week3 anti depressants Flashcards
Fluoxetine
moa, clinical use, side effects, must knows
MOA: SSRI – blocks serotonin reuptake
Use: Depression, bulimia, OCD, panic disorder, PTSD
Side Effects: Insomnia, sexual dysfunction, GI upset, anxiety
Must-Knows:
approved for teens
Longest half-life (weeks); ideal for poor compliance
sertraline
MOA: SSRI
Use: Depression, anxiety, PTSD, OCD, panic disorder
Side Effects: GI distress (very common), sexual dysfunction
Must-Knows:
Most GI side effects among SSRIs
Often used postpartum; low drug transfer in breast milk
citalopram
MOA: SSRI
Use: Depression, anxiety
Side Effects: QT prolongation, sexual dysfunction, dry mouth
Must-Knows:
Dose-dependent QT prolongation
Avoid in patients with cardiac risk or on QT-prolonging drugs
escitalopram
MOA: SSRI (S-enantiomer of citalopram)
Use: Depression, GAD
Side Effects: Generally well tolerated; mild QT prolongation
Must-Knows:
Fewer drug interactions than citalopram
Cleanest SSRI for side effects; often first choice- approved for teens
paroxetine
MOA: SSRI
Use: Depression, GAD, panic, PTSD, PMDD
Side Effects: Sedation, weight gain, anticholinergic effects
Must-Knows:
Worst withdrawal syndrome (short half-life)
Avoid in pregnancy (Category D – teratogenic)
fluvoxamine
MOA: SSRI
Use: OCD (primary), social anxiety
Side Effects: GI upset, sedation, sexual dysfunction
Must-Knows:
CYP1A2 and CYP3A4 inhibitor → many drug interactions
Less used for depression
vortioxetine
MOA: SSRI + 5-HT1A partial agonist, 5-HT3 antagonist
Use: Major depressive disorder
Side Effects: Nausea, constipation, sexual dysfunction
Must-Knows:
Cognitive-enhancing effects (may help with “brain fog”)
Less weight gain than older SSRIs
vilazodone
MOA: SSRI + 5-HT1A partial agonist
Use: Depression
Side Effects: GI upset, sexual dysfunction, insomnia
Must-Knows:
Take with food for proper absorption
Risk of serotonin syndrome when combined with other serotonergic drugs
List common SSRI’s
Fancy Fluoxetine
Cool Citalopram
People Paroxetine
Find Fluvoxamine
Super Sertraline
“Calm”
Escitalopram Emotions
very Vortioxetine
vibrant Vilazodone
venlafaxine
MOA: SNRI – Inhibits 5-HT and NE reuptake (NE effect stronger at higher doses)
Clinical Use:
Major depressive disorder
Generalized anxiety disorder
Panic disorder
Social anxiety
PTSD
Side Effects:
Increased BP (dose-dependent)
Insomnia, anxiety, GI upset
Sexual dysfunction
Discontinuation syndrome if stopped abruptly
Must-Knows:
Avoid in hypertensive patients
**Short half-life **→ taper slowly to avoid withdrawal symptoms
duloxetine
MOA: SNRI – Balanced inhibition of 5-HT and NE reuptake
Clinical Use:
Depression +** chronic pain**
Diabetic peripheral neuropathy
Fibromyalgia
Chronic musculoskeletal pain
Side Effects:
Nausea, dry mouth
Fatigue, dizziness
Hepatotoxicity (rare)
Mild ↑ in BP
Must-Knows:
Great for patients with depression + pain
Avoid in patients with liver disease
Fewer sexual side effects than SSRIs
desvenlafaxine
MOA: SNRI – Active metabolite of venlafaxine
Clinical Use:
Major depressive disorder
Side Effects:
Similar to venlafaxine: ↑ BP, GI upset, insomnia
Must-Knows:
No advantage over venlafaxine, but has more predictable pharmacokinetics
Useful when patients can’t tolerate venlafaxine’s metabolism
levomilnacipran
MOA: SNRI – Inhibits NE > 5-HT reuptake (unlike others)
Clinical Use:
Major depressive disorder
Side Effects:
Nausea, constipation
Increased HR and BP
Sexual dysfunction
Must-Knows:
Stronger norepinephrine activity → may cause sympathetic side effects
Less commonly used SNRI
Avoid in uncontrolled hypertension
Bupropion
norepinephrine dopamine reuptake inhibitor
short half life
side effects- jitteriness
less sexual SE.
also used for smoking cessation.
Trazodone
moa- 5-HT and NE reuptake inhibition, alpha-1 and alpha-2, muscurinix and histamine antagonism
side effects- rare priapism
uses- insonmia becuase of its powerful sedation effects
Mirtazepine
tetracyclic antidepressant, alpha 2 and 5-HT antagonist
side effects- appetite stimulation, fewer sexual SE, low dose, more sedation.
