Drugs for Central Noradrenergic and Serotonergic Systems Flashcards
(24 cards)
reserpine
Monoamine theory of depression: Catecholamine theory
- dec NE
- induce depression-like syndrome (but good antihypertensive drug)
amphetamine
Monoamine theory of depression: Catecholamine theory
- inc NE
- reduces depression
iproniazid
Monoamine theory of depression: Catecholamine theory
- inc NE
- reduces depression
fluoxetine
Monoamine theory of depression: Monoamine theory
- inc 5HT
- reduces depression
imipramine
Tricyclic non selective reuptake inhibitors NSRIs: tricyclic antidepressants TCAs
- have 3-C rings
- dec NE and 5HT reuptake into axon terminals in CNS –> inc both concentration and effect in synaptic gap in CNS
- use: unipolar depression, bipolar disorder (depresive phases/episodes), enuresis (nighttime bedwetting), eating disorders, chronic pain, phobias & panic attacks, obsessive compulsive disorders
- side effect: parasympathetic nervous system (dry mouth, constipation), symp ns (vasodilation, tachycaria), CNS-based(weight gain [sexual dysfunction, sedation])
desimipramine
Tricyclic non selective reuptake inhibitors NSRIs: tricyclic antidepressants TCAs
- have 3-C rings
- dec NE and 5HT reuptake into axon terminals in CNS –> inc both concentration and effect in synaptic gap in CNS
- use: unipolar depression, bipolar disorder (depresive phases/episodes), enuresis (nighttime bedwetting), eating disorders, chronic pain, phobias & panic attacks, obsessive compulsive disorders
- side effect: parasympathetic nervous system (dry mouth, constipation), symp ns (vasodilation, tachycaria), CNS-based(weight gain [sexual dysfunction, sedation])
amytriptyline
Tricyclic non selective reuptake inhibitors NSRIs: tricyclic antidepressants TCAs
- have 3-C rings
- dec NE and 5HT reuptake into axon terminals in CNS –> inc both concentration and effect in synaptic gap in CNS
- use: unipolar depression, bipolar disorder (depresive phases/episodes), enuresis (nighttime bedwetting), eating disorders, chronic pain, phobias & panic attacks, obsessive compulsive disorders
- side effect: parasympathetic nervous system (dry mouth, constipation), symp ns (vasodilation, tachycaria), CNS-based(weight gain [sexual dysfunction, sedation])
aortryptyline
Tricyclic non selective reuptake inhibitors NSRIs: tricyclic antidepressants TCAs
- have 3-C rings
- dec NE and 5HT reuptake into axon terminals in CNS –> inc both concentration and effect in synaptic gap in CNS
- use: unipolar depression, bipolar disorder (depresive phases/episodes), enuresis (nighttime bedwetting), eating disorders, chronic pain, phobias & panic attacks, obsessive compulsive disorders
- side effect: parasympathetic nervous system (dry mouth, constipation), symp ns (vasodilation, tachycaria), CNS-based(weight gain [sexual dysfunction, sedation])
clomipramine
Tricyclic non selective reuptake inhibitors NSRIs: tricyclic antidepressants TCAs
- have 3-C rings
- dec NE and 5HT reuptake into axon terminals in CNS –> inc both concentration and effect in synaptic gap in CNS
- use: unipolar depression, bipolar disorder (depresive phases/episodes), enuresis (nighttime bedwetting), eating disorders, chronic pain, phobias & panic attacks, obsessive compulsive disorders
- side effect: parasympathetic nervous system (dry mouth, constipation), symp ns (vasodilation, tachycaria), CNS-based(weight gain [sexual dysfunction, sedation])
duloxetine
Non tricyclic non selective reuptake inhibitors
-same as TCA (side effects less intense), but not chemically
venlaxafine
Non tricyclic non selective reuptake inhibitors
-same as TCA (side effects less intense), but not chemically
isocarboxazid
MAO inhibitor
- dec NE and 2HT degradation in axon terminals in CNS –> inc both vesicular storage –> inc both release and receptor activation and effect
- use: only as antidepressant (when patient is refractory to other drugs)
- side effect from food and drug interactions: inc NE release (dietary amines are indirect sympathomimetics), cardiac effect lethal (combination of dietary amine induced NE release and MAOI induced ind of stored/released NE causes massive release of NE into synaptic gap)
- food: cheese, wine, chocolate
phenelzine
MAO inhibitor
- dec NE and 2HT degradation in axon terminals in CNS –> inc both vesicular storage –> inc both release and receptor activation and effect
- use: only as antidepressant (when patient is refractory to other drugs)
- side effect from food and drug interactions: inc NE release (dietary amines are indirect sympathomimetics), cardiac effect lethal (combination of dietary amine induced NE release and MAOI induced ind of stored/released NE causes massive release of NE into synaptic gap)
- food: cheese, wine, chocolate
tranylcypromine
MAO inhibitor
- dec NE and 2HT degradation in axon terminals in CNS –> inc both vesicular storage –> inc both release and receptor activation and effect
- use: only as antidepressant (when patient is refractory to other drugs)
- side effect from food and drug interactions: inc NE release (dietary amines are indirect sympathomimetics), cardiac effect lethal (combination of dietary amine induced NE release and MAOI induced ind of stored/released NE causes massive release of NE into synaptic gap)
- food: cheese, wine, chocolate
fluoxetine
Serotonin specific reuptake inhibitors SSRIs
- inhibition of 5HT reuptake
- uses: unipolar depression, bipolar disorder (depressive phase), chronic pain, eating disorders, anxiety disorders, obsessive compulsive disorders
- side effect: CHRONIC not overdose: major decrease of sexual libido & satisfaction, ACUTE/CHRONIC overdose: “serotonin syndrome”, confusion, hallucinations, tachycardia, palpitations, hyperreflexia
- use: PROZAC for depression, SARAFEM for premenstrual dysphoria
sertraline
Serotonin specific reuptake inhibitors SSRIs
- inhibition of 5HT reuptake
- uses: unipolar depression, bipolar disorder (depressive phase), chronic pain, eating disorders, anxiety disorders, obsessive compulsive disorders
- side effect: CHRONIC not overdose: major decrease of sexual libido & satisfaction, ACUTE/CHRONIC overdose: “serotonin syndrome”, confusion, hallucinations, tachycardia, palpitations, hyperreflexia
- use: PROZAC for depression, SARAFEM for premenstrual dysphoria
paroxetine
Serotonin specific reuptake inhibitors SSRIs
- inhibition of 5HT reuptake
- uses: unipolar depression, bipolar disorder (depressive phase), chronic pain, eating disorders, anxiety disorders, obsessive compulsive disorders
- side effect: CHRONIC not overdose: major decrease of sexual libido & satisfaction, ACUTE/CHRONIC overdose: “serotonin syndrome”, confusion, hallucinations, tachycardia, palpitations, hyperreflexia
- use: PROZAC for depression, SARAFEM for premenstrual dysphoria
aripiprazole
Partial agonist @ dopamine receptors
- adjunct to TCA or SSRI as antidepressant (not used alone)
- partial agonist at DA receptors
- functionally DA antagonist
- side effect: hyperglycemia & development of diabetes
buproprion
NE and dopamine reuptake inhibitor
- inhibitor of DA reuptake by NE transporter in brain areas where DA transporter may be absent
- use: unipolar depression, bipolar disorder (depressive phases), WELLBUTRIN for depression, ZYBAN for aid to quit tobacco use
lithium
Therapeutic anti mania drugs: lithium
- mechanism of action unknown
- use: bipolar disorder & mania (not useful in unipolar depression, may cause depression, may be used with antidepressant to create “balance”)
- side effect: CHRONIC: renal damage (inc chance of acute intoxication), ACUTE: tremors & muscular rigidity, apathy & coma
valproate
Therapeutic anti mania drugs: antiepileptic
-use: manic phases of bipolar disorder
carbamazepine
Therapeutic anti mania drugs: antiepileptic
-use: manic phases of bipolar disorder
lamotrigine
Therapeutic anti mania drugs: antiepileptic
-use: prevent depressive cycling in bipolar disorder
aripiprazole
Therapeutic anti mania drugs: DA receptor partial agonist
- adjunct to TCA or SSRI as antidepressant (not used alone)
- partial agonist at DA receptors
- functionally DA antagonist
- side effect: hyperglycemia & diabetes development
