Antidepressants

Flashcards about drugs affecting the central nervous system - antidepressants

Depression

Intense feeling of sadness, hopelessness, and despair, inability to experience pleasure, changes in sleep patterns and appetite, loss of energy, and suicidal thoughts.

Mania

Enthusiasm, rapid thought and speech patterns, extreme self-confidence, and impaired judgment.

Bipolar Disorder

Intermixed depressive and manic episodes, usually dominated by long periods of depression.

Monoamine Theory

Depression results from pathologically decreased 5-HT and/or NE neurotransmission. Conversely, mania is caused by overactivity of these neurotransmitters.

SSRIs (Selective Serotonin Reuptake Inhibitors)

Block the reuptake of 5-HT, thereby increasing 5-HT concentration at the synapse.

Adverse Effects of SSRIs

Headache, sweating, anxiety and agitation, GI effects, weakness and fatigue, sexual dysfunction, and sleep disturbances.

Therapeutic Uses of SSRIs

Depression, obsessive-compulsive disorder, panic disorder, generalized anxiety disorder, posttraumatic stress disorder, social anxiety disorder, premenstrual dysphoric disorder, and bulimia nervosa.

SNRIs (Serotonin/Norepinephrine Reuptake Inhibitors)

Block the reuptake of 5-HT and NE, thereby increasing 5-HT/NE concentration at the synapse.

TCAs (Tricyclic Antidepressants)

Block the reuptake of 5-HT and NE, thereby increasing 5-HT/NE at the synapse.

Adverse Effects of TCAs

Blurred vision, dry mouth, urinary retention, sinus tachycardia, constipation, aggravation of narrow-angle glaucoma, postural hypotension, dizziness, reflex tachycardia, sedation, and weight gain.

Therapeutic Uses of TCAs

Moderate to severe depression, panic disorder, migraine headache, and chronic pain syndromes.

MAOIs (Monoamine Oxidase Inhibitors)

Block the degradation of 5-HT and NE in the cytoplasm of the presynaptic nerve terminal, increasing uptake and storage in synaptic vesicles and leakage into the synaptic cleft.

Adverse Effects of MAOIs

Severe and unpredictable side effects, due to drug-food and drug-drug interactions, drowsiness, postural hypotension, blurred vision, dry mouth, constipation.

Therapeutic Uses of MAOIs

Depressed patients who are unresponsive or allergic to TCAs or who experience strong anxiety, useful in the treatment of phobic states and atypical depression.

Bupropion

Weak DA and NE reuptake inhibitor, used for depression and decreasing craving and withdrawal symptoms from nicotine. Few sexual side effects.

Mirtazapine

Enhances 5-HT and NE neurotransmission by blocking presynaptic α2 receptors. It is sedating and an appetite stimulant.

Nefazodone and Trazodone

Block postsynaptic 5-HT2A receptors. Used in the treatment of depression and insomnia.

Lithium

Most effective agent for treating bipolar disorder. Used for treating manic-depressive patients and in the treatment of manic episodes. Considered a “mood stabilizer.”

Common adverse effects of Lithium

Headache, dry mouth, GI distress, fine hand tremor, dizziness, fatigue, dermatologic reactions, and sedation.