| Term | Definition |
|---|
| Tricyclic antidepressants | Mixed 5-HT and NE uptake inhibitors; block a1 (orthostatic hypotension), muscarinic (mydriasis, dry mouth, constipation), histamine (sedative) receptors; can also lead to strong NE activation of heart B1, can be fatal; sexual dysfunction; interact with MAO-Is (increased cardiotoxicity), depressants (sedative effect), sympathomimetics (enhanced effects); photosensitivity; may be an increased risk for suicide |
| Amitriptyline | Prototypical tricyclic antidepressant; affects 5-HT more than NE; begins with 'A' |
| Imipramine | Prototypical tricyclic antidepressant; affects 5-HT more than NE; begins with 'I' |
| Desipramine | Secondary comp. tricyclic antidepressant; fewer side effects than prototypical; affects NE; can produce sudden death in children (used for ADHD) |
| Nortriptyline | Secondary comp. tricyclic antidepressant; fewer side effects than prototypical; effects 5-HT more than NE; begins with 'N' |
| Bupropion | 2nd generation "other cyclic antidepressant"; MOA unclear (some DA few 5-HT/NE effects); psychomotor activation; few cardiovascular effects; fewer sexual complications than TCAs; high dose can lead to seizures; used in nicotine withdrawal; Wellbutrin |
| Trazodone | 2nd generation "other cyclic antidepressant"; relatively poor antidepressant; few side effects; sedation (good hypnotic); produces priapism |
| Mirtazapine | 3rd generation "other cyclic antidepressant"; begins with 'M' |
| Venlafaxine | SNRI; inhibits 5-HT and NE reuptake; comparable to TCAs in antidepressant activity; relatively free of cardiotoxicity; high doses produce increases in diastolic blood pressure |
| SSRIs | Good antidepressants (except severe depression); not sedating; no cardiovascular toxicities; block 5-HT transporter; few NE effects; no effects on a1, muscarinic, or histamine receptors |
| Fluoxetine | Prototypical SSRI; potent, highly selective 5-HT reuptake inhibitor; good efficacy; non-sedating; low cardiac toxicity; behavioral activation (nervousness, insomnia, restlessness, motor activity); increased risk for suicide; nausea; decreased food intake; headache; sexual dysfunction; inhibits P-450 (interactions with other drugs); long acting |
| Sertraline | SSRI; similar to fluoxetine; less akathisia; NO inhibition of P-450; shorter half-life |
| Paroxetine | SSRI; similar to Sertraline; SOME inhibition of P-450; short half-life; begins with 'P' |
| Fluvoxamine | SSRI; similar to Sertraline; SOME inhibition of P-450; short half-life; begins with 'F' |
| Citalopram | SSRI; similar to Sertraline; most selective; Lexapro |
| Serotonin Syndrome | When SSRIs and MAO-Is (or triptans) are mixed, this occurs; excessive serotonin levels in synapse that can be lethal; hyperthermia, muscle rigidity, myoclonus, altered mental state |
| Phenelzine | Long-acting MAO-I; inhibits both type A (NE, 5-HT, tyramine) and type B (DA); irreversibly bound; dosage adjustment is difficult |
| Selegiline | MAO-I; relatively selective for MAO-B (DA), used in PD and major depression |
| MAO-Is | MOA is to increase NE, 5-HT, DA levels; works within 1-2 days; mood elevation in depressed AND NORMAL individuals; transition from depression to hypomania; decrease in blood pressure (related to DA effects in ganglionic neurons inhibiting sympathetic output); headache; sexual dysfunction; interaction with tyramine can cause dangerous hypertension |
| Duloxetine | SNRI; begins with 'D' |
Combine with other sets
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