Antidepressants, Mood Stabilizers, and Antipsychotic Drugs

  1. 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
  2. Desipramine
    • N-demethylated TCA; blocks reuptake of NE and serotonin
    • Slow onset of clinical effects; less sedating than imipramine otherwise SE as with imipramine
  3. 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
  4. 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
  5. Bupropion (Wellbutrin and Zyban)
    • Relatively selective dopamine reuptake inhibitor
    • Used for both depression (having less sexual side effects) and tobacco cessation
  6. 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
  7. Carbamazepine
    "Mood stabilizer"
    Anticonvulsant used in bipolar illness; mechanism related to rapid cycling
  8. Divalproex
    "Mood stabilizer"
    A form of valproic acid; anticonvulsant; same rationale as carbamazepine
  9. 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)
  10. Trifluoperazine
    • Same uses as chlorpromazine; prototypic piperazine phenothiazine; potent, relatively specific dopamine receptor blocker
    • Same as chlorpromazine with high incidence of pseudoparkinsonism
    • "Low dose"
  11. 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"
  12. 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"
  13. 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
  14. Benxotropine
    • Pseudoparkinsonism SE of antipsychotics/ anticholinergic (antimuscarinic)
    • Typical SE of antimuscarinics including dry mouth, blurred vision, nausea, constipation, urinary retention
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Antidepressants, Mood Stabilizers, and Antipsychotic Drugs
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