Pharmacology of Antidepressants Flashcards
Describe all six drugs that Induce depression.
- Beta-Blockers (Atenolol)
- Calcium Channel Blockers (CCBs)
- Benzodiazepines (Diazepam)
- Dopaminergic agents (Levodopa, alpha-methyldopa)
- Corticosteroids (Methylprednisolone)
- Anabolic Steroids (Testosterone)
Describe the treatment of depression
- Psychotherapy
- Pharmacotherapy
>tricyclic antidepressants
>Selective Serotonin Reutake Inhbitors(SSRIs)
>Serotonin-Norepinephrine Reuptake Inhbitors (SNRIs)
>5HT2 antagonists
>MOnoamine Oxidase Inhibitors
>Atypical Antidepressants
>Lithium
Describe the Agents, MOA, Indications, DI, A/E of Selective Serotonin Reuptake Inhibitors (SSRIs)
Agents
FAP SEC
Fluoxetine, Paroxetine, Atomoxetine, Citalopram, Escitalopram, Sertraline
MOA: Prevent the reuptake of 5-HT, leaving more 5-HT to stimulate postsynaptic 5-HT1 receptors.
Indications: MAJOR DEPRESSION, Anxiety disorders (PTSD, PD, OCD, PDD etc)
Side Effects: N, D, Anxiety, Restlessness, Insomia, Sexual Dysfunction
Drug Interactions: Do not use with MAOI (Monoamine oxidase inhibitor).
Describe the Indications, D/I, A/E, C/E, Dose of Fluoxetine
MOA: Prevent the reuptake of 5-HT, leaving more 5-HT to stimulate postsynaptic 5-HT1 receptors.
Dose: 20 to 40 mg po od, note cardiovascular and suicide risk in the elderly.
Indications: MAJOR DEPRESSION, Anxiety disorders (PTSD, PD, OCD, PDD etc)
Side Effects: N, D, Anxiety, Restlessness, Insomia, Sexual Dysfunction
Drug Interactions: Do not use with MAOI (Monoamine oxidase inhibitor).
Fluoxetine can inhbit Cyt p450 isoenzymes and this inhibit the metabolism of certain B-Blockers including propranolol and metoprolol, leading to hypokinesia and bradycardia.
Describe the Indications, D/I, A/E, C/E of Paroxetine
MOA: Prevent the reuptake of 5-HT, leaving more 5-HT to stimulate postsynaptic 5-HT1 receptors.
Indications: MAJOR DEPRESSION, Anxiety disorders (PTSD, PD, OCD, PDD etc)
Side Effects: N, D, Anxiety, Restlessness, Insomia, Sexual Dysfunction
Drug Interactions: Do not use with MAOI (Monoamine oxidase inhibitor).
Describe the Indications, D/I, A/E, C/E of Atomoxetine
MOA: Prevent the reuptake of 5-HT, leaving more 5-HT to stimulate postsynaptic 5-HT1 receptors.
Indications: MAJOR DEPRESSION, Anxiety disorders (PTSD, PD, OCD, PDD etc)
Side Effects: N, D, Anxiety, Restlessness, Insomia, Sexual Dysfunction
Drug Interactions: Do not use with MAOI (Monoamine oxidase inhibitor).
Describe the Indications, D/I, A/E, C/E of Citalopram
MOA: Prevent the reuptake of 5-HT, leaving more 5-HT to stimulate postsynaptic 5-HT1 receptors.
Indications: MAJOR DEPRESSION, Anxiety disorders (PTSD, PD, OCD, PDD etc)
Side Effects: N, D, Anxiety, Restlessness, Insomia, Sexual Dysfunction
Drug Interactions: Do not use with MAOI (Monoamine oxidase inhibitor).
Describe the Indications, D/I, A/E, C/E of Escitalopram
MOA: Prevent the reuptake of 5-HT, leaving more 5-HT to stimulate postsynaptic 5-HT1 receptors.
Indications: MAJOR DEPRESSION, Anxiety disorders (PTSD, PD, OCD, PDD etc)
Side Effects: N, D, Anxiety, Restlessness, Insomia, Sexual Dysfunction
Drug Interactions: Do not use with MAOI (Monoamine oxidase inhibitor).
Describe the Indications, D/I, A/E, C/E of Sertraline
MOA: Prevent the reuptake of 5-HT, leaving more 5-HT to stimulate postsynaptic 5-HT1 receptors.
Indications: MAJOR DEPRESSION, Anxiety disorders (PTSD, PD, OCD, PDD etc)
Side Effects: N, D, Anxiety, Restlessness, Insomia, Sexual Dysfunction
Drug Interactions: Do not use with MAOI (Monoamine oxidase inhibitor).
Describe the Agents, MOA, Indications, and A/E of SELECTIVE Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)
Agents(Selective SNRIs): Venlafaxine, Desvenlafaxine, Duloxetine.
MOA: Prevent the reuptake of 5-HT, NE and DA(weak), so that there’s more 5-ht and NE to stimulate postsynaptic repceptors.
Indications:MAJOR DEPRESSION, Anxiety disorders (PTSD, PD, OCD, PDD etc)
Adverse Effects: N, D, Anxiety, Restlessness, Sexual Dysfunction, Increased Blood Pressure, Agitation.
Repeatition
Describe the MOA, Indications and A/E of Venlafaxine
MOA: Prevent the reuptake of 5-HT, NE and DA(weak), so that there’s more 5-ht and NE to stimulate postsynaptic repceptors.
Indications: MAJOR DEPRESSION Anxiety disorders (PTSD, PD, OCD, PDD etc)
Adverse Effects: N, D, Anxiety, Restlessness, Sexual Dysfunction, Increased Blood Pressure, Agitation.
Repeatition
Describe the MOA, Indications and A/E of Desvenlafaxine
MOA: Prevent the reuptake of 5-HT, NE and DA(weak), so that there’s more 5-ht and NE to stimulate postsynaptic repceptors.
Indications: MAJOR DEPRESSION, Anxiety disorders (PTSD, PD, OCD, PDD etc)
Adverse Effects: N, D, Anxiety, Restlessness, Sexual Dysfunction, Increased Blood Pressure, Agitation.
Repeatition
Describe the MOA, Indications and A/E of Duloxetine
MOA: Prevent the reuptake of 5-HT, NE and DA(weak), so that there’s more 5-ht and NE to stimulate postsynaptic repceptors.
Indications: MAJOR DEPRESSION, Anxiety disorders (PTSD, PD, OCD, PDD etc)
Adverse Effects: N, D, Anxiety, Restlessness, Sexual Dysfunction, Increased Blood Pressure, Agitation.
Describe the Agents, MOA, Indications, and A/E of Tricyclic Antidepressants(TCAs)
Agents(TCAs): Imipramine, Amitriptyline, Amoxapine, Doxepin, Mirtazapine etc.
MOA(TCAs): Prevents the reuptake of 5-ht and NE by neurona; membrane. It also downregulates Beta-adrenergic and 5-ht receptors.
Indications: Major Depression AND Anxiety disorders.
Adverse effects: Antimuscarinic(fry mouth, constipation, urinary retention), Orthostatic hypotension due to peripheral alpha-1-blockade.
Describe the Agents, MOA, Indications, and A/E of Imipramine, Clomipramine and Trimipramine.
MOA(TCAs): Prevents the reuptake of 5-ht and NE by neurona; membrane. It also downregulates Beta-adrenergic and 5-ht receptors.
Indications: Major Depression AND Anxiety disorders.
Adverse effects: Antimuscarinic(fry mouth, constipation, urinary retention), Orthostatic hypotension due to peripheral alpha-1-blockade.