This document discusses different classes of anti-depressant drugs, including:
1) Amine Re-uptake Inhibitors (ARI) such as tricyclic antidepressants (TCAs) and heterocyclic antidepressants that work by inhibiting the reuptake of neurotransmitters like serotonin and norepinephrine.
2) Selective Serotonin Reuptake Inhibitors (SSRIs) that more selectively inhibit the reuptake of serotonin.
3) Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs) like venlafaxine that inhibit the reuptake of both serotonin and norepinephrine.
4) Monoamine
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Pharmacology .. Anti-Depressants Drugs
1. P H R M A C O L O G Y - NOTE 11 - Anti-Depressants Drugs
ANTI-DEPRESSANT
DRUGS
ARI MAOI
Selective
Tricyclic Heterocyclic SNARI SSRI Tranylcypromine
NERI
Amitriptyline Amoxapine Venlafaxine Fluoxetine Imipramine Selegiline
Nortriptyline Maprotiline Fluvoxamine Atomoxetine Moclobemide
Imipramine Trazodone Citalopram
action of Tyramine
MAOI cause (sympathomimetics)
Serotonin syndrom with SSRI
Clomipramine Bupropion Sertraline does not cause
selective MAO-B I tyramine related
reactions
hyperthermia.
Serotonin muscle rigidity.
syndrom has myoclonus.
Endogenous (melanocholic)
griefe biochemical bipolar CVS & Resp. failure.
disorder
Reactive (secondary)
illness affective
Manic-depression
(genatically) disorder due to depletion
inability to depression of amine stores in
CNS
depression
depression
cope with
minor life 33
events
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2. P H R M A C O L O G Y - NOTE 11 - Anti-Depressants Drugs
Amine Re-uptake Inhibitors (ARI)
DRUG PHARMACOKINETIC MECHANISM OF ACTION USES SIDE EFFECT
Amitriptyline Caution in glaucoma & BPH re-uptake of NE & 5-HT. Depression. Anti-muscarinic
due to anti-muscarinic side effect. also concentration in synapse. Anxiety disorders. blurred vision, dry mouth.
anti-depreesant
Nortriptyline Caution in driving & skill full word Chronic pain. HR, confusion.
due to sedation constipation, urine retention .
Tricyclic
Enuresis.
Imipramine 留 blocking
ejaculation & orthostatic BP
sedation.
Clomipramine
Seizure.
Weight gain.
Sex disturbances.
Amoxapine re-uptake of NE & 5-HT. Depression. Parkinsonism. moderate
anti-depreesant
D2 receptors. Anxiety disorders Akathesia. sedation
Heterocyclic
So, it acts as anti-psychotic prolactin. &
Maprotiline re-uptake of NE & 5-HT Seizures. anti-
Arrhythmias muscarinic
Trazodone Induce sleep.
Bupropion re-uptake of NE, 5-HT & DA. Seizures.
Aggravate psychosis.
Venlafaxine Low dose acts as SSRI. re-uptake of 5-HT (& NE but less). Depression. Low dose
5-HT & N-ad RI
High dose acts as TSAs Anxiety disorders. o Sedative & anti-muscarinic.
(SNARI)
Chronic pain High dose
o Sedative & anti-muscarinic.
o Nausea.
o BP
o Sex distrabunces.
Fluoxetine re-uptake of 5-HT (more selective). obsessive & compulsive D Transient nausea.
depression
Bulimia Libido. (initial)
anxiety
SSRI
Fluvoxamine obsessive & compulsive D Sex dysfunction. (maintenance
Citalopram therapy)
Sertraline
S NERI Imipramine re-uptake of NE (more selective). Attention deficit hyperkinetic
Atomoxetine disorder.
Mono-Amine Oxide Inhibitors (MAOI)
DRUG PHARMACODYNAMIC MECHNISM OF ACTION USES SIDE EFFECT
Tranylcypromine Inhibits MAO-A & MAO- B. They metabolism of amines by MAO. Headache.
duration of action of Drowsiness.
Selegiline Inhibit MAO- B. NE, 5-HT & DA. Weight gain. 34
also concentration. Postural PB.
o MAO-A metabolizes NE , 5-HT & Tyramine. Sex disturbances.
o MAO-B metabolizes DA more than others.
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