Antidepressant Drug Chart

Antidepressant Drug Chart


Phenelzine (Nardil)
Tranylcypromine (Partite)
Selegiline (Eldepryl & Emsam)
*An MAOI approved by the FDA for treatment of Parkinson’s and major depression.* Emsam is supplied in patch form

MAO is an enzyme found in brain, gut, and liver. MAOIs Will ↑ norepi, serotonin, and dopamine within the neuron.
HA, Tachycardia, Nausea, HTN, cardiac arrhythmias, stroke, death—cheese effect
Downiness, ortho hypotn, blurred vision, dry mouth, sleep disturbance, dysuria, and constipation
MAOIs and SSRI can cause serotonin syndrome
Demerol (Meperdine
Cheese effect—foods that are fermented (cheese, wine, beer, ckn liver) can result in HTN ER
Wash out period of 14-20dys before another drug started
(Tricyclic Antidepressants)
Amitripyline (Elavil)
Despiramine (Norpramin)
Imipramine (Tofranil)
Nortriptyline (Pamelor)
Doxepin (Sinequan
Potent inhibitors of the neuronal re-uptake of norepinephrine and serotonin into presynaptic nerve terminals. Do not block dopamine transporters. Block serotonergic, α adrenergic, histaminic, and muscarinic receptors.O-Orthostatic hypo TN
C-Cardiac arrhythmias (EKG)
A-Anticholinergic SE (BPH/glaucoma)
S-Sedation, seizure, sexual SE
Weight gain
Caution in manic-dep pt can unmask manic behavior

Narrow therapeutic index and have a narrow lethal dose (SUICIDE)
Depressed pt should only be given limited amt of drug and be monitored closely

Monitor—CBC, leukocytes and diff, LFTs
(Serotonin Norepinephrine Reuptake Inhibitors)
Desvenlafaxine (Pristiq)
Duloxetine (Cymbalta)
Venlafaxine (Effexor, XR)
Tx of major dep with prominent pain complaints.

Similar to TCAs but not muscarinic, histaminic or α adrenergic receptors.

inhibitor or serotonin and norepinephrine reuptake and less potent inhibitor of dopamine
N, Dizzy, Insomnia, sedation, constipation
AT HIGH DOSES CAN CAUSE ↑BP, Sweating, nervous, agitation, lower SZ threshold

GI SE, N, dry mouth, constipation, sexual dysfxn
{EFFEXOR} Hyponatremia (SIADH), Mydriasis (↑ICP in glaucoma pt)

should not be given to pt with liver failure or end stage renal disease. Can cause HEPATOTOXICITY
has been approved for the treatment of diabetic neuropathy and fibromyalgia.
(Selective Serotonin Reuptake Inhibitors)
Fluoxetine (Prozac)
Sertraline (Zoloft)
Paroxetine HCL (Paxil)
Escitalopram (Lexapro)
Citalpram (Celexa)
Paroxetine mesylate (Pexeva)

Blocks reuptake of serotonin; Longest half-life and very stimulatory; Available in weekly time released form

Has some antihistamine actions and more likely to cause sedation and constipation

Is a metabolite of Citalpram (Celexa)

Major inhibitor of several CYP enzymes resulting in a lot of DDI

Acts at an unidentified site to alleviate symptoms of depression
Zyban—Nicotine sensation

Blocks 5-HT2 and alpha 2 receptors, antihistaminic activity

block 5-HT1 presynaptic auto receptors and increase serotonin release
Block the reuptake of serotonin, leading to increased concentration of the neurotransmitters in the synaptic clefts

Also plays a role in migraines and antiemetic
S-stimulatory, sedation, stomach Aches
S- Serotonergic syndrome
R-Reduced libido
I-Insomnia, increased

↓appetite and weight loss, ↓SZ threshold, ↓platelet aggregation (bleeding), Hyponatremia in elderly, Rash (dc if pt develops)

Greater Weight Gain, nervousness,
sweating, irritation, jitteriness, ↑sexual SE and ↑ DC of symptoms than other SSRI; Sleep disturbance

High degree of QTc interval prolongation, HEPATOXICITY

Less side effects than Celexa

Tardive dyskinesia, CNS depression, psychotic symptoms; Weight Gain

Dry mouth, sweating, tremor, weight loss, HTN and ↓ SZ threshold

Severe sedation, Increased appetite, Weight gain, dizzy, elevated cholesterol, ortho hypoTN; Agranulocytosis, cardiac, renal/hepatic

Sedation, Priapism, Cardiac disease, Ortho Hypotension

High degree of QTc interval prolongation, HEPATOXICITY

Causes most GI upset, most associated with N/V
MAOIs, antimicrobial agents (zyvox), other serotonergic drugs (dextromethorphan (Demerol), sumatriptan (Imitrax), tramadol, Zofran, St johns wart

Abrupt withdrawal can lead to Flu-like sx –taper slow

Highest degree of DDI-inhibits the metabolism of other drugs-- P450
Renal/Hepatic pt

A lot of DDI

Alosetron (lotronex), pimozide (Orap), tizanidine (Zanaflex), thioridazine (Mellaril), mesoridazine (Serenity)

Sz disorders, bulimia or anorexia, withdrawal from ETOH/Drugs, MAOIs

Titrate dose carefully…a lot of DDI
Serotonergic syndrome Most commonly a result of an interaction with MAOIs; Life-threatening condition characterized by: Altered mental changes, Fever, tachycardia, hypertension, Agitation, tremor, myoclonus, hyperreflexia, ataxia, incoordination, Seizure, Diaphoresis, shivering, GI symptoms

Monitor platelets; DOC for treatment of children and adolescents

When you think about Zoloft think about S for stomach

When you think about Paxil think of PACKING ON THE POUNDS

mg to mg Lexapro is more potent than Celexa

Rarely used

Better drug for depressed pt without severe anxiety who cannot tolerate sexual dysfxn, weight gain, and sedation of other drugs

Useful when insomnia or agitation is prominent, and depressed pt with marked anorexia

Put a pt in a trance