SSRIs Flashcards
- MOA: inhibition of SERT
- Use: treatment of MAJOR DEPRESSION but also GAD, PTSD, OCD, panic disorder, PMDD and bulimia
- metabolized to active product which may have greater plasma concentration than the parent and has a half-life 3x longer -> important since serotonin syndrome can occur if MAOI is given within 4 weeks of discontinuing this drug
Fluoxetine
Prozac
MOA: highly selective blockade of SERT with little effect on NET
-increases serotonergic synaptic activity
-slower changes in signaling pathways & neurotrophic activity
Use: major depression, anxiety disorders, panic disorder, OCD, PTSD, perimenopausal vasomotor symptoms, eating disorder (bulimia)
Metab: Half-life 15-75 hrs; orally active
Toxicity: well tolerated but causes sexual dysfunction, risk of serotonin syndrome with MAOIs
Interactions: some CYP inhibition (fluoxetine, fluvoxamine, paroxetine)
sertraline (Zoloft)
paroxetine (Paxil)
citalopram (Celexa)
fluvoxamine
MOA: inhibition of 5-HT reuptake
low or minimal inhibition of CYP450
Use: Adult major depressive disorder, Adult generalized anxiety disorder
Metab: half-life 27-32 hrs, peak 3-8 hrs
Side Effects: slight increase in suicidal thoughts, anxiety, agitations, increased postpartum depression with discontinuation during pregnancy, sexual dysfunction, decreased libido, anorgasm, nausea, diarrhea, anorexia, vomiting, flatulence and dypepsia (all from effects on 5HT3 receptor)
Interactions: significantly increases concentrations of desipramine (tricyclic antidepressant) and metoprolol (Lopressor - HTN)
escitalopram
Lexapro
