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What is Citalopram (Celexa)
- -SSRI
- -First line agent
- -Side effects: Mostly Sexual dysfunction and GI effects
- -Works with R and S isomer
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What is Escitalopram (Lexapro)?
- -SSRI
- -First line agent
- -Better side effect profile: mostly GI Effects
- -Can be used for GAD
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What is Fluoxetine (Prozac, Sarafem)?
- -SSRI
- -First line agent
- -Side effects: Insomnia, Sexual dysfunction, GI effects
- -Can be used for bulimia, premenstrual dysphoric disorder, pain management and promoting smoking cessation
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What is Fluoxetine/Olanzapine (Symbyax)?
- -SSRI
- -Unique combo for those with bipolar and depression
- -Only drug approved for acute treatment-resistand depression
- -Side effects: sexual dysfunction, weight gain, hyperglycemia, and high cholesterol
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What is Fluvoxamine (Luvox)?
- -SSRI
- -First line agent
- -Approved for OCD.
- -Side effects: similar to other SSRIs
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What is Paroxetine (Paxil, Paxil CR, Pexeva)?
- -Potent SSRI
- -First line agent
- - Common side effect: nausea, causes sexual side effects, GI effects
- -May be teratogenic.
- -Given a once daily basis
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What is Sertraline (Zoloft)?
- -SSRI
- -Given once daily with or without food.
- -Side effects: sexual dysfunction, usually returns to normal after 2-3 days and GI effects
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What is Bupropion (Wellbutrin, Aplenzin)?
- -Novel, NDRI
- -Only one with dopamine reuptake inhibition and does not affect serotonin systems
- -Good side effect profile, mostly insomnia
- -Do not give with drugs that increase dopamine
- -Off sets SSRI mediated sexual inhibition
- -Do not give with seizure disorders!
- -Can be used as a smoking cessation agent
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What is Venlafaxine (effexor)?
- -Novel, SNRI
- -At lower doses causes serotonin to be enhanced, at medium to high doses NE reuptake is inhibited, and at high doses dopamine levels are increased
- -Few side effects, other than high blood pressure
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What is Duloxetine (Cymbalta)?
- -Novel, SNRI
- -Acts like Venlafaxine (Effexor)
- -Good side effects, mostly nausea
- -Approved for diabetic neuropathic pain
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What is Trazodone (desyrel)?
- -Novel
- -Prescribed for sleep, side effect sedation
- -Adverse reaction-priapism, if this happens patient should stop medication and call prescriber
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What is Mirtazapine (Remeron)?
- -Novel, alpha 2 antagonist with 5 HT2 and 5 HT3.
- -Approved for Major depression
- -Increase NE and serotonin
- -An increase in serum cholesterol level occurs
- -Side effect profile good, sedation is high
- -Dissolvable tablet available
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What is Amitriptyline (Elavil)?
- -TCA
- -Highly anticholinergic and one of the most sedating and cardiotoxic antidepressants
- -Side effects: orthostatic hypotension common
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What is Amoxapine (Asendin)?
- -TCA
- -Metabolite of antipsychotic drug loxapine
- -Beneficial for psychotic and depressed patients
- -Side effects such as EPSE and TD
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What is Desipramine (Norpramin)?
- -TCA
- -Metabolite of imipramine
- -Activating antidepressant so good for apathetic, lethargic, and hypersomnic patients
- -Most toxic TCA
- -Does have certain effects on the heart so use with care when dealing with certain age groups
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What is Imipramine (Tofranil)?
- -TCA
- -Anticholinergic properties, sedating and causes sexual dysfunction
- -Proven effective in treating childhood enuresis, however use care with child
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What is Nortriptyline (Aventyl, Pamelor)?
- -TCA
- -Sedating but other than that has a good side effect profile
- -Least toxic TCA
- -Often prescribed for older adult patients who are depressed, agitated and suffering from insomnia
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What is Phenelzine (Nardil)?
-MAOI
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What is Tranylcypromise (Parnate)?
- -MAOI
- -Side effects: Insomnia, anticholinergic, orthostatic hypotension
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What is Moclomemide (Menerix)?
- -MAOI, inhibits only MAO-A
- -Side effects: Sexual dysfunction, insomnia, orthostatic hypotension
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What is Seligiline (Emsam)?
- -MAOI
- -Anticholinergic and orthostatic hypotension as side effects
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What are serious side effects of SSRIs?
- -Energizing effect on suicide risk (happens 2 weeks after patient starts taking drug)
- -Serotonin syndrome (Overdose of serotonin, Shivering most common side effect that can be seen!)
- -Withdrawal syndrome
- -Avoid St John Wort and MAOI
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What are serious side effects of Novel antidepressants?
- -Energizing effect on suicide risk
- -Priapism (Desyrel)
- -Seizures (Wellbutrin)
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What are serious side effects of TCA?
- -Energizing effect on suicide risk
- -Cardiac arrhythmias
- -Very lethal only give 7 day supply
- -Do not mix with alcohol, MAOI, OTC stimulates, antihypertensive
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What are serious side effects of MAOIs?
- -Energizing effect on suicide risk
- -Hypertensive Crisis
- -Has many food-drug (avoid tyramine) interactions and drug-drug interactions
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