Apr 8th, 2015
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Study guide on anti depressants

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Antidepressants & antipsychoticsINTRODUCTION The amine hypothesis of depression :decrease in brain NE and/ or serotonin isresponsible for the disorder. Most drugs effective in major depressionappear to facilitate the activity of brainamines. Usually, 2-6 weeks at a therapeutic-dose levelare needed to observe a clinical responseClassification-1.A) Tricyclics (TCAs) E.g. Amitriptyline, imipramine, clomipramine block neuronal reuptake of NE and 5- HT(serotonin)increasing their postsynaptic actions.Pharmacokinetics incompletely absorbed Undergo significant first-pass metabolism. Tricyclics are metabolized to activemetabolites- eg amitryptilline to nortryptiline,imipramine to desipramine highly protein binding Relatively high lipid solubility therefore largevolume of distribution tend to be very large.B)Heterocyclics: 2nd Generation Amoxapine & maprotiline block NE reuptake.Resemble the tricyclics. Trazodone blocks serotonin reuptake. Strongalpha 1 blockade. Associated with priapism &cardiac arrythmias Bupropion : NE & Dopamine reuptake blocker.Associated with seizures. Pharmacokinetics are similar to TCAs Trazodone and venlafaxine have short plasmahalf-livesCont,C)3rd Generation: Venlafaxine blocks reuptake of NE & 5- HT Mirtazapine antagonizes presynaptic 2 receptors increasing NE synthseis & releasecauses wt gain therefore used Esp for px withanorexia.Clinical indicat

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