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Antidepressants
USMLE Step 1
Drug | MOA & ADRs |
---|---|
Amitriptyline | MOA:TCA 4 severe major depression & panic disorders,- reuptake of NE & 5-HT also - muscarinic,alpha & H1Rs;ADRs:physical & psych dependence,slow onset,antiCh effects(use 4 enuresis),reflex tachy & orthostatic hypoTN,contra 4 bipolar & suicidal pts can OD |
Desipramine | MOA:TCA 4 severe major depression & panic disorders,- reuptake of NE & 5-HT also - muscarinic,alpha & H1Rs;ADRs:physical & psych dependence,slow onset,antiCh effects(use 4 enuresis),reflex tachy & orthostatic hypoTN,contra 4 bipolar & suicidal pts can OD |
Imipramine | MOA:TCA 4 severe major depression & panic disorders,- reuptake of NE & 5-HT also - muscarinic,alpha & H1Rs;ADRs:physical & psych dependence,slow onset,antiCh effects(use 4 enuresis),reflex tachy & orthostatic hypoTN,contra 4 bipolar & suicidal pts can OD |
Citalopram | MOA: SSRI block reuptake of 5-HT,fewer side effects,used for depression,bulimia,OCD, anorexia,panic disorder,diabetes-related neuropathic pain & PMS,taper to discontin; ADRs: loss of libido,delayed ejaculation,weight gain, anorgasmia,OD causes seizures |
Escitalopram | MOA: SSRI block reuptake of 5-HT,fewer side effects,used for depression,bulimia,OCD, anorexia,panic disorder,diabetes-related neuropathic pain & PMS,taper to discontin; ADRs: loss of libido,delayed ejaculation,weight gain, anorgasmia,OD causes seizures |
Fluoxetine | MOA: SSRI block reuptake of 5-HT,fewer side effects,used for depression,bulimia,OCD, anorexia,panic disorder,diabetes-related neuropathic pain & PMS,taper to discontin; ADRs: loss of libido,delayed ejaculation,weight gain, anorgasmia,OD causes seizures |
Paroxetine | MOA: SSRI block reuptake of 5-HT,fewer side effects,used for depression,bulimia,OCD, anorexia,panic disorder,diabetes-related neuropathic pain & PMS,taper to discontin; ADRs: loss of libido,delayed ejaculation,weight gain, anorgasmia,OD causes seizures |
Sertraline | MOA: SSRI block reuptake of 5-HT,fewer side effects,used for depression,bulimia,OCD, anorexia,panic disorder,diabetes-related neuropathic pain & PMS,taper to discontin; ADRs: loss of libido,delayed ejaculation,weight gain, anorgasmia,OD causes seizures |
Phenelzine | MOA:MAOI 4 phobias & depressed pts unre or allergic 2 TCAs,SSRIs or who have strong anxiety component 2 their probs;ADRs:dont use w/ SSRI or TCA b/c need 'wash-out' b/t antidepressants,constipation,blurry vision,xerostomia,drowsiness,dysuria & HPTN crisis |
Isocarboxazid | MOA:MAOI 4 phobias & depressed pts unre or allergic 2 TCAs,SSRIs or who have strong anxiety component 2 their probs;ADRs:dont use w/ SSRI or TCA b/c need 'wash-out' b/t antidepressants,constipation,blurry vision,xerostomia,drowsiness,dysuria & HPTN crisis |
Tranylcypromine | MOA:MAOI 4 phobias & depressed pts unre or allergic 2 TCAs,SSRIs or who have strong anxiety component 2 their probs;ADRs:dont use w/ SSRI or TCA b/c need 'wash-out' b/t antidepressants,constipation,blurry vision,xerostomia,drowsiness,dysuria & HPTN crisis |