Phenelzine & Tranylcypromine

MOA-I's

MOA: inhibit MOAa & MOAb (degradation of DA/NE)

Use: atypical depressions

DI: w/ things that increase NE or 5HT more

 inc NE = tyramine, TCA's, alpha1 agonists, levodopa (hypertensive crisis w/ inc BP, arrhythmias, excitation, hyperthermia)

inc 5HT = SSRI's, TCA's, meperidine, dextromethorphan (serotonin syndrome w/ sweating, rigidity, myoclonus, hyperthermia, ANS instability, seizures

Amitriptyline, Imipramine, Clomipramine

MOA: nonspecific blockade of 5HT and NE reuptake (tricyclic antidepressants)

Uses: major depression, phobic/panic states, OCD, Neuropathic pain, Enuresis (block muscarinc receptors)

SE: muscarinic and alpha blockade

Toxicity: Coma, Convulsions, Cardiotoxicity

DI: hypertensive crisis w/ MAOI's

Serotoniin syndrome w/ SSRI's & MAOI's

Fluoxetine, Paroxetine, Sertaline, Citalopram, Escitalopram

MOA: selective blockade fo 5HT reuptake (SSRI's)

Uses: major depression, OCD, bulimia, anxiety disorders, PMDD

SE: anxiety, agitation, bruxism, anorgasmia, weight loss

Toxicity: serotonin syndrome w/ MAOI's/TCA's

Trazodone

Other antidepressant

SE: cardiac arrhythmias and priapism (lasts 48hrs)

Venlafaxine

Bupropion

Mirtazapine

Alpha 2 antagonist (don't get negative feedback on original signal so continues to release)

Assoc. w/ weight gain

Lithium

DOC: for bipolar disorders

MOA: prevents recycling of inositol (dec. PIP2)--> decrease cAMP

SE: narrow therapeutic index (requires monitoring), hypothyroidism w/ goiter (inhibits 5 prime deiodinase) causes tricuspid atresia

Methylphenidate

Amphetamine-like

Use: ADHD

SE: agitation, restlessness, insomnia, cardiovascular toxicity

Atomoxetine

MOA: selective NE reuptake inhibitor (works like cocaine)

Use: ADHD

 SE: similar to TCA's (muscarinic and alpha blockade)