Psychotropic Drugs - Antidepressants and Lithium Salts

Comprehensive vocabulary flashcards covering drug classes, specific agents, mechanisms of action, key therapeutic indications, and severe adverse effects of antidepressants and lithium based on the lecture notes.

Tricyclic Antidepressants (TCAs)

A class of antidepressants including Imipramine, Clomipramine, Amitriptyline, and Nortriptyline that inhibit neuronal reuptake of both $\text{5-HT}$ and norepinephrine (NA), while also blocking $H_1$, $H_2$, \text{Alpha}_{1\text{\null}\text{\null}\text{&}2}, $\text{GABA-A}$, and muscarinic receptors.

Imipramine

A Tricyclic Antidepressant (TCA) used for major depressive disorder, chronic pain syndromes (fibromyalgia), neuropathic pain, migraine prophylaxis, and nocturnal enuresis in children.

TCA Overdose Management

Treatment protocol where the 1st step is $\text{IV NaHCO}_3$, followed by IV lidocaine; dialysis is ineffective due to a large volume of distribution ($V_D$).

Selective Serotonin Reuptake Inhibitors (SSRIs)

A class of antidepressants including Fluoxetine, Paroxetine, Sertraline, Citalopram, and Escitalopram that selectively block $\text{5-HT}$ reuptake, causing an accumulation of $\text{5-HT}$ in brain tissue.

Sertraline

An SSRI whose absorption is increased by food and is the preferred antidepressant selection following a myocardial infarction.

Serotonin Reaction

A severe adverse reaction characterized by hyperthermia, muscle rigidity, and cardiovascular collapse occurring when SSRIs are combined with MAOIs or TCAs.

Serotonin/Norepinephrine Reuptake Inhibitors (SNRIs)

A drug class including Venlafaxine and Duloxetine that blocks $\text{5-HT}$ and norepinephrine reuptake, resulting in monoamine accumulation in brain tissue.

Venlafaxine

An SNRI that mainly blocks $\text{5-HT}$ reuptake at lower doses and requires higher doses to block norepinephrine (NA) reuptake.

Duloxetine

An SNRI antidepressant that blocks both $\text{5-HT}$ and norepinephrine reuptake at any therapeutic dose.

Trazodone

An atypical antidepressant that blocks mainly $\text{5-HT}_{2\text{A}}$ receptors, plus $H_1$ and $\text{Alpha}_1$ receptors, selectively inhibiting neuronal reuptake of serotonin; key side effects include high sedation and postural hypotension.

Mirtazapine

An atypical antidepressant that blocks $\text{5-HT}_{2\text{A}}$ and $H_1$ receptors, as well as presynaptic $\text{Alpha}_2$-adrenergic autoreceptors to increase neuronal release of NE and serotonin.

Bupropion

A weak inhibitor of dopamine and NE neuronal reuptake and noncompetitive antagonist at nicotinic cholinergic receptors, used for depression and to reduce cravings/attenuate withdrawal in smoking cessation.

Phenelzine

A 1st-generation Monoamine Oxidase Inhibitor (MAOI) that acts as an irreversible inhibitor of both MAO-A and MAO-B.

Moclobemide

A 2nd-generation Monoamine Oxidase Inhibitor (MAOI) that acts as a reversible inhibitor of MAO-A.

Selegiline

A 3rd-generation selective MAO-B inhibitor used for Parkinsonism treatment and administered via transdermal patch for depression.

Cheese Reaction

A hypertensive crisis caused by combining non-selective MAOIs with tyramine-rich foods (such as fermented cheese, yogurt, and herring) due to failure to break down tyramine via MAO-A.

Prazosin and Propranolol

A combination of $\text{Alpha} + \text{Beta}$ blockers used to treat hypertensive crisis induced by MAOI and tyramine interaction.

Lithium

A medication used prophylactically for manic-depressive patients and treatment of manic episodes in bipolar disorder; elevated plasma levels produce toxicity symptoms such as ataxia, slurred speech, coarse tremors, confusion, and convulsions.