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22 Cards in this Set

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  • Back
What are four classes of ADs?
tricyclic (TCA)
serotonin selective re-uptake inhibitors (SSRI)
monoamine oxidase inhibitor (MAOI)
misc (atypical, heterocyclic, 2nd or 3rd generation, "other")
How do TCAs work
block reuptake of NE and/or 5HT --> inc synaptic levels
AND
block receptors
Which TCAs favor 5HT reuptake block?
tertiary amines, but becuase they are metabolized to secondary amines, they also block NE
Which TCAs favor NE reuptake block?
secondary amines
How do SSRIs work?
block reuptake of 5HT, don't block receptors
How does sertraline differ?
also causes some block of DA reuptake
How does venlafaxine differ
also inhibits NE reuptake (SNRI) (more like SSRIs than TCAs because it doesn't block receptors)
How do MAOIs work?
block oxidative metabolism of amines by IRREVERSIBLY inhibiting MAO-A and MAO-B
How do trazodone and nefazodone work?
1. weak inhibition of 5HT reuptake, some NE reuptake
2. block certain postsynaptic 5HT receptors
3. block presynaptic 5HT receptors
How does mirtazapine work?
blocks alpha-2 and 5HT presynaptic receptors --> increases noradrenergic and serotonergic transmission
How does bupropion work?
blocks DA reuptake, also NE and 5HT
Describe acute TCA effects
drowsy, dysphoric, anxious, impaired cognition, autonomic effects
Describe chronic TCA effects
2-6 wks- most or all depression sx improved, side effects diminish
is mood elevation euphoria?
no
Describe acute SSRI effects
CNS stimulation, anxiety, agitation (excess serotonin)
Describe chronic SSRI effects
2-6 wks- most or all sx of depression improved
CNS activation remains, but anxiety resolves
Describe acute MAOI effects
CNS stimulation, agitation, possibly euphoria
Describe chronic MAOI effects
2-6 wks- most or all sx of depression improved
CNS activation remains, may be lessened
Other indications for TCAs
panic disorder
OCD (clomipramine only)
anxiety ds, enuresis
chronic pain
other indications for SSRIs
panic disorder
OCD
eating disorder
ADD
Other indications for MAOIs
panic disorder
agoraphobia
Other indications for bupropion
(Zyban)
nicotine addiction/withdrawal