of MOAIs?
- MAOIs act by inhibiting the activity of monoamine oxidase
- Preventing the breakdown of monoamine neurotransmitters
- Increasing their availability.
What the side effects of SSRIs?
- Serotonin syndrome
- Weight change
- GI Problems
- Pregnancy
- Antidepressant-induced mania
- Sexual
- Emotional blunting
- Hyponatraemia
What the side effects of TCAs?
- Drowsiness
- Dry mouth
- Blurred vision
- Constipation
- Urinary retention
- Lengthening of QT interval
When taking a MAOI what foods do they need to avoid?
- Cheese
- Contain tyramine which can cuase a hypertensive crisis
Can SSRIs be used in pregnancy?
- It is advised that paroxetine be avoided in pregnancy unless the benefits outweigh the risk
- Paroxetine can lead to congenital malformations
What interacts with SSRIs to cause GI bleeding?
NSAIDs
How long should SSRIs be taken for?
6 months AFTER remission of symptoms
What are the features of SSRI discontinutation syndrome?
- increased mood change
- restlessness
- difficulty sleeping
- unsteadiness
- sweating
- gastrointestinal symptoms: pain, cramping, diarrhoea, vomiting
- paraesthesia
What monitoring is needed for Venlafaxine?
Blood pressure monitoring
