ANTI-DEPRESSENTS

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 Depression :

intense feeling of sadness, hopelessness, despair


SELECTIVE SEROTONIN REUPTAKE INHIBITORS
MOA:
inhibit serotonin reuptake...have little ability to block Dopamine
Actions:
 Citalopram & Fuloxetine are Racemic mixture..Escitalopram is S-enantiomer
of Citalopram...Fuloxetine has 50hr t1/2.
T.E:
 treat Depression, Bulimia Nervosa, GAD, PTSD
S.E:
Sexual dysfunction, Suicidal ideation in Adults...Sleep disturbance..

What is the mechanism of depression? What is the first line treatment for depression? What are the 12 types of depression? What is the drug of choice for depression?



Serotonin syndrome: Hyperthermia, muscle rigidity, Myoclonus muscle on withdrawl
SEROTONIN/NOREPINEPHRINE REUPTAKE INHIBITOR
Inhibit reuptake of both Serotonin & NorEpinephrine

Venlafaxine & Desvenlafaxine= Desvenlafaxine is metabolite of Venlafaxine..
Duloxetine=Contraindicated in kidney impair..

T.E:
used in Depression, Backache, MuscleAche, Diabetic peripheral neuropathy

ATYPICAL ANTIDEPRESSENTS
Mixed group of agents have action at different sites

Bupropion :
weak dopamine & norepinephrine reuptake inhibitor..O.D administer..
Decrease craving for Nicotine...contraindicated in Seizure

Mirtazapine:

block α2receptor...increase serotonin & norepinephrine conc.....Block 5-
HT2 receptor...SEDATIVE b/c has Antihistaminic activity..
Nefazodone & Trazodone

weak inhibitor of serotonin reuptake..block 5-HT2A.. trazodone cause Priapism...Nefazodone cause hepatotoxicity

TRICYCLIC ANTIDEPRESSENTS
Block norepinephrine & serotonin reuptake..block cholinergic , histaminic , α2 receptor,
serotonergic receptor.. ..ENZYME INDUCER
What is the most popular antidepressant? Do Antidepressants Make You Happy? What is antidepressant used for? How do antidepressants work?


T.E:
 used in Depression, Panic disorder, ...Imipramine used to control “Bedwetting” in
children..Amitryptylline used in MIGRAINE, headace & chronic pain
S.E:
blurred vision, xerostomia, constipation, urinary retention, aggaravation of
Glaucoma, Hypotension, reflex tachycardia...Erectile dysfunction in
men...Anorgasmia in women..
TCA have Narrow Therapeutic Index..used with caution in Bipolar Disorder,Epilepsy,
Benign Prostatic Hyperplasia, unstable Angina

MONAMINE OXIDASE INHIBITORS
Inhibit MOA enzyme that cause degradation of monoamines..increase the conc. Of
monoamines..
T.E:
used in Phobia, Atypical Depression(Labile mood, rejection sensitivity, appetite
disorder)
S.E:
tyramine inhibit MOA enzyme ...consumption of food containing Tyramine cause
“Hypertensive crisis”

DRUGS TO TREAT MANIA & BIPOLAR DISORDER

Lithium=used prophylactically to treat Manic-depressive patients...considered „MOOD
STABILIZER”...block PIP2(phosphatidylinositol biphosphate) second messenger
resynthesis...Take with food..S.E: polydipsia, polyuria,polyphagia (diabetes insipidus)
Amiloride treat diabetes insipidus




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