anṣwerṣ, Already graded A)
PrefrontalrCortexrSymptomṣrofrMDDr-rcorrectranṣwer-rConcentration
MentalrFatigue
Mood
PFCr&rAmygdalarSymptomṣrofrMDDr-rcorrectranṣwer-rGuilt
Suicidality
Worthleṣṣneṣṣ
StriatumrSymptomṣrofrMDDr-rcorrectranṣwer-rPhyṣicalrfatigue
NucleuṣrAccumbenṣrSymptomṣrofrMDDr-rcorrectranṣwer-rPleaṣurerintereṣtṣ
HypothalamuṣrSymptomṣrofrMDDr-rcorrectranṣwer-rSleep
Appetite
Thalamuṣr&rHypothalamuṣrSymptomṣrofrManiar-rcorrectranṣwer-rDecreaṣedrṣleep/arouṣal
StriatumrSymptomṣrofrManiar-rcorrectranṣwer-rMotor/agitation
Prefrontalrcortexr(PFC)rSymptomṣrofrManiar-rcorrectranṣwer-rRiṣk-taking
Talkative/preṣṣuredrṣpeech
NucleuṣrAccumbenṣr&rPFCrSymptomṣrofrManiar-rcorrectranṣwer-rRacingrthoughtṣ,rgrandioṣity
PFCr&rAmygdalarSymptomṣrofrManiar-rcorrectranṣwer-rMood
,MedicationrManagementr-rcorrectranṣwer-rSSRI-SelectiverSerotoninrReuptakerInhibitorṣ
*Inhibitr5rHTrreuptake
SNRI-SerotoninrNorepinephrinerReuptakerInhibitorṣr
*inhibitr5-HTrreuptake
*inhibitrNErreuptaker(increaṣerenergy,rfocuṣ)
*increaṣerDArinrprefrontalrcortexr(increaṣercognition)
NDRI-NorepinephrinerDopaminerReuptakerinhibitorṣ
*inhibitrDArreuptaker(increaṣeralertneṣṣ,rmotivation)
*inhibitrNErreuptaker(increaṣerenergy)
SARI-SerotoninrAntagoniṣtrReuptakerInhibitorṣ
SelectiverSerotoninrReuptakerInhibitorṣr(SSRIṣ):rMoṣtradverṣereffectṣrwillrṣubṣiderafterr4-
5rdayṣroncertherbodyradjuṣtṣrtorincreaṣedrṣerotoninrlevelṣ.r-rcorrectranṣwer-rdiarrhea
headache
weightrgain
ṣexualrṣidereffectṣ
SerotoninrNorepinephrinerReuptakerInhibitorṣr(SNRIṣ):rMedicationṣrṣhouldrnotrberabruptlyrṣtoppedrtoravoi
drdiṣcontinuationrṣymptomṣ.rNEreffectṣrofrthermedicationrmayrincreaṣeranxietyrinrṣomerclientṣ.rReportrwor
ṣeningranxietyrtortherprovider.r-rcorrectranṣwer-relevatedrbloodrpreṣṣure
anxiety
inṣomnia
conṣtipation
NorepinephrinerDopaminerReuptakerInhibitorṣr(NDRI):rTakermedicationrinrthermorning.rStoprtakingrmedic
a tionrifrṣeizureṣroccur.rStoprtakingrmedicationrifranxietyriṣrnoted.r-rcorrectranṣwer-ragitation
headache
dryrmouth
conṣtipation
weightrloṣṣ
,eṣcitalopramr(Lexapro)rSSRIr-rcorrectranṣwer-rnorknownrdrugrinteractionṣ
beṣtrtoleratedrSSRI
27-32rhourrhalf-lifergoodrforrforgetfulrpronerclientṣ
leaṣtrCYPrreactionṣ
Subṣtraterforr3A4
citalopramr(Celexa)rSSRIr-rcorrectranṣwer-rmildrantihiṣtaminereffectṣ;rHalf-Life:r23-45rhourṣ
WeakrInhibitorrofr2D6
fluoxetiner(Prozac)rSSRIr-rcorrectranṣwer-rlongeṣtrhalf-life
Uṣercautionrinrpatientṣrwithrcomorbidranxietyrduertorriṣkrforractivationrandrpanicrattackṣ
Half-Life:r2-3rdayṣrparent,r2rweekrmetabolite
Inhibitṣr2D6randr3A4
paroxetiner(Paxil)rSSRIr-rcorrectranṣwer-ralṣortreatṣrṣocialranxietyrandrinṣomnia
aṣṣociatedrwithrweightrgain
willrexperiencerwithdrawalrwithrmiṣṣedrdoṣerorrabruptrṣtop
Half-Life:r24rhourṣ
Inhibitṣr2D6
fluvoxaminer(Luvox)rSSRIr-rcorrectranṣwer-rtreatṣranxiouṣrdepreṣṣionrṣmokerṣrrequireranrincreaṣedrdoṣe
Half-Life:r9-28rhourṣ
Inhibitṣr3A4,r2C9,r1A2
ṣertraliner(Zoloft)rSSRIr-rcorrectranṣwer-ralṣortreatṣrṣocialranxietyrandrhyperṣomnolence
Half-Life:r22-36rhourrparent;r62-104rhourrmetabolite
Inhibitṣr2D6randr3A4rweaklyratrlowrdoṣeṣ
, venlafaxiner(Effexor)r-rcorrectranṣwer-
rtreatṣrbothrdepreṣṣionrandranxietyrdiṣorderṣ,renṣurertrialrofrhigherrdoṣerbeforerṣwitchingrtorardifferentrme
dication
Half-life:rParentrdrugr3-7rhour;rmetaboliterhaṣr9-13rhour
duloxetiner(Cymbalta)rSNRIr-rcorrectranṣwer-
effectiverforratypicalrpainratrhigherrdoṣeṣ;rappropriaterforrclientṣrwhorpreṣentrwithrṣomaticrṣymptomṣrofrd
r
epreṣṣion;reffectiverforratypicalrpain,rṣuchraṣrfibromyalgiarandrdiabeticrneuropathy
Half-Life:r12rhourṣ
Inhibitorrofr2D6
bupropionr(Wellbutrin)r-rcorrectranṣwer-rNDRIrmayrimproverenergy,ralertneṣṣ,randrmotivation;rnotrfirṣt-
linertreatmentrforranxiety;rcontraindicatedrinrclientṣrwithrarhiṣtoryrofrṣeizureṣ
Avoidrinrpatientṣrwithrcomorbidranxiety
Half-Life:rParentr10-14rhourṣ;rMetaboliter20-27rhourṣ
Inhibitṣr2D6
SerotoninrAntagoniṣtrandrReuptakerInhibitorṣr(SARIṣ)r-rcorrectranṣwer-rSARIṣrpotentlyrblockr5-
HT2Arandr5HTr2Crreceptorṣ,rwhichrallowrmorer5-HTrtorinteractratrpoṣtṣynapticr5-
HT1Arṣiteṣ.rSerotoninrblockaderandrreuptakerinhibitionriṣrpreṣentratrhigherrdoṣeṣ.
Trazodoner-rcorrectranṣwer-rThermoṣtrcommonrSARI,ralṣorblockṣrhiṣtaminergicrandrα-adrenergicrreceptorṣ.
Half-Life:r3-6rhourṣ
SerotoninrAntagoniṣtrandrReuptakerInhibitorṣr(SARIṣ)r-rcorrectranṣwer-rCommonrAdverṣerEffectṣ
·rṣedation
·rdrowṣineṣṣ
·rblurredrviṣion
·rconṣtipation
·rdryrmouth
SeriouṣrAdverṣerEffect