Lecture Notes on Antidepressants
Overview
This lecture focuses on medications used to treat depression, including:
- Tricyclic Antidepressants
- MAOIs (Monoamine Oxidase Inhibitors)
- Atypical Antidepressants
Tricyclic Antidepressants (TCAs)
- Examples: Amitriptyline, Imipramine
- Uses: Depression, neuropathy, fibromyalgia, insomnia
- Mode of Action: Increases serotonin and norepinephrine in the CNS
- Side Effects:
- Sedation
- Orthostatic hypotension
- Anticholinergic effects (urinary retention, constipation, dry mouth, blurry vision, photophobia)
- Dysrhythmias, sweating, seizures
- Memory Aid: "Amy in the desert trips over a tricycle" (Amitriptyline)
- Patient Teaching:
- Chew gum, wear sunglasses, increase fluid and fiber intake
MAOIs (Monoamine Oxidase Inhibitors)
- Examples: Phenelzine, Tranylcypromine
- Uses: Depression
- Mode of Action: Inhibits monoamine oxidase, increasing dopamine, epinephrine, norepinephrine, and serotonin
- Side Effects:
- Agitation, anxiety, orthostatic hypotension
- Hypertensive Crisis
- Drug Interactions: Interacts with many medications, including OTC cold products
- Dietary Restrictions: Avoid tyramine-rich foods to prevent hypertensive crisis (e.g., aged cheese, smoked meat, avocado, red wine, chocolate)
- Memory Aid: "With phenelzine, you can't eat life's finer things because they contain tyramines."
Atypical Antidepressants
Bupropion
- Uses: Depression, smoking deterrent
- Mode of Action: Decreases reuptake of dopamine and norepinephrine
- Side Effects:
- Insomnia, headache, GI upset, weight loss, agitation
- Increased risk of seizures
- Memory Aid: "Be appropriate with bupropion and don't smoke."
Trazodone
- Uses: Depression
- Mode of Action: Serotonin antagonist and reuptake inhibitor
- Side Effects:
- Sedation, hypotension, dry mouth
- Patient Teaching: Avoid alcohol to prevent exacerbation of sedation; chew gum or suck on hard candy for dry mouth
Upcoming Topics
- Next video will cover SSRIs and SNRIs, which are used for both depression and anxiety.