Antidepressants Flashcards by E D

Tricyclic antidepressants (2)

Nortriptyline

Amitriptyline

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Nortriptyline: MOA

Inhibits SERT, NET

Blocks 5HT receptors

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Nortriptyline: Indication

Depression

Off label: chronic pn, PTSD

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Nortripltyline: side effects

Sexual dysfunction, long QT, anticholinergic effects

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Nortriptyline: contraindications

Recent MI

MAOI use within 14 days

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Remeron: class

Tetracyclic

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Remeron: MOA

Disinhibits NE and 5HT release.

Blocks NE negative feedback loop.

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Remeron: indication

Depression

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Trazadone: class

SRI

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Trazadone: MOA

5HT antagonist
Inhibits 5HT reuptake via SERT
Decrease number of 5HT-R

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Trazadone: indication

MDD

Insomnia at lower doses

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Trazadone: side effects

Very sedating
priapism
orthostatic HOTN

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Trazadone: contraindication

Recent MI

other 5HT drugs

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Trazadone uniquely binds ____ and ____ receptors

alpha 1

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Does Trazadone have a lot of anticholinergic effects?

Minimal

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Name the SSRIs (6)

Fluoxetine (Prozac)
Sertraline (Zoloft)
Citalopram (Celexa)
Escitalopram (Lexapro)
Fluvoxamine (Luvox)
Paroxetine (Paxil)

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Fluoxetine (Prozac): MOA

Inhibits 5HT reuptake via SERT
Reduces 5HT-R numbers
M1 inhibition

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Fluoxetine: indication

MDD
dysphoric d/o
anxiety
OCD
eating d/o

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Fluoxetine: contraindications

Seizure Hx, Platelet dysfunction, CVD

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Fluoxetine: T 1/2

10 days

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Sertraline (Zoloft): MOA

Selectively inhibits SERT and increases 5HT level in synapse

Sertraline: indication

MDD
PMDD
PD
PTSD
OCD
Social anxiety d/o

Sertraline: contraindication

MAOI use within 14 days

Concomitant use of other 5HT drugs

Does Sertraline raise prolactin levels?

Nope…no gynecomastia or galactorrhea here

Citalopram (Celexa): MOA

Selectively inhibits SERT; mild antihistamine activity

Citalopram: Indication

Depression

SSRI: common side effects

Insomnia Sexual dysfunction Altered glucose control

SSRI: Stimulating Middle of the road Sedating

Stimulating: Fluoxetine, Sertraline Middle of the road: Citalopram Sedating: Paroxetine

SNERIs (2)

Venlafaxine (Effexor) | Duloxetine (Cymbalta)

Effexor: MOA

Inhibits SERT at lower doses and NET at higher doses

Effexor: Indication

``` MDD GAD SAD panic disorder Off label: pn, OCD, hot flashes) ```

Cymbalta: MOA

Inhibits SERT and NET; increasing 5ht, NE, D

Cymbalta: indication

MDD Fibro GAD Chronic MSK pn

Cymbalta: contraindication

MAOI use within 14 days glaucoma smoking

SNERI: side effects

``` Insomnia Somnolence Nervousness Nausea Dizziness Sexual dysfunction Hyperhydrosis Abnormal dreams ```

Phenelzine (Nardil): class

MAOI

Phenelzine: MOA

MAO inhibition increases 5HT, NE, and D

Phenelzine: indication

Refractory depression

Bupropion (Wellbutrin): class

Atypical antidepressant

Bupropion: MOA

NE and D reuptake inhibition

Bupropion: indication

Depression | smoking cessation

The up side to Bupropion is...

Less sexual side effects

Vortioxetine (Brintellux): class

5HT1-R agonist/5HT3-R antagonist

Brintellux: MOA

Inhibits SERT | Partial 5HT agonist/antagonist

Brintellux: indictaion

MDD

Brintellux may also increase _____ risk

Bleeding

Vilazodone (Viibryd): class

SSRI/5HT-R partial agonist

Vilazodone: MOA

Inhibits SERT with elevation of 5HT levels.

Does Vilazodone affect NE or D?

Nope

Vilazodone: indication

MDD