CNS 2 TEST 1.2

SSRI (PROZAC)

LONG 1/2 LIFE (NORFLUOXETINE METABOLITE SO GREAT FOR NONCOMPLIANCE)

• 20-60MG/DAY
• 90MG/DAY MAX

INHIBITS 2D6, 3A3/3A4

ACTIVATING - SO TAKE IN MORNING

HA, STOMACH UPSET, WEIGHT LOSS, SEXUAL DYSFUNCTION

SSRI (ZOLOFT)

50-200MG/DAY

INHIBITS 2Cs, 2D6

ACTIVATING

INTERMEDIATE 1/2 LIFE, SO COULD LEAVE WITHDRAWAL SYMPTOMS (FLU LIKE)

SSRI (PAXIL)

20-60MG/DAY

*LEAST ACTIVATING + ANTICHOLINERGIC SO NOT FOR WEARY/MOTOR RETARDED

POTENT 2D6 INHIBITOR

INTERMEDIATE 1/2 LIFE SO WITHDRAWAL SYMPTOMS

INCREASE IN CONGENITAL MALFORMATIONS, PREGNANT WOMEN STAY AWAY (ACCORDING TO ONE STUDY AT LEAST)

POSSIBLE TERATOGEN

SSRI (CELEXA) R & S ISOMERS

20-60MG/DAY

• 3A4 INHIBITOR
• 2D6 INHIBITOR (WEAK)

• POSSIBLY LESS SEXUAL DYSFUNCTION
• WITHDRAWAL SYMPTOMS
• HIGHLY SERT SELECTIVE
• ACTIVATING

SSRI (FOR OCD, NOT MDD) (LUVOX)

50-300MG/DAY

• INDICATED FOR OCD
• LONG 1/2 LIFE

INHIBITS 1A2, 3A4, 2C19

• WITHDRAWAL SYNDROME
• N&V STOMACH ISSUES, AGITATION, INSOMNIA, SEXUAL DYSFUNCTION

SNRI (EFFEXOR/PRISTIQ)

• 37.5-225MG/DAY
• SHORT 1/2 LIFE SO BID
• LOWEST PROTEIN BINDING

MINOR 2D6 INHIBITOR, FEW DRUG INTERACTIONS

DOSE RELATED HTN DUE TO NE COMPONENT, SO MORE DANGEROUS IN OVERDOSE CASES

• SNRI (CYMBALTA)
• ALSO FOR DIABETIC NEUROPATHY/PAIN

• 30-90+MG/DAY
• TMAX 6HRS, 1/2 LIFE 15HRS

• METABOLIZED BY 1A2 AND 2D6, SO INHIBITORS OF THESE WILL INCREASE CYMBALTA CONCENTRATIONS
• INHIBITS 2D6 MODERATELY

NAUSEA, DRY MOUTH, CONSTIPATION, INSOMNIA, DIZZINESS

DAT/NET BLOCKER (WELLBUTRIN/ZYBAN)

• CONTROLLED RELEASE UP TO 200MG BID
• EXTENDED RELEASE QD <450MG/DAY

*LOWERS SEIZURE THRESHOLD

*LESS SEXUAL DYSFUNCTION THAN SSRIs, AND NO WITHDRAWAL

AGITATION, NAUSEA, INSOMNIA, PSYCHOSIS, DOSE RELATED SEIZURES

DRUG INTERACTIONS WITH ANTIEPILEPTICS, AND RITONAVER WOULD INCREASE LEVELS OF BUPROPION

• (DESYREL)
• MORE FOR SLEEP AT 50MG THAN ANTIDEPRESSANT

3A4 INHIBITOR, SO BAD WITH RITONIVIR AND BENZOS

COMBINE WITH SSRIs AND MAOIs FOR SEROTONIN SYNDROME

PRIAPISM

REMERON

ANTIHISTAMINIC AND SEDATIVE AT LOW DOSES, NOT SO MUCH AT HIGHER DOSES

• WEIGHT GAIN
• LIVER ENZYME ELAVATION (MONITOR LFTs)

METABOLIZED BY 3A4, 2D6, 1A2, 2C9, SO VERY FEW DRUG INTERACTIONS