-
4 tricyclic antidepressants
- amitriptyline - elavil
- desipramine - norpramin
- imipramine - tofranil
- nortriptyline - aventyl
-
8 heterocyclics antidepressants
- amoxapine - asendin
- buproprion - wellbutrin
- maprotiline - ludiomil
- mirtazapine - remeron
- nefazodone - serzone
- trazadone - desyrel
- venlafaxine - effexor
- duloxetine - cymbalta
-
3 MOAI antidepressants
- phenelzine - nardil
- tranylcypromine - parnate
- selegiline - eldepryl
-
6 SSRI antidepressants
- fluoxetine - prozac
- fluvoxamine - luvox
- paroxetine - paxil
- citalopram - celexa
- escitalopram - lexapro
- sertraline - zoloft
-
4 major therapeutic uses for TCAD's
- depression
- bipolar disorder
- neuropathic pain
- enureses
-
4 Tx of TCAD toxicity
- gastric lavage
- ingestion of activated charcoal
- physostigme - crossses BBB
- propranolol, lidocaine, phenytion(supress seizure activity and arrythmias)
-
advantage of SSRI's over TCAD
- less hypotension, sedation, or anticholinergic effects; less seizure risk
- OD doesn't cause cardiac toxicity
-
disadvantage of SSRI's over TCAD
more agitation/insomnia and sexual dysfunction
-
3 AE of SSRI
- HA
- seratonin syndrome
- bleeding disorders
-
drugs of choice for atypical depression
MAOI's
-
TCAD effects in normal sujects 3
- anticholinergic actions
- sleepiness, lightheadedness
- no stimulating or mood elevation effects
-
TCAD effets in depressed subjects
- elevation in mood only after 2-3 wks
- not used PRN
-
TCAD 5 CNS AE
- disorientation
- sedation
- neurological disturbances
- aggravation of psychosis
- seizures
-
TCAD Cardiovascular AE 2
- orthostaic hypotension
- cardiac toxicity; tachy and arrhythmias
-
7 AE of TCAD
- CNS
- cardiovascular
- anticholineric effects
- weight gain
- diaphoresis
- allergic reactions
- yawngasm
-
SSRI
T1/2 - 2days
active metabolite T1/2 7 days
4 wks to steady state and also washout
fluoxetine - prozac
-
SSRI
blocks uptake of 5HT & DA
minimal effects of seizure threshold
SE - diarrhea
NAS & PPHN (when used in late preg) drug interaction with pimozide (arrhythmias)
sertraline - zoloft
-
SSRI
ind - OCD & anxiety
rapidly absorbed from GI tract
SE - constipation
weight gain
abnormal liver function
fluvoxamine - luvox
-
SSRI
ind - social phobia
panic disorder
paroxetine - paxil
-
SSRI
labeled for major depression but used in anxiety
SE - somnolence
dry mouth
NAS
citalopram - celexa
-
2 S/NRI's
- venlafaxine - effexor
- duloxetine - cymbalta
-
S/NRI
low dose - SSRI
higher dose - NE, DA
little cholinergic, histaminic or alpha block
serious reactions with MAOI's
SE - weight loss
hyponatremia - elderly
neonatal withdrawal syndrome
venlafaxine - effexor
-
S/NRI
does not inhibit MAO
ind -pain of diabetic peripheral neuropathy
fibromyalgia
highly protein bound
AE - blurred vision
duloxetine - cymbalta
-
heterocyclic
2nd gen
metabolite of loxapine - DA antagonism
ind - useful for depression in psychotic pts?
EPS and amenorrhea
amoxapine - asendin
-
heterocyclic
2nd gen
most important action blocks NE reuptake
high doses associated with seizures
maprotiline - ludiomil
-
heterocyclic
3rd gen
low dose - like SSRI
high dose - block NE
block DA
venlafaxine - effexor
-
heterocyclic
3rd gen
fewer adverse sexual effects than SSRI
rare but dangerous hepatotoxicity
nefazodone - serzone
-
heterocyclic
3rd gen
5HT2A and alpha-adrenoreceptor antagonism
mirtazapine - remeron
-
heterocyclic
3rd gen
suppress appetite
less adverse sexual effects
bupropion - wellbutrin
-
3 therapeutic uses of bupropion - wellbutrin
- depression
- smoking cessation - zyban
- seasonal affective disorder
-
MAO MOA
- converts monoamine neurotransmitters into inactive products
- MAO-A - inhibits NE &5HT
- MAO-B - inhibits DA and NE,5HT in high doses
- inactivates tyramine & biogenic amines
-
MAOI
transdermal
lower risk of hypertensive crisis
selegiline - emsam
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