Anti-Depressants- MAOI, TCA

Question 1

TCA’s

Use

Side Effects

Answer 1

TCA’s inhibit the reuptake of norepinephrine and serotonin

Lethal in overdose

Don’t use first line

1. Side Effects:
   
   1. Cardiotoxicity
   2. Coma
   3. Convulsions
2. Antimuscarininc effects
3. Orthostatic Hypotension

Question 2

Amitriptyline (Elavil)

What makes it special?

Answer 2

Amitriptyline

use in chronic pain, migraines, and insomnia

Question 3

Imipramine (Tofranil):

What makes it special?

Answer 3

Imipramine can be useful in enuresis and panic disorder

Question 4

Clomipramine (Anafranil)

What makes it special?

Answer 4

Clomipramine is the most serotonin-specific so can be used to treat OCD

Question 5

Nortriptyline (Pamelor, aventyl)

What makes it special?

Answer 5

Nortriptyline is least likely to cause orthostatic hypotension but it should still be discontinued if there is a risk of falling or a history of falling

Question 6

Amoxapine (Asendin)

What makes it special?

Answer 6

Amoxapine is more activating and has the least anitcholinergic effects

Question 7

MAOIs

Use:

Side Effects:

Answer 7

MAOIs- prevents the inactivation of biogenic amines such as nor-epinepherine, serotonin, dopamine, and tyramine

not used as first-line agents but can be used in certain types of refractory depression

1. Side Effects
   
   1. Serotonin Syndrome
   2. Hypertensive Crisis
      
      1. when taken with tyramine-rich foods
      2. elevated BP, headache, sweating, N/V, photophobia, chest pain, arrhythmias, and death
   3. Orthostatic hypotension

Question 8

What three drugs are MAOIs?

Answer 8

Phenelzine (Nardil)

Transcypromine (Parnate)

Isocarboxazid (Marplan)