MT 6314 PCOL Antidepressants

1. Selective Serotonin Reuptake Inhibitors (SSRIs)

2) Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)

3) Tricyclic Antidepressants (TCAs)

4) 5-HT Receptor Modulators

5) Tetracyclics, Unicyclic

6) Monoamine Oxidase Inhibitors (MAOIs)

7) NMDA Receptor Antagonists

8) GABAA Receptor Modulators

Enumerate: 8 Types of Antidepressants

Selective Serotonin Reuptake Inhibitors (SSRIs)

Identify: Type of Antidepressant

Highly selective blockade of serotonin transporter (SERT)

Selective Serotonin Reuptake Inhibitors (SSRIs)

Identify: Type of Antidepressant

Little effect on norepinephrine transporter (NET)

Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)

Identify: Type of Antidepressant

Moderately selective blockade of NET and SERT

Tricyclic Antidepressants (TCAs)

Identify: Type of Antidepressant

Mixed and variable blockade of NET and SERT

Nefazodone

Trazodone

Inhibition of 5HT2A

receptor

Vortioxetine

Antagonist at 5HT3, 5HT7, 5HT1D receptors

Vortioxetine

Partial agonist at 5HT1B receptor

Vortioxetine

Agonist at 5HT1A receptor

Vortioxetine

Inhibits SERT

1) Nefazodone

2) Trazodone

3) Vortioxetine

Enumerate: 3 5-HT Receptor Modulators

1) Bupropion

2) Amoxapine

3) Maprotiline

4) Mirtazapine

Enumerate: 4 Tetracyclics, Unicyclic

Bupropion

Increased norepinephrine and dopamine activity

Amoxapine

Maprotiline

NET > SERT inhibition

Mirtazepine

Increased release of norepinephrine, 5HT

1) Phenelzine (Hydrazine)

2) Tranylcypromine (Nonhydrazine)

3) Selegiline (Nonhydrazine)

Enumerate: Monoamine Oxidase Inhibitors (MAOIs)

Phenelzine

Blockade of MAO-A and MAO-B (nonselective)

Low-dose Selegiline

MAO-B irreversible selective MAO-B inhibition

NMDA Receptor Antagonists

Noncompetitive antagonism at the NMDA receptor

1) Ketamine (off-label)

2) Esketamine

Enumerate: 2 NMDA Receptor Antagonist

Brexanolone

Positive allosteric modulator of the GABAA

chloride channel, binding

site distinct from benzodiazepine site

SSRIs

Identify: Type of Antidepressant

Fluoxetine

SSRIs

Identify: Type of Antidepressant

Citalopram

SSRIs

Identify: Type of Antidepressant

Escitalopram

SSRIs

Identify: Type of Antidepressant

Paroxetine

SSRIs

Identify: Type of Antidepressant

Sertraline

SSRIs

Identify: Type of Antidepressant

Fluvoxamine

SNRIs

Identify: Type of Antidepressant

Duloxetine

SNRIs

Identify: Type of Antidepressant

Venlafaxine

SNRIs

Identify: Type of Antidepressant

Levomilnacipran

SNRIs

Identify: Type of Antidepressant

Desvenlafaxine

SNRIs

Identify: Type of Antidepressant

Milnacipran

TCAs

Identify: Type of Antidepressant

Imipramine

TCAs

Identify: Type of Antidepressant

Clomipramine

5-HT Receptor Modulators

Identify: Type of Antidepressant

Nefazodone

5-HT Receptor Modulators

Identify: Type of Antidepressant

Trazodone

5-HT Receptor Modulators

Identify: Type of Antidepressant

Vortioxetine

Tetracyclics, Unicyclic

Identify: Type of Antidepressant

Bupropion

Tetracyclics, Unicyclic

Identify: Type of Antidepressant

Amoxapine

Tetracyclics, Unicyclic

Identify: Type of Antidepressant

Maprotiline

Tetracyclics, Unicyclic

Identify: Type of Antidepressant

Mirtazepine

MAOIs

Identify: Type of Antidepressant

Phenelzine

MAOIs

Identify: Type of Antidepressant

Tranylcypromine

MAOIs

Identify: Type of Antidepressant

Selegiline

NMDA Receptor Antagonists

Identify: Type of Antidepressant

Ketamine

NMDA Receptor Antagonists

Identify: Type of Antidepressant

Esketamine

GABAA Receptor Modulators

Identify: Type of Antidepressant

Brexanolone

SSRIs

Identify: Type of Antidepressant

Acute increase of serotonergic synaptic activity

SSRIs

Identify: Type of Antidepressant

Slower changes in several signaling pathways and neurotrophic activity

SNRIs

Identify: Type of Antidepressant

Acute increase in serotonergic and adrenergic synaptic activity

TCAs

Identify: Type of Antidepressant

Like SNRIs plus significant blockade of autonomic nervous system and histamine receptors

Clomipramine

Identify: Type of Antidepressant

TCAs; Treatment of obsessive-compulsive disorder

5-HT Receptor Modulator, Trazodone

Identify: Type of Antidepressant

Forms a metabolite (m-cpp) that blocks 5- HT2A,2C receptor

5-HT Receptor Modulator, Vortioxetine

Identify: Type of Antidepressant

Complex modulation of serotonergic systems

Tetracyclics, Unicyclic, Bupropion

Identify: Type of Antidepressant

Presynaptic release of catecholamines but no effect on 5 HT

Tetracyclics, Unicyclic, Amoxapine & Maprotiline

Identify: Type of Antidepressant

Resemble TCAs

MAOIs

Identify: Type of Antidepressant

Transdermal formulation of selegiline achieves levels that inhibit MAO-A

NMDA Receptor Antagonist

Identify: Type of Antidepressant

Anesthesia

NMDA Receptor Antagonist

Identify: Type of Antidepressant

Possible increase in serotonergic activity, dopaminergic activity

GABAA Receptor Modulator, Brexanolone

Identify: Type of Antidepressant

Unclear: possibly replaces endogenous

allopregnanolone, which decreases markedly after delivery

ALL 6

Identify: Type of Antidepressant

Major depression

SSRIs

Identify: Type of Antidepressant

Anxiety disorders

SSRIs

Identify: Type of Antidepressant

Panic disorder

SSRIs, TCAs

Identify: Type of Antidepressant

Obsessive-compulsive disorder

SSRIs

Identify: Type of Antidepressant

Post-traumatic stress disorder

SSRIs, SNRIs

Identify: Type of Antidepressant

Perimenopausal vasomotor syndrome

SSRIs

Identify: Type of Antidepressant

Eating disorder (Bulimia)

SNRIs, TCAs

Identify: Type of Antidepressant

Chronic pain disorders

SNRIs

Identify: Type of Antidepressant

Fibromyalgia

TCAs, MAOIs

Identify: Type of Antidepressant

Major depression not responsive to other drugs

TCAs

Identify: Type of Antidepressant

Incontinence

5-HT Receptor Modulator, Trazodone

Identify: Type of Antidepressant

Sedation and hypnosis

Tetracyclics, Unicyclics, Bupropion

Identify: Type of Antidepressant

Smoking cessation

Tetracyclics, Unicyclic Mirtazapine

Identify: Type of Antidepressant

Sedation

MAOIs, Selegiline

Identify: Type of Antidepressant

Parkinson disease

NMDA Receptor Antagonist, Ketamine

Identify: Type of Antidepressant

Anesthesia

NMDA Receptor Antagonist, Esketamine

Identify: Type of Antidepressant

Refractory depression

GABAA Receptor Modulator, Brexanolone

Identify: Type of Antidepressant

Postpartum depression only

SSRIs

Identify: Type of Antidepressant

Toxicity: Well tolerated but cause sexual dysfunction