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Amoxapine 150-300mg
Maprotiline 75-300mg
Trazadone 50-600mg
Bupropion 200-400mg
Classification of antidepressant drugs
3)Third generation antidepressants:
(Heterocyclic antidepressants):
Nefazodone 200-600mg
Venlafaxine 75-225mg
Mirtazapine 15-60mg
Classification of antidepressant drugs
4) Selective serotonin reuptake inhibitors
(SSRIs):
Escitalopram 10-30mg
Fluoxetine (Prozac) 10-60mg
Paroxetine (Paxil) 20-50mg
Citalopram (Celexa) 20-60mg
Sertraline (Zoloft) 50-200mg
Fluvoxamine 100-300mg
Classification of antidepressant
drugs
5) Monoamine oxidase inhibitors:
Irreversible inhibitors (non selective)
Isocarboxazide
Tranylcypramine
Phenelzine
Reversible inhibitors:
Moclobemide
Brofaromine
Tricyclic antidepressants
Mechanism of action:
Blocking the reuptake of serotonin and
noradrenaline into presynaptic nerve
terminal and increase in the levels of
monoamines in synaptic cleft resulting
antidepressant effect.
In addition TCAs bind to alpha, histamine
and cholinergic receptors which accounts
for many of the side effects seen with these
agents.
Actions
TCAs elevate mood, improve mental
alertness, increase physical activity.
Mechanism of action:
Not clear. The major possibilities being investigated
include:
Effects on electrolytes and ion transport:
It blocks sodium channels
Mechanism of action
Effects on neurotransmitters:
Blocks dopamine receptors, may
decrease NA also.
Effects on second messangers:
Depletion of IP3 and DAG
Side effects
Edema
Weight gain
Bradycardia-tachycardia (sick sinus syndrome)
Decrease thyroid function
Tremor
Polydipsia and polyurea
Leukocytosis
Drug Interactions
ACE inhibitors, NSAIDs , Thiazides, Fluoxetine
increase lithium concentrations.
Lithium+antipsychotics or Benzodiazepines may
increase risk for neurotoxicity particularly with
long term combination therapy.
Acetazolamide, osmotic diuretics, theophylline
increase lithium excretion.
Contraindication
Acute renal failure
Pregnancy
Thyroid disease
Cardio vascular disease.
Pharmacokinetics