block reuptake of norepinephrine and serotonin
Side effects: anticholinergic effects (urinary retention, constipation, tachycardia, dry mouth, blurred vision, mental status changes), sedation, sexual dysfunction, orthostatic hypotension, hyperpyrexia (fever greater than 104), confusion and hallucinations in the elderly, serotonin syndrome
Three C's: cardiotoxic, coma, confusion
1 weeks supply is deadly
2D6 interactions For bipolar disorder
alters intracellular second messangers (e.g. IP3)
side effects: nausea, diarrhea, vomiting, fine hand tremor, sedation, muscle weakness, edema, weight gain, dry mouth, polyuria/polydipsia, hypothyroism and goiter, acne, leukocytosis, psoriasis, teratogenesis
Narrow therapeutic window, can be toxic For bipolar disorder (mania)
Anticonvulsant, increase GABA activity
Side effects: somnolence, dizziness, GI upset, diplopia, ataxia, rash, hepatitis, pancreatitis, prolonged bleeding, alopecia, weight gain, polycystic ovary syndrome, hepatotoxicity antagonists at the post synaptic mesolimbic dopaminergic brain receptors as well as in the nigrostriatal and tuberoinfuncdibular pathways
Side effects: anticholinergic (more in low potency medications), EPS (parkinsonian symptoms, akathesia, acute dystonias, tardive dyskinesia), neuroleptic malignant syndrome (hyperpyrexia, rigidity, ANS dysfunction, myoglobinuria), endocrine agents (high potency medications), hypotensive (alpha receptors) and sedative (histamine receptors) properties, agranulocytosis and impaired temperature regulation