Antidepressants

Pharmacotherapyu Antidepressantsu Anxiolyticsu Mood stabilizersu Antipsychotics

Psychotherapyu Cognitive behavioral

therapyu Interpersonal therapyu Marital/family counselingu Group therapy

Somatic Therapyu Electroconvulsive therapyu Bright light therapyu Possibly:

F Transcranial magnetic stimulation

F Vagal nerve stimulationF Sleep deprivation

TCA

• block reuptake of NE & 5ST

• major depression, bedwetting, OCD, fibromyagia

TCA SIDE EFFECTSTricyclic Action SE

(-)presynaptic NT (NE/5ST) reuptake tremor, insomnia

Block of cardiac fast Na channels conduction defect, arrythmias, hypotension

antagonism of c/p muscarinic Ach receptor hyperthermia, flushing, dilated pupil, ileus

SSRI

FLUOXETINE

PAROXETINE

SERTRALINE

CITALOPRAM

SSRI MOA

SEROTONIN SPECIFIC REUPTAKE INHIBITORS

CLINIC USE:DEPRESSION, OCD,BULIMIA, SOCIAL PHOBIAS, PTSD

SNRI

• INHIBIT SEROTONIN AND NE REUPTAKE

• CLINICAL USE: DEPRESSIONo VENLAFAXINE CAN ALSO BE USED FOR

GENERALIZED ANXIETY DISORDERo DULOXETINE ALSO INDICATED FOR DIABETIC

PERIPHERAL NEUROPATHY

MAO INHIBITORS

TRANYLCYPROMINE

PHENELZINE

ISOCARBOXAZID

SELEGILINE

MOA:NONSELECTIVE MAO INHIBITION WHICH WILL INCREASE LEVELS OF AMINE NT

MAOI

CLINICAL USE:

ATYPICAL DEPRESSION

ANXIETY

HYPOCHONDRIASIS

HYPERSOMNIA

ATYPICAL ANTIDEPRESSANTSBUPROPION

INCREASE NE DA

TOXICITY(STIMULANT EFFECT)

TACHYCARDIA, INSOMNIA, HEADACHE, SEIZURE IN BULIMIC PATIENTS

MIRTAZAPINE

A2-ANTAGONIST:INCREASE RELEASE OF NE AND 5ST

POTENT 5ST2 AND 5ST3 ANTAGONIST

SE:SEDATION, INCREASED APPETITE, WEIGHT GAIN, DRY MOUTH

MAPROTILINE

BLOCKS NE REUPTAKE

SE:SEDATION, ORTHOSTATIC HYPOTENSION

TRAZODONE

INHIBITS 5ST REUPTAKE

USED FOR INSOMNIA

SE: SEDATION, NAUSEA, PRIAPISM, POSTURAL HYPOTENSION