IP8 Exam 1 MOAs

Citalopram

SSRI: Selectively blocks the serotonin transporter (SERT), preventing the reuptake of serotonin and thereby increasing its availability in the synaptic cleft.

Escitalopram

SSRI: Selectively blocks the serotonin transporter (SERT), preventing the reuptake of serotonin and thereby increasing its availability in the synaptic cleft.

Fluoxetine

SSRI: Selectively blocks the serotonin transporter (SERT), preventing the reuptake of serotonin and thereby increasing its availability in the synaptic cleft.

Fluvoxamine

SSRI: Selectively blocks the serotonin transporter (SERT), preventing the reuptake of serotonin and thereby increasing its availability in the synaptic cleft.

Paroxetine

SSRI: Selectively blocks the serotonin transporter (SERT), preventing the reuptake of serotonin and thereby increasing its availability in the synaptic cleft.

Sertraline

SSRI: Selectively blocks the serotonin transporter (SERT), preventing the reuptake of serotonin and thereby increasing its availability in the synaptic cleft.

Venlafaxine

SNRI: Inhibits both the serotonin transporter (SERT) and the norepinephrine transporter (NET), increasing the synaptic availability of both serotonin and norepinephrine. (Note: Venlafaxine acts primarily like an SSRI at doses < 150 mg/day).

Desvenlafaxine

SNRI: Inhibits both the serotonin transporter (SERT) and the norepinephrine transporter (NET), increasing the synaptic availability of both serotonin and norepinephrine.

Duloxetine

SNRI: Inhibits both the serotonin transporter (SERT) and the norepinephrine transporter (NET), increasing the synaptic availability of both serotonin and norepinephrine.

Levomilnacipran

SNRI: Inhibits both the serotonin transporter (SERT) and the norepinephrine transporter (NET), increasing the synaptic availability of both serotonin and norepinephrine.

Amitriptyline

TCA: Inhibits the reuptake of both norepinephrine (NET) and serotonin (SERT). (They also possess antagonistic properties at alpha-1 adrenergic, histamine H1, and muscarinic receptors).

Clomipramine

TCA: Inhibits the reuptake of both norepinephrine (NET) and serotonin (SERT). (They also possess antagonistic properties at alpha-1 adrenergic, histamine H1, and muscarinic receptors).

Desipramine

TCA: Inhibits the reuptake of both norepinephrine (NET) and serotonin (SERT). (They also possess antagonistic properties at alpha-1 adrenergic, histamine H1, and muscarinic receptors).

Doxepin

TCA: Inhibits the reuptake of both norepinephrine (NET) and serotonin (SERT). (They also possess antagonistic properties at alpha-1 adrenergic, histamine H1, and muscarinic receptors).

Imipramine

TCA: Inhibits the reuptake of both norepinephrine (NET) and serotonin (SERT). (They also possess antagonistic properties at alpha-1 adrenergic, histamine H1, and muscarinic receptors).

Nortriptyline

TCA: Inhibits the reuptake of both norepinephrine (NET) and serotonin (SERT). (They also possess antagonistic properties at alpha-1 adrenergic, histamine H1, and muscarinic receptors).

Isocarboxazid

MAOI: Non-selectively inhibits monoamine oxidase enzymes, decreasing the catabolism/breakdown of serotonin, norepinephrine, dopamine, and tyramine, thereby increasing their availability

Phenelzine

MAOI: Non-selectively inhibits monoamine oxidase enzymes, decreasing the catabolism/breakdown of serotonin, norepinephrine, dopamine, and tyramine, thereby increasing their availability

Selegiline

MAOI: Selectively inhibits for MAO-B at lower doses of selegiline) inhibits monoamine oxidase enzymes, decreasing the catabolism/breakdown of serotonin, norepinephrine, dopamine, and tyramine, thereby increasing their availability

Tranylcypromine

MAOI: Non-selectively inhibits monoamine oxidase enzymes, decreasing the catabolism/breakdown of serotonin, norepinephrine, dopamine, and tyramine, thereby increasing their availability

Bupropion

Inhibits the dopamine transporter (DAT) and norepinephrine transporter (NET), increasing dopamine and norepinephrine in the synapse.

Mirtazapine

Central presynaptic alpha-2 adrenergic antagonist (increasing NE and 5-HT release), plus antagonism at postsynaptic 5-HT2/5-HT3 receptors and histamine H1 receptors.

Trazodone

Inhibits SERT and acts as an antagonist at 5-HT2A, histamine (H1), and alpha-1 adrenergic receptors.

Vortioxetine

Serotonin modulators: Serotonin reuptake inhibition (SRI) combined with 5-HT1A receptor agonism. (Vortioxetine also acts as a 5-HT3 antagonist).

Vilazodone

Serotonin modulators: Serotonin reuptake inhibition (SRI) combined with 5-HT1A receptor agonism.

Dextromethorphan/Bupropion

Dextromethorphan is a noncompetitive NMDA receptor antagonist + weak SERT inhibitor; Bupropion acts as a DAT/NET inhibitor and inhibits CYP2D6 metabolism to boost dextromethorphan levels.

Esketamine

Noncompetitive, nonselective NMDA receptor antagonist that de-suppresses BDNF translation and activates downstream neuroplasticity pathways.

Zuranolone

Positive allosteric modulator of GABAA receptors (neuroactive steroid analog of allopregnanolone).

Alprazolam

BZD: Binds to a specific regulatory site on the GABAA receptor complex (allosteric modulator), increasing the frequency of chloride channel openings in response to GABA, thereby enhancing central nervous system inhibition.

Clonazepam

BZD: Binds to a specific regulatory site on the GABAA receptor complex (allosteric modulator), increasing the frequency of chloride channel openings in response to GABA, thereby enhancing central nervous system inhibition.

Diazepam

BZD: Binds to a specific regulatory site on the GABAA receptor complex (allosteric modulator), increasing the frequency of chloride channel openings in response to GABA, thereby enhancing central nervous system inhibition.

Lorazepam

BZD: Binds to a specific regulatory site on the GABAA receptor complex (allosteric modulator), increasing the frequency of chloride channel openings in response to GABA, thereby enhancing central nervous system inhibition.

Oxazepam

BZD: Binds to a specific regulatory site on the GABAA receptor complex (allosteric modulator), increasing the frequency of chloride channel openings in response to GABA, thereby enhancing central nervous system inhibition.

Temazepam

BZD: Binds to a specific regulatory site on the GABAA receptor complex (allosteric modulator), increasing the frequency of chloride channel openings in response to GABA, thereby enhancing central nervous system inhibition.

Buspirone

Azapirones: Acts as a partial agonist with high affinity for serotonin 5-HT1A autoreceptors and heteroreceptors.

Zolpidem

Subunit-selective modulators of GABAA receptors with a high affinity/specificity for the alpha-1 subunit, leading to sedative-hypnotic effects.

Zaleplon

Subunit-selective modulators of GABAA receptors with a high affinity/specificity for the alpha-1 subunit, leading to sedative-hypnotic effects.

Eszopiclone

Subunit-selective modulators of GABAA receptors with a high affinity/specificity for the alpha-1 subunit, leading to sedative-hypnotic effects.

Melatonin

Melatonin Agonists: Agonists at MT1 and MT2 melatonin receptors (MT1 induces sleepiness; MT2 regulates the circadian rhythm).

Ramelteon

Melatonin Agonists: Agonists at MT1 and MT2 melatonin receptors (MT1 induces sleepiness; MT2 regulates the circadian rhythm).

Tasimelteon

Melatonin Agonists: Agonists at MT1 and MT2 melatonin receptors (MT1 induces sleepiness; MT2 regulates the circadian rhythm).

Suvorexant

DORA: Blocks the binding of wake-promoting neuropeptides orexin A and orexin B to OX1R and OX2R receptors in the arousal system.

Lemborexant

DORA: Blocks the binding of wake-promoting neuropeptides orexin A and orexin B to OX1R and OX2R receptors in the arousal system.

Daridorexant

DORA: Blocks the binding of wake-promoting neuropeptides orexin A and orexin B to OX1R and OX2R receptors in the arousal system.

Modafinil

Dopamine transporter (DAT) inhibition (and possible 5-HT effects).

Armodafinil

Dopamine transporter (DAT) inhibition (and possible 5-HT effects).

Pitolisant

Histamine H3 receptor inverse agonist.

Solriamfetol

Dopamine and norepinephrine reuptake (DAT/NET) inhibition.