Shelf Drugs

Question 1

Other disorders for which antidepressants are used

Answer 1

Obsessive–compulsive disorder (OCD): SSRIs, TCAs Panic disorder: SSRIs, TCAs, MAOIs
Eating disorders: SSRIs, TCAs, and MAOIs Dysthymia: SSRIs
Social phobia: MAOIs and SSRIs
Posttraumatic stress disorder: SSRIs, TCAs
Irritable bowel syndrome: SSRIs, TCAs
Enuresis: TCAs
Neuropathic pain: TCAs
Migraine headaches: TCAs, SSRIs, bupropion
Smoking cessation: Bupropion
Autism: SSRIs
Premenstrual dysphoric disorder: SSRIs
Depressive phase of manic depression: SSRIs, bupropion Insomnia: Mirtazapine, TCAs

Question 2

MoA of TCAs

Answer 2

Inhibit reuptake of serotonin and norepinephrine

Blockage of H1, M1, & peripheral alpha1 receptors

Question 3

TCAs

Answer 3

Imipramine, amitriptyline, nortriptyline, trimipramine, doxepin, clomipramine

Question 4

Clomipramine

Answer 4

Most serotonin specific. Good for OCD

Question 5

Desipramine

Answer 5

Least sedating, fewest anticholinergic side effects

Question 6

Nortriptyline

Answer 6

Least likely to cause orthostatic hypotension

Question 7

TCA toxicity

Answer 7

Coma, confusion, delirium, mydriasis, dry mouth, hypotension, seizures, tachycardia, urinary incontinence
R wave in aVR, QRS widening (>120 ms)

Question 8

Treatment of TCA toxicity

Answer 8

Benzos for seizures
Sodium bicarbonate for QRS widening
Norepinephrine or phenylephrine for hypotension (dopamine in kids)