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Imipramine
- Tricyclic antidepressant (TCA); blocks reuptake of serotonin and NE
- Slow onset of clinical effectiveness (3-4 weeks); anticholinergic effects, hypotension, weight gain, CV effects, secual dysfunction, sedation; drug interactions
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Desipramine
- N-demethylated TCA; blocks reuptake of NE and serotonin
- Slow onset of clinical effects; less sedating than imipramine otherwise SE as with imipramine
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Fluoxetine (Prozac)
- Depression/representative selective serotonin reuptake inhibitor (SSRI)
- Slow onset of clinical effects; less cardiotoxicity and weight gain than TCAs; produces anticholinergic effects and sexual dysfunction
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Tranlcypromine (Parnate)
- Depression (second line)/ Increases level of synaptic NE and/or serotonin by monoamine oxidase (MOA) inhibition
- Slow onset of clinical effects; cardiotoxicity; drug interactions and foods containing tyramine (CHEESE EFFECT) can cause hypertensive crisis
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Bupropion (Wellbutrin and Zyban)
- Relatively selective dopamine reuptake inhibitor
- Used for both depression (having less sexual side effects) and tobacco cessation
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Lithium
Mood Stabilizer
- Mood stabilizer used in bipolar disorder, especially manic phase. Mechanism poorly understood
- Target blood level at 0.9 - 1.4 mEq/L.
- Toxic at levels > 2mEq/L
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Carbamazepine
"Mood stabilizer"
Anticonvulsant used in bipolar illness; mechanism related to rapid cycling
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Divalproex
"Mood stabilizer"
A form of valproic acid; anticonvulsant; same rationale as carbamazepine
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Chlorpromazine
Antipsychotic drug
- Prototypic aliphatic phenothiazine; used for psychoses, acute mania, Tourette's, intractable hiccough, stimulant OD, emesis/dopamine (D2) receptor blocker
- Mental slowing, pseudoparkinsonianism (EPS), tardive dyskinesia, hypotension, anticholinergic effects, hormonal effects (a "high dose" antipsychotic)
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Trifluoperazine
- Same uses as chlorpromazine; prototypic piperazine phenothiazine; potent, relatively specific dopamine receptor blocker
- Same as chlorpromazine with high incidence of pseudoparkinsonism
- "Low dose"
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Thioiridazine
- Same uses as chlorpormazine; prototypic piperidine phenothiazine; less specific dopamine receptor blocker with significant antimuscarinic blockade
- Same as chlorpromazine with lower indicence of pseudoparkinsonism and higher incidence of anticholinergic SEs
- "High dose"
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Haloperidol
- Same uses as chlorpromazine; butyrophenone antipsychotic; potent, specific dopamine receptor blocker
- Same as pehnothiazines with high incidence of pseudoparkinsonism and tardive dyskinesias and NO anticholinergic effects
- "Low dose"
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Clozapine
- Prototypic atypical antipsychotic; serotonin- dopamine antagonise
- Low incidence of pseudoparkinsonism; high incidence of anticholinergic effects; agranulocytosis. May work in patients not responsive to typical antipsychotics
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Benxotropine
- Pseudoparkinsonism SE of antipsychotics/ anticholinergic (antimuscarinic)
- Typical SE of antimuscarinics including dry mouth, blurred vision, nausea, constipation, urinary retention
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