1. Which two pathways do anti-depressants target?
    • Serotonin
    • Norepinephrine
  2. How long does it take to see effects of anti-depressants?
    2-4 weeks
  3. What drugs are used for panic disorder w/ or w/o agoraphobia? (4)
    • SSRIs
    • MAOIs
    • TCAs
    • high potency benzodiazepines (alprazolam and clonazepam)
  4. What drugs are used for OCD?
    • Serotonin selective tricyclic clompiramine (Anafranil)
    • SSRIs at high doses (Fluoxetine at 60-80 mg)
  5. Which is more responsive to pharmacotherapy - Obsession or Compulsions?
  6. How long does it take for S/S to respond to pharmacotherapy in OCD?
    12 weeks
  7. Binging and purging behavior associated with bulimia is responsive to which drugs? (3)
    • SSRIs (first line because of low SE profile)
    • TCAs
    • MAOIs
  8. What is the MOA for TCAs?
    Block presynaptic reuptake of serotonin and norepinephrine.
  9. List SSRIs (6)
    • Fluoxetine (Prozac)
    • Sertraline (Zoloft)
    • Paroxetine (Paxil)
    • Fluvoxamine (Luvox)
    • Citalopram (Celexa)
    • Escitalopram (Lexapro)
  10. List SNRIs (2)
    • Venlafaxine (Effexor)
    • Duloxetine (Cymbalta)
  11. List Serotonin receptor agonists and anatagonists (2)
    • Trazodone (Desyrel)
    • Nefazodone
  12. List NDRIs (1)
    Bupropion (Wellbutrin)
  13. List TCAs (4)
    • Nortriptyline (Pamelor)
    • Imipramine (Tofranil)
    • Despiramine (Norpramin)
    • Clomipramine (Anafranil)
  14. List MAOIs (3)
    • Tranylcypromine (Parnate)
    • Phenelzine (Nardil)
    • Isocarboxazid (Marplan)
  15. What kind of drug is Mirtazapine (Remeron)
  16. Which anti-depressants are generally well-tolerated and considered 1st line tx for major depression? (5)
    • SSRIs
    • Bupropion (Wellbutrin)
    • Duloxetine (Cymbalta) SNRI
    • Venlafaxine (Effexor) SNRI
    • Mirtazapine (Remeron)
    • All of the above have low sedative, anticholinergic, and orthostatic hypotensive effects
    • Esp useful in pts with cardiac conduction disease, constipation, glaucoma, prostatic hypertrophy
  17. Which TCAs have the least sedative, anti-cholinergic, and orthostatic effects? (2)
    • Nortriptyline (Pamelor)
    • Desipramine (Norpramin)
    • Esp useful in younger, healthier people
  18. What is useful for pts on TCA to determine appropriate dosing?
    Serum levels
  19. What should be monitored regularly in children and adolescents started on anti-depressants?
    Suicidal thinking
  20. What are SE of SSRIs? (6)
    • Nausea
    • Headache
    • Neuromuscular restlessness (resembles akathisia)
    • Insomnia/sedation
    • Delayed ejaculation/anorgasmia
  21. What can dangerous condition can result when SSRIs are combined with MAOIs?
    Fatal serotonin syndrome
  22. What are the SE of TCAs? (4)
    • Orthostatic hypotension (most common)
    • Anticholinergic effects
    • Cardiac toxicity (sinus tachycardia, v-fib, prolongation of PR, QRS, and QT, heart block, ST and T-wave changes)
    • Sexual dysfun
  23. What are patients who take MAOIs at risk for?
    Severe hypertensive crises (tyramine crisis) w/ potential MI or stroke
  24. What foods should be avoided w/ pts that take MAOIs?
    • Meats/fish, beer, red wine, cheese, overripe fruits
    • Over-the-counter pain meds
  25. Which MAOI can cause insomnia and agitation?
    Tranylcypromine (Parnate)
  26. Which MAOI cna cause daytime somnolence?
    Phenelzine (Nardil)
  27. Vagal nerve stimulation is useful for what?
    treatment-refractory depression
Card Set
Anti-depressant drugs