antidepressants

what is the normal function of norepinephrine?

NT that increases alertness, arousal, and attention

what is the normal function of serotonin?

NT that regulates sleep/wake cycles with melatonin, increases learning, memory, attention, and mood

what is the normal function of dopamine?

NT responsible for reward/pleasure feelings in the brain, plays a role in mobility/muscle coordination

what are the names of some tricyclic antidepressants?

impramine, amitriptyline, nortriptyline

what is the MOA for tricyclic antidepressants?

blocks reuptake of norepinephrine and serotonin (which increases the amount of norepinephrine and serotonin available) causing a sedating/calming effect

what are the uses for tricyclic antidepressants?

depression, anxiety assoc with depression, fibromyalgia, chronic pain → do not stop abruptly, do not start new meds without discussion w provider

what are the adverse effects of tricyclic antidepressants?

sedation, sleep disturbances, fatigue, disorientation, visual disturbances, weakness, incr risk for suicide → want to assess mood/behavior, energy prior to administrating med

what is the name of a monoamine oxidase inhibitor MAOIS?

phenelzine

what is the MOA of monoamine oxidase inhibitors MAOIS?

monoamine oxidase is the enzyme that breaks down norepinephrine, serotonin, and dopamine → blocking this enzyme causes increased levels of these NTs

what are the uses for monoamine oxidase inhibitors MAOIS?

depression, atypical depression

what are some adverse effects of monoamine oxidase inhibitors MAOIS?

dizziness, headache, tremors, hyperreflexia, incr risk for suicide → not rx much now d/t many side effects/drug interactions & need to avoid tyramine containing foods

what are the names of some selective serotonin reuptake inhibitors SSRIs?

fluoxetine, escitalopram, paroxetine, sertraline → increases amount of serotonin available

what are some uses for SSRIs?

depression, OCD, panic attacks, PTSD, social anxiety → do NOT take with MAOIs

what are some adverse effects of SSRIs?

headache, insomnia, sexual dysfunction, incr risk for suicide, serotonin syndrome (rare)

what is the name of a selective norepinephrine reuptake inhibitor SNRI?

duloxetine → incr amounts of norepinephrine, serotonin, and minimally increases

what are selective norepinephrine reuptake inhibitors SNRIs used for?

depression → AEs: nausea, dry mouth, dizziness, sexual dysfunction, incr risk for suicide

what are some “other antidepressants” that are more sedating and usually taken at night?

buproprion, trazodone, mirtazapine → do not take with MAOIs

what does pharmacology for tx depression focus on?

increasing the amount of NT available for use; most drugs have a slow onset (sometimes 4-8 weeks)

what are some things to know about antidepressants in general?

many experts suggest continuing CBT with meds, ALL these drugs have a black box warning for the risk of suicide esp in children/adolescents/young adults