Antidepressents

In: Other Topics

Submitted By Phsarah
Words 573
Pages 3
Antidepressants:
I) Tricyclic Antidepressents:TCA:
Drugs:
- 3ry amines; old generation more selective to 5HT reuptake inhibition are: imipramine, trimipramine, clomipramine, amitriptyline, and doxepin( potent H1 blocking agent).
- 2ry amines; new generation more selective to NE reuptake inhibition are: nortriptyline, protriptyline, maprotiline, desipramine, and amoxapine(can block DA receptor causing Park-like effect).
MOA: they block NE and 5HT reuptake, thus increase their levels. Plus they inhibit histaminergic, cholinergic, alpha adrenergic receptors.
It requires weeks to give antidepressent effect. And alpha blocking effect will subside withing few weeks.
It is used in; enursis, tics, neuropathic pain, ADHD, and depression.
Avoid adrupt D/C, taper down 25% of dose every week.
Side effects: Must monitor since NTR
Anticholinergic, CV due to NE reuptake inhibition, sedation due to H1 blocking effect thuse give at bed time, OH and reflex tachycardia due to alpha inhibition, Wt gain, skin rashes and leukopenia.

II) SSRI:
Drugs; citalopram-escitalopram(least DDI), paroxetine(sedative give at bed time), fluoxetine(wt loss &only approved for pediatrics)-fluvoxamine(most DDI), and sertraline.
MOA: it inhibits 5HT reuptake and stimulate 5HT1-2A for antidepressent effect. It needs 80% of receptor to be bound for effect.
Used in OCD, panic, and depression.
We need a washout period btw SSRI and TCA about 2 weeks, and between SSRI-MAOI about 4-6 weeks to avoid Serotonin syndrome.
Serotonin Syndrome: muscle twitches, hyperreflexia, sweating, penile erection, shivering, tremors, seizure, and coma. Once occuring D/C drugs causing it. ( with ergots, triptans, maoi, buspirone.......)
Side effects: due to 5HT3 -2C
N&V, HA, rash, sexual dysfunction, insomnia, suicidal attempts, and SIADH(dilutional hypoNa).
Treatment is for 6 months.

III) MAOI:
Drugs;…...

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