Please enable JavaScript.
Coggle requires JavaScript to display documents.
antidepressant, compination, patients in whom SSRIs are ineffective.,…
antidepressant
(SSRIs)
selectivity for the
serotonin
They have little blocking activity at: Muscarinic, α-adrenergic, and Histaminic H1 receptors.
increased conc.s of the NT in the synaptic cleft.
2 weeks to produce significant improvement maximum benefit 12 week
half-lives16-36h
Fluoxetine 50h
its
active metabolite S-nor-fluoxetine 10 days
The antidepressants require a washout period of at least 2 weeks before the other type is administered, with the exception of fluoxetine, which should be discontinued at least 6 weeks
Fluoxetine, Citalopram, Escitalopram, Fluvoxamine, Paroxetine, and Sertraline.
adverse effects
suicidal
Sleep disturbances.
Overdose
Seizures
Cardiac arrhythmias
Serotonin syndrome
hyperthermia, muscle rigidity, sweating, clonic muscle twitching, and changes in mental status and vital signs
Discontinuation syndrome.
Atypical antidepressants
Bupropion(weak dopamine and NE reuptake
inhibitor)
Nefazodone and trazodone Weak inhibitors of serotonin reuptake.
block postsynaptic 5-HT2a
sedating agent
Vortioxetine
SRI
5-HT partial agonist
Vilazodone
SRI
Mirtazapine
enhances serotonin and norepinephrine
Antagonism at 5-HT2 receptors sedation
(MAO)inhabitors
last-line agents
contraindicated with other antidepressants
drug–drug
and drug–food interactions.
Use of MAOIs is limited due to the complicated dietary restrictions required while taking these agents.
Phenelzine
stable complexes with the enzyme, causing irreversible inactivation.
increased stores of NE, serotonin, and dopamine within the neuron
liver
gut
inhibit oxidative deamination of drugs and potentially toxic substances
increase Tyramine causes the release of large
amounts of stored catecholamines
hypertensive, with signs and
symptoms
Headache, Stiff neck, Tachycardia, Nausea, Hypertension, Cardiac arrhythmias, Seizures, and, Stroke.
brain
Tranyl-cypromine
Iso-carboxazid
Selegiline
TCA (narrow therapeutic index.)
Tertiary amines imipramine, amitriptyline, clomipramine, doxepin, and trimipramine.
Secondary amines desipramine and nortriptyline and pro-triptyline.
Mechanism of action
Blocking of receptors Serotonergic, α-adrenergic, Histaminic, and Muscarinic receptors.
Amoxapine a blocks 5-HT2 and D2
Inhibition of neurotransmitter reuptake
slow onset 2 weeks or longer.
uses
insomnia Low doses
prevent migraine headache.
Imipramine bed wetting
chronic pain syndromes of unkomn
cause.
adverse effect
block of muscarinicزغلولة الناشفة حبست جوزها ابو سريع
block α Hypotension, Dizziness, and Reflex tachycardia.
block H1 sedation
Weight gain
Tetracyclic” antidepressant agents, maprotiline
and amoxapine
(SNRIs)
Venlafaxine, Desvenlafaxine, Levomilnacipran, and Duloxetine.
uses
chronic
pain with depression
compination
relieving pain associated with diabetic peripheral neuropathy, and low back pain
patients in whom SSRIs are ineffective.
Alleviate the symptoms of depression
Decreasing withdrawal symptoms of nicotine in smokers
5-HT1a
partial
Sexual dysfunction