Week 28 - Depression CBL Drugs

Question 1

SSRI

Answer 1

Example: Citalopram (Celexa), Escitalopram (Cripralex) Fluoxetine (Prozac)

MOA: Blocks seratonin reuptake

Common SE: Nauzeau, diarrhea, restlessness, anxiety, dizziness, insomnia

Comments: Well tolerated. Some SSRIs have potential drug drug interactions at the cytochrome P450 level.

Question 2

SNRI

Answer 2

Example: Venlafaxine, Desvenlafaxine, Duloxetine

MOA: Venlafaxine (seratonin uptake inhibitor, more NA and DA effect)), Desvenlafaxine (inhibits 5HT and NA reuptake), Duloxetine (potent inhibitor of 5HT and NA reuptake)

Common SE: Similar to SSRIs with lower incidence of weight gain

Question 3

RIMA

Answer 3

Example: Moclobermide (Mannerix)

MOA: Reversible inhibitor of MAO-A (ie. reduces levels of NA, DA, 5HT)

Common SE: Insomnia, hypomania, headache, tremor. Orthostatic HT, palpitations.

Comments: Better than old MAOs. Washout period.

Question 4

MAO1

Answer 4

Example: Phelzine (Nardil) Tranycypromine (Parnate)

Question 5

Novel or Atypical Agents

Answer 5

Example: Buproprion (Wellbutrin) Mirtazapine (Romeron) Tranzaodone (Desyrel)

MOA: Example: Buproprion (NA DA uptake inhibitor) Mirtazapine (NOA and specific serotingergic antidepressant) Tranzaodone (5HT2 receptor antogonist)

SE: (Bup. = anxiety, restlessness and insomnia) (Mirt - Sedation and wait gain) (Tranz = Sedation and postural hypotension)

Comments: Used from smoking session, less weith gain and sexual disfunction than SSRIs.

Question 6

TCA

Answer 6

Example: Amitriptyline (Elavil), Clomipramine…

MOA: Non-selective inhibition of 5HT and NA reuptake.

SE: anticholinergic, antihistamine

Comment: Amitriptyline and clomipramine second line.