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34 Cards in this Set
- Front
- Back
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Example of three antidepressants that are indicated for obsessive compulsive disorder
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Clomipramine, fluoxetine and fluvoxamine
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Neurotransmitters affected by the action of antidepressants
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Norepinephrine and serotonin
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Usual time needed for full effect of antidepressant therapy
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2 to 3 weeks
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Population group especially sensitive to side effects of antidepressants
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Elderly patients
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All antidepressants have roughly the same efficacy in treating depression, agents are chosen based on these criterion
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Side-effect profile and prior pt response
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Well-tolerated and are first-line antidepressants
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SSRI's, bupropion, and venlafaxine
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Most useful in patients with significant anxiety, phobic features, hypochondriasis, and resistant depression
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Monamine oxidase inhibitors
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Condition will result from in combination of MAOI with tyramine containing foods (ex. wine, cheese, and pickled meats)
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Hypertensive crisis
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MAOI should not be administered with SSRI's or potent TCA's due to development of this condition
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Serotonin syndrome
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Sedation is a common side effect of these drugs, they lower seizure threshold, uses include BAD, acute panic attacks, phobias, enuresis, and chronic pain and their overdose can be deadly
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Tricyclic antidepressants (TCA)
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Three C's associated with TCA toxicity
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Coma, Convulsions, Cardiac problems (arrhythmias and wide QRS)
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Agents having higher sedation and antimuscarinic effects than other TCA's
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Tertiary amines
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TCA used in chronic pain, a hypnotic, and has marked antimuscarinic effects
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Amitriptyline
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TCA used in chronic pain, enuresis, and ADD
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Imipramine
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TCA with greatest sedation of this group, and marked antimuscarinic effects, used for sleep
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Doxepin
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TCA used in obsessive compulsive disorder (OCD), most significant of TCA's for risk of seizure, weight gain, and neuropsychiatric signs and symptoms
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Clomipramine
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Secondary amines that have less sedation and more excitation effect
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Nortriptyline, Desipramine
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Side effects seen with tricyclic antidepressants
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Muscarinic blockade (dry mouth, constipation); weak alpha-1 block (orthostatic hypotension); weak hisamine block (sedation)
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Antidepressant associated with neuroleptic malignant syndrome
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Amoxapine
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Antidepressant associated with seizures and cardiotoxicity
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Maprotiline
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Antidepressant having stimulant effects similar to SSRI's and can increase blood pressure
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Venlafaxine
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Antidepressant inhibiting norepinephrine, serotonin, and dopamine reuptake
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Venlafaxine
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Antidepressant also used for sleep that causes priapism
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Trazodone
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Antidepressant which is inhibitor of CYP450 enzymes and may be associated with hepatic failure
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Nefazodone
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Heterocyclic antidepressants least likely to affect sexual performance, used for management of nicotine withdrawal, SE's include dizziness, dry mouth, aggravation of psychosis, and seizures
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Bupropion
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Antidepressant with MOA as alpha 2 antagonist, has effects on both 5-HT and NE, blocks histamine receptors, and is sedating
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Mirtazapine
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SE of mirtazapine
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Liver toxicity, increased serum cholesterol
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Except for these agents all SSRI have significant inhibition of CytP450 enzymes
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Citalopram and its metabolite escitalopram
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Side effects frequently seen with SSRIs
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CNS stimulation; GI upset
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Antidepressants with no effect on BP, no sedation
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SSRIs
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SSRI with long T1/2 and can be administered once weekly for maintenance, not acute tx
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Fluoxetine
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SSRI indicated for premenstrual dysphoric disorder
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Fluoxetine (Sarafem)
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Some of SSRIs' therapeutic effects beside depression
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Panic attacks, social phobias, bulimia nervosa, and PMDD (premenstrual dysphoric disorder), OCD
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SSRI less likely to cause a withdrawal syndrome
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Fluoxetine
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