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AntiDepressants (TCA's (SE's (Arrythmias = LETHAL OVERDOSE (QRS…

- - - - NE
      - Serotonin
    - - -> sedation
    - - Anticholinergic SE's
        
        blurry vision
        
        bloating
        
        constipation
        
        dry mouth
    - - -> postural hypotension
  - - - QRS widening
      - mental status changes
      - seizures
  - - - Tx: neuropathic pain
    - - Tx: enuresis
  - - - Tx: Insomnia
    - - Tx: aid in smoking cessation
  - - - seizures <-
- - - - Inhibits cytP450
        
        Enhances effects of drugs metabolized by this enzyme
        
        TCA's
        
        Haoperidol
        
        AntiArrythmics
      - Longest half life (10 days!)
        
        Useful to prevent discontinuation syndrome
      - Little weight gain
      - Más activante
        
        Not good for anxiety
        
        Insomnia
        
        Add BDZ
        
        useful for depression + psychomotor retardation
    - - Short half life
        
        Higher chance of discontinuation syndrome =
      - Most sedating
      - weight gain
      - CYP2D6 interaction, affecting other med metabolisms
    - - Safetest for post-MI patients
      - least sedating
      - Longer halflife (tiene metabolito activo que dura ~72 hrs)
      - increase dosage in a step-wise manner
    - - OCD
      - Shortest half-life
      - Lots of SE; therefore not used often
        
        GI distress
        
        HA
        
        sedation
    - - Least SE of ALL SSRI's
      - No P450 interaction
    - - DOESNT inh P450
      - Few GI sx
      - Dose-dependent QTc prolongation
        
        = keep at <40mg
  - - - -> potentiates serotonin effect at postsynaptic-R
  - - - decreased libido
      - anormgasmia
    - - Use w/ BDZs in 1st 2 wks
  - - - -> Serotonin syndrome = OH-HAAMMS
        
        Altered mental status
        
        Muscle stiffness
        
        Autonomic instability
        
        Hyperthermia
        
        seizures; coma; death
        
        Orthostatic HYPOtns
- - - - Selectively Inh Mao-B
        
        incr DOPA @ presynaptic neuron <-
        
        Tx Parkinsons with LevoDOPA
  - - - NE
      - Serotonin
    - - DOPA
    - - When inhibited, Tyramine increases
        
        Incr NE
        
        Incr Epi
        
        Hypetensive Crisis
        
        HA
        
        HTN
        
        Cardiac arrhythmia
- - - - Duloxetine (Cymbalta)
  - - - GI upset -> Take with food
      - Short 1/2 life ->
        
        bad discontinuation syndrome
      - Increases BP (by 10-15mmHg)
      - NO p450 interaction
      - Incr HRate
    - - TX
        
        Diabetic Neuropathy
        
        Fibromyalgia
      - LIVER FAILURE!!!!
      - SNRI that least affects BP
    - - Active metabolite of Venlafaxine
      - NO p450 interaction b/c metabolite of Venlafaxine who also doesn't interact with it
      - Increases BP; less than Venlafaxine since its metabolite
  - - - NE
      - Serotonin
- - - - Priapism
    - - ->
      - hepatic failure
    - - Inh alpha-2 adrenergic-R
        
        Incr NE
      - Inh 5HT-2 & 5HT3 Rs
        
        Incr Setrotonin
      - SE
        
        sedation
        
        No sexual dysfunction or GI disturbances
        
        Useful for when patients don’t tolerate SSRIs due to SE
        
        weight gain
        
        = Monitor
        
        lipids
        
        TG
        
        weight
      - No P450 interaction
        
        good in geriatric population!
    - - Uses
        
        ADHD; 2nd line
        
        depression
        
        NOT for anxiety b/c DA NE
      - Mechanism
        
        = reuptake inhibition of
        
        DA
        
        NE
      - ContraIndications
        
        Bulimia
        
        Anorexia nervosa
        
        Traumatic Brain Injury
      - SEs
        
        NO weight gain OR sexual dysfunction
    - - Inh reuptake of
        
        NE
        
        Serotonin
  - - - = Mirtazapine
    - - -> weight gain
    - - = Venlafaxine
- - - - diappears in 6mo