Action of Benzodiazepines
Increase the effect of GABA - Reduces neural excitability
Action of SSRIs (selective serotonin reuptake inhibitors)
Increase serotonin by inhibiting the reuptake of it
Action of SNRIs (Selective serotonin-norepinephrine reuptake inhibitors)
Increase both serotonin and norepinephrine but inhibiting the reuptake
Action of TCA's (Tricyclic antidepressants)
Increases norepinephrine and serotonin
- some increase acetylcholine and histamine
Action of NDRI (norepinephrine-dopamine reuptake inhibitor)
Increase norepinephrine and dopamine by blocking reuptake
Action of MAOIs (monoamine oxidase inhibitors)
Increase monoamines
- interferes with enzyme that breaks down neurotransmitters
Action of Antipsychotics
Decrease dopamine
-atypical decrease dopamine and increase serotonin
What disorders can antidepressants treat other than depression?
Anxiety, OCD, panic disorder, eating disorders, sleep aid, pain syndromes
Classes of antidepressants
-Selective Serotonin Reuptake Inhibitors (SSRI)
-Serotonin-Norepinephrine Reuptake Inhibitors (SNRI)
Serotonin antagonist and reuptake inhibitor (SARI)
-Tricyclic Antidepressants (TCA)
-Monoamine Oxidase Inhibitors (MAOI)
-Psychotherapeutic Combinations
-Heterocyclics
-Atypical Antipsychotics
SSRI's
GOLD STANDARD for depression
Trintellix
SSRI
receptor agonist
, Celexa (citalopram)
SSRI
Lexapro (escitalopram)
SSRI
Prozac (fluoxetine)
SSRI
more exciting
longest half life
Luvox (fluvoamine)
SSRI
Paxil (paroxetine)
SSRI
sedative effects
Vilazodone (viibryd
SSRI and receptor agonist, lower sexual SE
Zoloft (sertraline)
SSRI
SSRI side effects
-often self limiting, go away with time
-agitation
-shakiness/jittery
-tremors
-headache
- sexual dysfunction
-Mild GI (nausea and diarrhea) because of high serotonin
Serotonin syndrome
POTENTIALLY TOXIC
-usually caused by combo of SSRI and MAOI or SSRI and ecstasy
-FIRST sign is HTN
-initial symptoms: mental status change (restlessness/agitation), lethargy, flushing, confusion,
tremors, diaphoresis, ataxia
-later signs: hyperthermia, renal failure, hypertonicity, seizure, death
Discontinuation syndrome (not lethal)
Occurs with abrupt stopping of medication
- can last 4-6 weeks and will go away with reinstitution of medications
-Flu like symptoms, insomnia, nausea, congestion, vertigo
SNRI's