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Anti-depressant

UVa med pharmacology block 2

QuestionAnswer
Imiprimine/Desipramine -Imi = proDesi TCA Inhib NE/5-HT (NE>5-HT) uptake - M, H1, alpha1 antag - unipolar depression, panic disorder, chronic pain, REM depriving sleep disorders delayed genomic fx->chronic elevation->BDNF expression Fx take 2-3wks to develop
Clomipramine (3`amine) TCA Inhib 5-HT uptake - M, H1, alpha1 antag - unipolar depression, panic disorder, OCD, chronic pain, REM depriving sleep disorders delayed genomic fx->chronic elevation->BDNF expression Fx take 2-3wks to develop, OCD b/c 5-HT specific
Amitriptyline TCA Inhib NE/5-HT (NE>5-HT) uptake - M, H1, alpha1 antag - unipolar depression, panic disorder, chronic pain, REM depriving sleep disorders delayed genomic fx->chronic elevation->BDNF expression Fx take 2-3wks to develop
Buproprion Atyp AD - NE spec uptake inhib + DA release - tx depression, depr assoc'd w/psychomotor retardation, smoking cessation fx: no cardiac problems, hypoten, antiACh fx, lower seizure threshold
Fluoxetine SSRI - no M/H1/alpha1 activity (decr sidefx from TCA)- major depression (TCAs better), anxiety, panic disorder, OCD Long T1/2 (2days) 2-3 wks for fx fx: nausea, insomina, sex dysfunct, nervousness/headache/fatigue
Sertraline/Fluvoxamine/Paroxetine SSRI - no M/H1/alpha1 activity (decr sidefx from TCA)- major depression (TCAs better), anxiety, panic disorder, OCD Fx take 2-3wks to dev fx: nausea, insomina, sex dysfunct, nervousness/headache/fatigue
Phenelzine non-selective MAOI - incr synaptic 5-HT levels (slight fx on NE/DA) - unipolar depression(2nd/3rd line), atypical depression, narcolepsy tx fx take 2+ wks CI: sympathomimetic amines, restrict tyramine ingestion (wine/cheese syndrome)
Tranylcypromine non-selective MAOI - incr synaptic 5-HT levels (slight fx on NE/DA) - unipolar depression(2nd/3rd line), atypical depression, narcolepsy tx fx take 2+ wks CI: sympathomimetic amines, restrict tyramine ingestion (wine/cheese syndrome)
Selegiline B-subtype MAOI - irreversible inhib - PD, may have AD efficacy Minimal Fx risk - no wine/cheese synd, decr risk of hypertensive crisis
Lithium Inositol inhibition or AA cascade downreg -> decr NT/COX2 effects respectively - tx acute manic episode, bipolar depression (can be prophylaxis) reqs 5-6 for tx build up - low Therapeutic index
Carbamazepine anticonvulsant - prevs recurrence of manic episodes - tx/prophylaxis bipolar depression reqs 1-2wks chronic use for tx
Valproate Broad-spectrum anticonvulsant - impairs fx of voltage-depend ion channels - tx/prophyl bipolar depression
Created by: sam.mrosenfeld
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