-
imipramine
- antidepressant, TCA
- MOA: inhibits 5HT and NE reuptake sites
- USES: major depression and axiety disorders, including OCD, neuropathic pain, nocturnal enuresis, urinary incontinence
- AE: drowsiness, weight gain, cardiac arrhythmias, narrow TI, lethal overdose
-
amitriptyline
- antidepressant, TCA
- MOA: inhibits 5HT, and NE reutake sites
- USES: major depression, anxiety, neuropathic pain,
- AE: cardiac arrhythmias, lethal if overdose
-
clomiparamine
- antidepressant, TCA
- MOA: inhibits 5HT and NE reuptake sites
- USES: major depression, anxiety, neuropathic pain, nocturnal enuresis, very good in OCD b/c favors 5HT
- AE: cardiac arrhythmias, letal in overdose
-
phenelzine
- antidepressant, MAOI
- MOA: decrease breakdown of NE, 5HT, and DA, so increase the amount released from vesicles
- USES: severe depression, and pts resistant to other antidepressants, useful in pts with PTSD
- AE: HTN crisis in tyramine rich foods, serotonin syndrome
-
selegiline
- antidepressant, MAOI, patch
- MOA: inhibits the break down of NE, 5HT, and DA
- USES: major depression disorder in adults, parkinsons disorder (low doses increase DA)
- AE: headache, insomnia, weight loss
- avoids going through the stomach so no HTN crisis b/c no tyramine food interactions
-
fluoxetine
- antidepressant, SSRI
- MOA: inhibits 5HT reuptake transport sites, autoreceptors will still work to shut down the release of 5HT
- USES: major depression and anxiety, eating disorders, sleep disorders
- AE: favorable SE, GI effects, sexual effects (switch or add bupropion to limit sexual AE)
- inhibits p450 enzymes
-
paroxitine
- antidepresant, SSRI
- MOA: inhibits 5HT reuptake
- USES: major depression and anxiety
- AE: favorable AE, sexual AE (give buproprion to limit)
- discontinuation syndrome if taken off too quickly
- inhibits p450 enzymes
-
escitalopram
- antidepressant, SSRI
- MOA: inhibits 5HT reuptake
- USES: major depression and anxiety
- AE: favorable, sexual AE (give buprpion to limit)
-
sertaline
- antidepressant, SSRI
- MOA: inhibits neuronal reuptake of 5HT
- USES: depression, OCD, panic disorder, PTSD, SAD
- AE: nausea, anorexia, sleepiness, sexual AE (less than with fluoxetine and paroxitine)
-
duloxetine
- antidepressant, SNRI
- MOA: 5HT and NE reuptake inhibitor
- USES: anxiety disorders, major depression, fibromyalgia, neuropathic pain disorders
- AE: liver toxicity warning, same AE as SSRI;s
- no p450 interactions
-
venlafaxine
- antidepressant, SNRI
- MOA: 5HT and NE reuptake inhibitor
- USES: anixety disorders, major depression, fibromyalgia, neuropathic pain disorders
- AE: same as SSRI
- no p450 interactions
-
desvenlafaxine
- antidepressant, SNRI
- MOA: 5HT and NE reuptake inhibitor
- USES: major depression and anxiety, fibromyalgia, neuropathic pain
- AE: same as SSRIs
- no p450 interactions
-
trazodone
- atypical antidepressants
- MOA: weak inhibitor of 5HT reuptake, 5HT antagonist
- USES: NOT USED, b/c of sedative properties
- AE: orthostatic HTN, dizziness, headache
-
bupropion
- atypical antidepressnt
- MOA: NE and DA uptake inhibitor
- USES: all types of depression, can use as monotherapy or adjunct, smoking cessation, can counteract sexual dysfunction if given in combo
- AE: dry mouth, nervousness,
- safe to use in cardiac pts,
-
mirtazapine
- atypical antidepressant
- MOA: alpha 2 antagonist on central neurons - increases NE
- USES: second line or as adjunct to other antidepressants
- AE: sedating, weight gain - prevented by exercise, reduced sexual AE - can be added to limit these effects
-
agomelatine
- atypical antidepressant
- MOA: 5HT antagonist, disinhibits NE and 5HT release - increasing their release
- USES: highly efficacious antidepressant restores circadian rhythms, improves sleep quality
- AE: few SE
- not yet approved
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