ANTIDEPRESSANTS - QUESTION Classify anti-depressants Discuss the basic pharmacology of any 2 class INTRODUCTION Antidepressants are drugs used mainly to

ANTIDEPRESSANTS - QUESTION Classify anti-depressants...

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Page 1 QUESTION: Classify anti-depressants. Discuss the basic pharmacology of any 2 class INTRODUCTION: Antidepressants are drugs used mainly to treat Major depressive disorders . Their mechanism of anti-depression is based on the Monoamine theory of Mood which indicates that the functional decrease in the activity of monoamines, esp. norepinephrine (NE) and serotonin (5-HT) results in mood depression ; whereas functional increase of their activity results in mood elevation. CLASSIFICATION OF ANTIDEPRESSANTS BASED ON THEIR MECHANSIMS OF ACTIONS A. Typical antidepressants 1. Tricyclic antidepressants ( TCAs ) - whose mech. of action is the same with selective NE reuptake inhibitors (SNRIs) with additional action of blocking α -, H 1 - and M- receptors I mipramine ( prototype & 1 st generation ) , Desipramine, Clomipramine Amitriptyline, nortriptyline, Amoxapine, Doxepin, 2. Selective Serotonin Reuptake inhibitors ( SSRIs ) Fluoxetine or Prozac ( prototype ) , Paroxetine Citalopram , Escitalopram Fluvoxamine Sertraline (Zoloft) 3. Monoamine oxidase inhibitors ( MAOIs ) Irreversible MAOIs: Phenelzine , Tranylcypromine, isocarboxazid, Selegiline Reversible MAOIs : Moclobemide B. Atypical antidepressants (stms called The Heterocyclics) 4. Tetracyclic antidepressants a.k.a . Noradrenergic and specific Serotonergic antidepressants ( NaSSAs ) Maprotiline, mianserin, Mirtazapine 5. Serotonin-Norepinephrine Reuptake inhibitors ( SNRIs ) more central acting; minimal peripheral action Duloxetine Venlafaxine, Desvenlafaxine 6. Serotonin receptor Antagonist and Reuptake inhibitor ( SARIs ) Trazodone, Nefazodone 7. Norepinephrine-Dopamine reuptake inhibitor ( NDRI ) Bupropion, Amineptine, BASED ON THE ERA OF INTRODUCTIONS 1. First Generation (in the 1950s) Most TCAs and MAOIs 2. Second generation (in the 1980s), with less side effects SSRIs, A newer TCA (Amoxapine), Viloxazine, Maprotiline Mianserin, Trazodone, Bupropion 3. Third generation or Newer antidepressants (in the 1990s) Mirtazapine, Duloxetine, Nefazodone, Venlafexine, Antidepressants with significant anti-muscarinic (M receptor block) activity = Imipramine, Amitriptyline, Amoxapine, Doxepin, Nefazodone, trazodone, Mirtazapine Antidepressants with significant α 1 antagonism (= amitriptyline, Doxepin); with α 2 and H 1 antagonism (= Mirtazapine) SSRIs and SNRIs have minimal sedative and anti-muscarinic effects
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  • Spring '17
  • DR SHITTU
  • Selective serotonin reuptake inhibitor, Antidepressant, Tricyclic antidepressant, selegiline, major depression disorders

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