A little "Head Med" reference

[liftsiron]

Antidepressants

? Tricyclics
? prevent reuptake of serotonin or norepinephrine/epinephrine. Block acetylcholine and histamine receptors.
? Elavil (amitryptiline), (Asendin) amoxapine, Norpramin (desipramine), Tofranil (imipramine)
? MAO Inhibitors
? block monoamine oxidase (MAO) from breaking down monoamines (serotonin, dopamine, and norepinephrine/epinephrine)
? Nardil (phenelzine), Parnate (tranylcypromine)
? SSRIs (selective serotonin reuptake inhibitors)
? Block reuptake of serotonin by presynaptic neuron
? Prozac (fluoxetine), Zoloft (setraline), Paxil (paroxetine), Celexa (citalopram)
? Increased serotonin release = sexual side effects (reduced drive and function)
? SNRI (serotonin-norepinephrine reuptake inhibitor)
? Blocks reuptake of serotonin and norepinephrine by presynaptic neuron
? Also have sexual side effects
? Cymbalta (duloxetine), Effexor (venlafaxine)
? Triple Reuptake Inhibitors (TRIs)
? New, experimental class of antidepressants. Block reuptake of dopamine, serotonin and norepinephrine
? Theoretically should have reduced sexual side effects, due to:
? Relatively lower blockade of serotonin transporters
? Enhanced availability of dopamine
? Functional TRI: take bupropion (Wellbutrin; inhibits DA and NE reuptake) plus fluoxetine (Prozac; inhibits serotonin reuptake)
? DOV 216,303: Experimental TRI in Phase II trial. Related compound (DOV 21,947) starts Phase II in January 2007.

? Atypical antidepressants
? Generally act on dopamine or norepinephrine systems, but not always serotonin
? Bupropion (Wellbutrin), maprotiline (Ludiomil), mirtazapine (Remeron)
? Wellbutrin is a reuptake inhibitor of dopamine and norepinephrine

Bipolar Disorder

? Mood Stabilizers
? Lithium: a salt that stabilizes mood by decreasing mania
? Less effective for depression (often given with an antidepressant)
? Cessation of lithium results in increased bouts of mania and increases suicide risk
? Complex mechanism of action
? Increases serotonin release
? Alters second messenger activity
? Alters neurotrophic factors
? Anticonvulsants
? Have mood-stabilizing effects
? Depakote (valproate), Tegretol (carbamazepine), Topamax (topiramate)
? Increase GABA release
? Sedatives (anxiety or insomnia)
? Benzodiazepines, e.g., Klonopin (clonazepam)
? Sleep Aids: Lunesta, Ambien
? Both the benzodiazepines, Lunesta and Ambien facilitate increased GABA neurotransmission
? Antidepressants
? Antipsychotic Drugs
? Offer mood stabilizing effects as well.
? Clozaril (clozapine), Zeprexa (olanzapine), Seroquel (quetiapine), Geodon (ziprasidone)