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antidepressant meds
MAOI's
monoamine oxidase inhibitor blocks enzyme that metabolizes norepinephrine and serotonin
special diet-avoid tyramine-in aged food and beverages..cheese wine... and avoid cough medicine w pseudoephedrine to prevent hypertensive crisis
phenelzine(Nardil) and tranylcypromine (parnate)
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TCAs Tricyclic Antidepressants
- Block norepinephrine & serotonin receptors thereby increasing norepinephrine at the synapse.-dizziness & hypotension/risk for falls-cardiotoxicity
- Elavil (amitripytylline)
- anafranil (clomipramine)
- norpramin (desipramine)
- toframil (imipramine)
- pamelor(nortriptylline)
- asendin (amoxapine)
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SSRI (selective serotonin reuptake inhibitors)
- Prevent reuptake of serotonin
- -suicidal impulses, anxiety, insomnia, sex dysfx,
- GI problems
- -slow tapering to avoid withdrawal
- Escitalopram (Lexapro)
- Fluvoxamine (Luvox)
- Paroxetine (Paxil)
- Sertraline (Zoloft)
- Fluoxetine (Prozac) or (Sarafem) for PMS
- Citalopram (Celexa)
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SNRIs
serotonin-norepinephrine reuptake inhibitors
- increase levels of serotonin and norepinephrine
- also used for neuropathic pain
- Duloxetine (Cymbalta)
- Desvenlafaxine (Pristiq)
- Venlafaxine (Effexor)
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SNDIs
serotonin -norepinephrine disinhibitors
Remeron (antianxiety/antidepressant)
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NDRIs
Norepinephrine-dopamine reuptake inhibitors
- Bupropian (Wellbutrin)
- Trazadone (Desyrel)
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Lithium (Eskalith, Carbolith, Lithane)
- Mood Stabilizer for Bipolar
- -works at cellular level Na/K to stabilize electrical activity & decrease mania
- -cardiac dysrhythmias, seizures
- -check kidney functioning and thyroid levels
- toxic > 1.5 meq/L drawn 8 hrs after
- Therapeutic 0.4 - 1.3
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Mood Stabilizers-Antimanic Drugs
often in conjunct with Lithium
- Anticonvulsants: enhance GABA, decrease mania
- Divalproex sodium (Depakote)
- Carbamazepine (Tegretol)
- Oxcarbazine (Trileptal)
- Lamofrigine (Lamictal)
- Gabapentin (Neurontin)
- Topiramate (Topamax)
- Valproic Acid (Depakene)
- Oxcarbezepine (Trileptal)
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First Generation/conventional(typical) Antipsychotics
- Bind to dopamine receptors and reduce transmission
- decrease positive schizophrenia symptoms
- cost effective
- -EPS, Tardive dyskinesia, NMS
- "phenothiazines"
- Chlorpromazine (thorazine)-low potency
- -orthostatic hypotension
- Haloperidol (Haldol) -high potency
- -less sedating, fewer anticholinergic effects
- -More EPS
- Fluphenazine (Prolixin)
- Pherphenazine (Trilafon)
- Thioridazine (Mellaril)
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anticholinergic effects
dry mouth, blurred vision, constipation, urinary hesitancy, tachycardia
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Adverse effects of receptor blockage of antipsychotic agents
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Second Generation/Atypical antipsychotics
- Colzapine (Clozaril): *agranulocytosis *
- Olanzapine (Zyprexa) : weight gain
- Risperidone (Risperdal) : EPS, orthostatic hypotension, sedation
- Quetiapine (Seroquel) : Sedation, orthostatic hypotension, weight gain
- Ziprasidone (Geodon) : dizziness, sedation & dysrhythmias
- aripiprazole (Abilify) : headache, insomnia, nausea
- Paliperidone (Invega)
- -fewer EPS/NMS
- -Affect negative & positive symptoms of schizophrenia
- -improves cognition
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