Antidepressant Drugs
Terms
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- Amitriptyline
- TCA
- Nortriptyline
- TCA
- Imipramine
- TCA
- Desipramine
-
TCA
Drug interaction w/ Fluoxetine (Prozac).
- Fluoxetine inhibits CYP2D6 preventing desipramine from being metabolized --> heart block - Clomipramine
-
TCA
good for OCD - anxiolytic - Doxepin
- TCA
- Amoxapine
- TCA - actually a heterocyclic but whatever
- Phenelzine
- MAOI - irreversible
- Tranylcypromine
- MAOI - reversible
- Selegiline
- MAOI - selective for MAO-B (DA). also anti-parkinsons.
- Fluoxetine
-
SSRI
aka Prozac
SRI NRI 2D6inh 3A4inh 5HT2C
-most activating, may cause aggitation
DI:
Desipramine + Fluoxetine: 2D6
Codeine + Fluoxetine: 2D6 - Fluvoxamine
-
SSRI
aka Luvox
SRI 1A2inh 3A4inh - Sertraline
-
SSRI
aka Zoloft
SRI DRI
- most diarrhea of SSRI's - Escitalopram
-
SSRI
aka Lexapro
SRI only
- most selective so least side fx - Citalopram
-
SSRI
SRI only
- most selective so least side fx - Paroxetine
-
SSRI
aka Paxil
SRI NRI mACH-antagonist 2D6inh 3A4inh
- anticholinergic fx b/c mACH antagonist
- causes most drowsiness of SSRI's - Buproprion
-
NDRI - primarily DA
aka Wellbutrin/Zyban
-preferred over SSRI for ppl that are depressed & bipolar
- no SRI side effects
Advantages: - mood stabilizing
- no sexual dysfunction
- no weight gain
- smoking cessation
Disadvantages: - no help w/ anxiety, possibly anxiogenic
- increased risk of seizure, esp in bulimics - Venlafaxine
-
SNRI
"side effexor"
Short 1/2 life and High efficacy so more side effects
Adv: - Superior efficacy in some
- Rapid onset
Disadv: - HTN b/c NRI
- increased early side effects
- Discontinuation syndrome
- OD more problematic than SSRI b/c cardiovascular system affected - Nefazodone
-
SARI - SE antagonist and reuptake inhibitor
Adv: - sleep enhancing
- sexual dysfunction and weight gain rare (b/c SE antagonism at spinal cord)
- good for anxiety disorders
Disadv: - drug interactions
- BID dosage
- alpha-1 effects: sleepy & hypotension -->dizzy
- rare liver toxicity - Mirtazapine
-
NaSSA - NE antagonist & SE antagonist
- also blocks H-1 --> increased hunger and sedation
-only anti-nausea antidepressant
- good for cancer & AIDS pts
Advs: -anti-emetic
- rapid onset
- sleep aid
Disadv: - weight gain
- sedation
- dry mouth
- constipation - Alprazolam
-
BZ
highly potent, use small dose - Lorazepam
-
BZ
highly potent, use small dose - Chlordiazepoxide
-
BZ
long 1/2 life
used for alcohol w/drawal - Clonazepam
-
BZ
long 1/2 life, good for chronic use
high potent, use small dose - Oxazepam
-
BZ
long 1/2 life
used for alcohol w/drawal and pts w/ liver disease b/c metabolized by kidney, not liver - Buspirone
-
5HT1A partial agonist
anxiolytic
adv: - no problems w/ abuse or w/drawal
- good for GAD, alcoholics, drug addicts, ppl w/ cognitive impairments w/ behavioral discontrol
disadv: 2 weeks to see effects - Propranolol
-
adrenergic blocker - Beta blocker
-performance anxiety and PTSD
- also migraine preventative - Clonidine
- Adrenergic blocker - alpha receptor agonist (activates inhibitor of neg feedback)
- Prazosin
- adrenergic blocker - alpha receptor antagonist