NR547 FINAL EXAM SUMMARY,
AND REVISION QUESTIONS
Medications for depression
SSRIs
SNRIs
SDRIs
TCAs
MAOIs
SSRIs
-Action: inhibit 5-HT reuptake
-Examples: citalopram, escitalopram, fluoxetine, paroxetine,
sertraline
-Adverse effects:
• nausea
• agitation
• diarrhea
• headache
• weight gain
• sexual side effects
SNRIs
-inhibit 5-HT reuptake
-inhibit NE reuptake (↑ energy, focus)
-increase DA in prefrontal cortex (↑ cognition)
,-Examples: desvenlafaxine, duloxetine, lev milnacipran,
venlafaxine
-Adverse effects:
• elevated blood pressure
• nausea
• sweating
• tremors
• anxiety
• insomnia
• constipation
• anorexia
• sexual dysfunction
SDRIs
-inhibit DA reuptake (↑alertness, motivation)
-inhibit NE reuptake (↑energy)
-Adverse effects:
• agitation
• headache
• dry mouth
• constipation
• weight loss
TCAs
-Action: inhibits the reuptake of serotonin and norepinephrine;
blocks norepinephrine, histamine, and acetylcholine receptors
-Examples: amitriptyline, clomipramine, desipramine, doxepin
-Common Side Effects:
,• dry mouth
• constipation
• blurred vision
• urinary retention
• sedation
• weight gain
• hypotension
• tachycardia
• sexual dysfunction
MAOIs
-Action: increases norepinephrine and serotonin by inhibiting
the enzyme that inactivates it
-Examples: isocarboxazid, phenelzine, tranylcypromine
-Common Side Effects:
• sedation
• dizziness
• sexual dysfunction
• hypertensive crisis
Prescribing pearls: citalopram (Celexa)
mild antihistamine effects
Prescribing pearls: escitalopram (Lexapro)
no known drug interactions
Prescribing pearls: fluoxetine (Prozac)
longest half-life
, Prescribing pearls: paroxetine (Paxil)
also treats social anxiety and insomnia
Prescribing pearls: fluvoxamine (Luvox)
treats anxious depression smokers require increased dose
Prescribing pearls: sertraline (Zoloft)
also treats social anxiety and hypersomnolence
Prescribing pearls: bupropion (Wellbutrin)
NDRI may improve energy, alertness, and motivation; not first
line treatment for anxiety; contraindicated in clients with a
history of seizures
Prescribing pearls: duloxetine (Cymbalta)
effective for atypical pain at higher doses; appropriate for
clients who present with somatic symptoms of depression;
effective for atypical pain, such as fibromyalgia and diabetic
neuropathy
Prescribing pearls: venlafaxine (Effexor)
treats both depression and anxiety disorders, ensure trial of
higher dose before switching to a different medication
Prescribing pearls: desvenlafaxine (Pristiq)
effective for perimenopausal vasomotor symptoms
considered when selecting a medication:
AND REVISION QUESTIONS
Medications for depression
SSRIs
SNRIs
SDRIs
TCAs
MAOIs
SSRIs
-Action: inhibit 5-HT reuptake
-Examples: citalopram, escitalopram, fluoxetine, paroxetine,
sertraline
-Adverse effects:
• nausea
• agitation
• diarrhea
• headache
• weight gain
• sexual side effects
SNRIs
-inhibit 5-HT reuptake
-inhibit NE reuptake (↑ energy, focus)
-increase DA in prefrontal cortex (↑ cognition)
,-Examples: desvenlafaxine, duloxetine, lev milnacipran,
venlafaxine
-Adverse effects:
• elevated blood pressure
• nausea
• sweating
• tremors
• anxiety
• insomnia
• constipation
• anorexia
• sexual dysfunction
SDRIs
-inhibit DA reuptake (↑alertness, motivation)
-inhibit NE reuptake (↑energy)
-Adverse effects:
• agitation
• headache
• dry mouth
• constipation
• weight loss
TCAs
-Action: inhibits the reuptake of serotonin and norepinephrine;
blocks norepinephrine, histamine, and acetylcholine receptors
-Examples: amitriptyline, clomipramine, desipramine, doxepin
-Common Side Effects:
,• dry mouth
• constipation
• blurred vision
• urinary retention
• sedation
• weight gain
• hypotension
• tachycardia
• sexual dysfunction
MAOIs
-Action: increases norepinephrine and serotonin by inhibiting
the enzyme that inactivates it
-Examples: isocarboxazid, phenelzine, tranylcypromine
-Common Side Effects:
• sedation
• dizziness
• sexual dysfunction
• hypertensive crisis
Prescribing pearls: citalopram (Celexa)
mild antihistamine effects
Prescribing pearls: escitalopram (Lexapro)
no known drug interactions
Prescribing pearls: fluoxetine (Prozac)
longest half-life
, Prescribing pearls: paroxetine (Paxil)
also treats social anxiety and insomnia
Prescribing pearls: fluvoxamine (Luvox)
treats anxious depression smokers require increased dose
Prescribing pearls: sertraline (Zoloft)
also treats social anxiety and hypersomnolence
Prescribing pearls: bupropion (Wellbutrin)
NDRI may improve energy, alertness, and motivation; not first
line treatment for anxiety; contraindicated in clients with a
history of seizures
Prescribing pearls: duloxetine (Cymbalta)
effective for atypical pain at higher doses; appropriate for
clients who present with somatic symptoms of depression;
effective for atypical pain, such as fibromyalgia and diabetic
neuropathy
Prescribing pearls: venlafaxine (Effexor)
treats both depression and anxiety disorders, ensure trial of
higher dose before switching to a different medication
Prescribing pearls: desvenlafaxine (Pristiq)
effective for perimenopausal vasomotor symptoms
considered when selecting a medication:
