med chem III antidepressants

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med chem III antidepressants
2013-03-10 01:03:35
med chem III antidepressants

med chem III antidepressants
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  1. NNDI if clinical trials
    agomelatine - valdoxen
  2. TCA tertiary
    tabs and injection
    discontinued but back on the market
  3. TCA tertiary
    ind - OCD
    high incidence of sexual dysfunction
    high serotonin uptake
    clomipramine - anafranil
  4. TCA tertiary
    not recommended for <12 yo
    moderate serotonin uptake
    doxepin - silenor
  5. TCA tertiary
    ind - depression and childhood enuresis <6
    high orthostatic compared to other TCA's
    imipramine - tofranil
  6. TCA tertiary
    slight serotonin and norepinephrine uptake blocker
    trimipramine - surmontil
  7. TCA secondary
    high NE uptake blocking activity and anitcholinergic effects
    not for kids, T1/2 67-89 hrs
    protriptyline - vivactil
  8. TCA secondary
    not for kids < 16 because of 50-600mg/day
    high anticholinergic and moderate sedation effect
    second generation agent
  9. TCA secondary
    moderate NE and high 5HT uptake block
    caps and solution
    nortriptyline - pamelor
  10. TCA secondary
    least anticholinergic, sedation and othostatic hypotension
    despiramine - norpramin
  11. Tetracycline
    CI in pts with known or suspected seizure disorders
    block NE reuptake
  12. tetracycline
    potent 5HT2&3 receptor antagonist
    potent antagonist of H1 = prominent sedative effect
    SE - agranulocytosis, 30 day Rx then bloodwork
    mirtazapine - remeron
  13. triazolopyridine
    ind - depression, alcoholism, aggressive behavior, cocaine withdrawal
    moa - selective inhibits serotonin reuptake and potentiates 5-hydroxytryptophan
    onset of action - 2-4 wks
    AE - inappropriate or painful erections
    trazodone - oleptro
  14. aminoketone
    ind - depression, smoking cessation, adunct in diabetes
    associated with seizures and frequency increases with dosage
    weight gain
    bupropion - wellbutrin
  15. once daily prep of bupropion
  16. phenythylamine
    AE - rash or hives or other allegic reactions occur
    venlafaxine - effexor
  17. main metabolite of venlafaxine
    desvenlafaxine - pristiq
  18. SNRI
    potent inhibitor of neuronal 5HT and NE reuptake and less DA
    ind - MDD, major mood disorder
    duloxetine - cymbalta
  19. SNRI
    ind - fibromyalgia
    no QT issues
    not approved for pediatric use
    milnacipran - savella
  20. phenylpiperidine
    may cause liver damage
  21. SSRI
    ind - bulimia nervosa
    tabs, pulvules, oral solution
    T1/2 - 1 to 348 hrs
    secondary amine
    fluxetine - prozac
  22. SSRI
    ind - OCD
    T1/2 14-16 hrs
    fluvoxamine - luvox
  23. SSRI
    ind - panic disorder, social anxiety
    max dose for pts with severe renal or hepatic impairment is 40mg/day
    caution on withdrawal - develop psychiatric problems
    paroxetine - paxil
  24. SSRI
    ind - PTSD
    T1/2 - 26-104hrs
    secondary amine
    sertraline - zoloft
  25. SSRI
    genetic, GRIK2, AMPA, GR1A3 - link to suicidal ideation
    QT elongation
    no weight gain, lower SE
    citalopram - celexa
  26. SSRI
    ind - Tx of major depression
    highly selectivve
    escitalopram - lexapro
  27. SSRI & 5HT1A partial agonist
    not for pediatric pts
    must be taken with food
    vilazodone - viibryd