Antidepressants
Categories:
- Selective Serotonin Reuptake Inhibitors (SSRIs)
- Notes:
- Increased risk of suicide in 0-24 y/o upon initiation (black box)
- More gestures and Ideations, no more completions
- Decreased risk of suicide in ≥65 y/o upon initiation (white men)
- Drug Interactions:
- Paroxetine ≥ Sertraline ≥ Citalopram
- Also helpful for anxiety associated depression
- SE (General):
- Sexual dysfunction is the MCC of noncompliance and MC SE (50-80%)
- Akathisia
- Early: HA/Nausea, dizziness, insomnia, anxiety
- Nonspecific: Flu-like, GI upset, Psych symptoms
- Late: sexual dysfunction and weight gain
- Citalopram (Celexa)
- Dose: 20mg up to 20-40mg daily (40mg max effective)
- Weak CYP2D6 inhibitor
- Use:
- Treats anxiety symptoms better than other SSRIs
- Least likely to have drug interaction
- Low P450
- SE: More cardiotoxic, May Prolong Qt interval (blockade of KCNH2 gene potassium channel)
- 20mg: 8.5ms, 40mg: 12.6ms, 60mg: 18.5ms
- Use 20mg if ≥60 or hepatic dysfunction
- Escitalopram (Lexapro)
- Dose: 10mg up to 10-20mg daily (10mg max effective)
- Most serotonin specific of SSRIs
- Most potent SSRI
- Use: Paraphilias, GAD, Chronic pain
- Post-MI depression due to low drug reaction potential
- Low p450, fewer SE than citalopram, rapid
- SE: QTc Prolongation: 10mg: 4.5ms, 20mg: 6.6ms, 30mg: 10.7ms
- Fluoxetine (Prozac)
- Dose: 20mg up to 20-80mg daily
- Potent CYP2D6 inhibitor
- Use: OCD, Bulimia, Panic Disorder
- Can be used with olanzapine for acute bipolar depression
- Doesn’t need to be tapered when stopping, long half-life
- SE: May cause agitation/anxiety and insomnia initially, sexual dysfunction, may cause weight loss
- Nausea, vomiting, diarrhea
- QTc prolongation (4.5ms)
- Fluvoxamine (Luvox)
- 50mg daily, max 300mg divided daily
- CYP3A4, 2C10, 1A2 inhibitor
- Most drug interations
- Use: OCD only
- No QTc Prolongation (-5.0ms)
- Paroxetine (Paxil)
- Dose: 20mg up to 20-60mg daily (50mg max effective)
- Potent CYP2D6 inhibitor
- Use: Premature ejaculation, Body dysmorphic disorder, SAD, OCD, PTSD
- Potent CYP2D6 inhibitor
- No QTc prolongation
- SE: Most likely to have side effects, Dizziness, most sedating and anticholinergic SSRI, highest rate of sexual dysfunction, higher rate of weight gain (30%), highest rate of discontinuation syndrome, sedating, constipation
- Cardiac septal defects in kids (pulm htn)
- Sertraline (Zoloft)
- Dose: 50mg up to 50-200mg daily
- Increased absorption with food
- Weak CYP2D6
- Use: PMDD, PTSD, SAD, OCD, Post-MI
- Best for breastfeeding
- SE: delayed ejaculation, QTc Prolongation, Bruxism (better with buspirone), generic may be activating, bruising, hair loss
- 3.0ms
- Most likely to cause GI upset (Nausea ≥ Diarrhea)
- May displace warfarin increasing PTT
- Dose: 50mg up to 50-200mg daily
- Notes:
- Selective Norepinephrine Reuptake Inhibitors (SNRIs)
- Notes:
- Nausea (MC), Sexual dysfunction, Hypertension (not duloxetine), Pseudo-anticholinergic effects (constipation, dizziness, dry mouth, sweating, agitation, anxiety, tachycardia) due to increased synaptic NE
- Duloxetine (Cymbalta)
- Dose: 20 mg up to 60mg daily (BID dosing may decrease SE)
- Aka Yantreve
- MOA: 5HT = NE at all doses
- Moderate CYP2D6
- Use: MDD, stress incontinence, panic disorder
- FDA approved for diabetic neuropathy, fibromyalgia
- Pain with depression
- Useful in diabetics with peripheral neuropathic pain
- Rapid symptom relief, few side effects
- Only SNRI w/o BP effects
- SE: Avoid in renal failure, Hepatic failure in liver disease, may increase HbA1c, Insomnia
- Nausea, dry mouth, constipation
- Prompt discontinuation due to side effects
- Less likely to cause HTN
- Dose: 20 mg up to 60mg daily (BID dosing may decrease SE)
- Desvenlafaxine (Pristiq)
- Dose: 50mg daily
- MOA: Inhibits 5HT and NE
- Active metabolite of venlafaxine and levo-milnacipran
- Avoids hepatic CYP2D6 metabolism
- Less likely to increase BP than Effexor
- Use: MDD, GAD, Panic Disorder, Menopause, Cocaine dependence
- Rapid, few side effects, low cytochrome P-450 effects
- No Weight gain
- Milnacipran
- Racemic mixture of levo- and dextro-milnacipran
- Use: Fibromyalgia (FDA)
- No CYP450 interaction, NET ≥SERT selectivity
- SE: HTN, Tachycardia, GI symptoms, hyperhidrosis, ED
- Levo-Milnacipran (Fetzima)
- 20mg; max 40-120mg daily
- Use: MDD
- More potent enantiomer of milnacipran
- Inhibits BACE-1 (B-amyloid plaques)
- SE: HTN, Tachycardia, GI symptoms, hyperhidrosis, ED
- Venlafaxine (Effexor)
- Dose: 37.5mg up to 75-375mg daily XR
- MOA: Inhibits 5HT ≥ NE low dose, NE ≥ 5HT at high dose
- Inhibits CYP2D6
- Use: MDD, GAD, Panic Disorder, Menopause, Cocaine dependence
- Rapid, few side effects, low cytochrome P-450 effects
- No Weight gain
- SE: May cause diastolic hypertension, activating, “stimulant effect”, Increases diastolic BP, most cardiotoxic SNRI, headache, constipation, sweating, Anxiety and HTN in high doses, discontinuation syndrome
- Nausea and sexual side effects in 30% due to NE not 5HT
- May have withdrawal
- Notes:
- Atypical Antidepressants
- Bupropion (Wellbutrin)
- Dose: 150mg up to 300-450mg daily
- MOA: NE and Dopamine reuptake inhibitor, increasing activity
- Metabolized by CYP2B6 to hydroxy- which is a moderate CYP2D6 inhibitor
- CYP2B6 substrate
- Use: Smoking cessation, MDD w/seasonal pattern, Adult ADHD, Obesity
- Good for weight loss, hypersomnia, smoking cessation, no sexual side effects
- Not good for anxious patients
- SE: Agitation, insomnia, anorexia, sweating, false positive for amphetamines on UDS, headache, tremor, dry mouth, psychosis
- Avoid in pregnancy
- CI: Seizures, Bulimia and Anorexia Nervosa, epilepsy
- Check for hypokalemic, hypochloremic metabolic alkalosis (self-induced vomiting seen in Bulimia Nervosa) prior to initiating
- Seizure risk is 2% at 600mg, 0.1% with 300-450mg, almost same as other antidepressants (0.05%)
- Mirtazapine (Remeron)
- Dose: 7.5mg up to 15-45mg daily
- <30mg = sedation
- ≥30mg = activating (more NE)
- MOA: Presynaptic Alpha-2 antagonist
- Increased NE and 5-HT release
- Selective postsynaptic 5-HT receptor antagonist
- Increased 5-HT1 receptor neurotransmission, antagonist at 5-HT2 and 5-HT3 receptor
- Antagonizes H1 receptors
- Clearance impaired in liver disease by 30%, 50% in renal disease, elderly (males 40%, females 10%)
- Use: Insomnia
- Sleep, Depression, Hunger (Weight Gain)
- Don’t break it in half, sedative already
- Additive effects with alcohol and benzos (substrate)
- Increases appetite, weight gain, increases mood, sleep
- Lacks sexual side effects
- SE: Drowsiness (54%), Xerostomia (25%), Weight Gain (12%), Sedation, Thrombocytopenia, Bone marrow suppression and neutropenia, hypertriglyceridemia, increase in appetite, constipation (13%), Disorientation and tachycardia, increased cholesterol, decreased ANC
- Dose: 7.5mg up to 15-45mg daily
- Maprotiline (Ludiomil)
- D2 blocker (NET ≥SERT inhibition)
- TCA like adverse effects, seizures, high NET affinity
- Use: Anxiety with depressive features
- Nefazodone (Serzone)
- 50mg BID up to 300mg BID
- 5-HT2A antagonists (relatively selective), Alpha1 receptor blockade, CYP3A4 inhibitor, weak Serotonin reuptake inhibitor (antagonist and agonist of serotonin receptor)
- Sedation, dose related GI effects < SSRIs
- Rare sexual effects, hypotension
- Short half life
- Use: Insomnia
- Black Box Warning: Fulminant liver failure
- Trazodone (Desyrel)
- MOA: 5-HT2A antagonist (relatively selective), Alpha-1 receptor blockade, CYP3A4 substrate, 5HT2C receptor agonist
- Vasodilation, Short half life
- Use: Insomnia in depression
- Depression: 150mg up to 150-600mg daily
- Sleep: 25-50mg qPM
- Pronounced sedation, dose related GI effects < SSRIs
- SE: Rare sexual effects, priapism (<1%), hypotension, sedation
- MOA: 5-HT2A antagonist (relatively selective), Alpha-1 receptor blockade, CYP3A4 substrate, 5HT2C receptor agonist
- Vilazodone (Viibryd)
- Dose: 10mg daily, goal 40mg daily, 10mg per week increase
- SSRI + 5HT1 partial agonist (MDD + GAD)
- CYP3A4
- Use:
- Less Sexual and Weight gain SE
- SE: Nausea and Diarrhea ≥ SSRIs, discontinuation syndrome
- Vortioxetine (Trintellix)
- Serotonergic, nausea, Sexual side effects
- Processing speed increase
- SSRI + 5HT1A full agonist/5HT1B partial agonist, 5-HT3/7/1D antagonist
- Bupropion (Wellbutrin)
- Monoamine Oxidase Inhibitors (MAOIs)
- Avoid: beer, wine, aged cheese, soy sauce, bananas, smoked meat
- SE: MCly Orthostatic hypotension and weight gain, paresthesia (from B6 deficiency), mania
- highest rates of sexual dysfunction of all antidepressants, Anorgasmia
- Activation, insomnia, and restlessness
- Confusion at higher doses
- Hypertensive Crisis (0.02%)
- Delirium-like discontinuation with psychosis, excitement, and confusion
- Meperidine is specifically contraindicated
- Need 2-week washout
- Nonselective
- MOA: Irreversibly inhibit MAOA/B
- Isocarboxazid (Marplan)
- 10mg BID, max 60mg daily
- Use: Geriatric Depression
- Tranylcypromine (Parnate)
- 30mg daily to 60mg in divided doses
- Use: Atypical Depression
- Phenelzine (Nardil)
- 15mg TID to 90mg TID
- Non-selective blockade of MAO
- More sedating than selegiline and tranylcypromine
- Pain, Eating, Panic disorders
- Selective
- Selegiline (Emsam)
- Dose: 6mg-12mg transdermal patch (24hr)
- MOA: MAO-B irreversible inhibition at low doses
- Increased dopamine
- MAO-A inhibition if given transdermally
- Use: Parkinson’s drug
- No dietary restriction if used in low dosages
- SE: Orthostatic hypotension
- Rasagiline
- Selegiline (Emsam)
- Tricyclic Antidepressants (TCAs)
- General
- MOA: Block NE and serotonin reuptake at synapse, some block Dopamine reuptake
- Inhibition of NE and 5-HT can trigger convulsions/seizures
- Also block muscarinic acetylcholine receptors
- Orthostatic hypotension due to alpha blockade
- H1 receptors also blocked
- Class 1A Antiarrhythmic agents at low doses, arrhythmic agents at high doses
- 2nd MCC of lethal OD in US (amitriptyline ≥ rest combined), death in 8.5/1000 OD
- SE: Convulsions, Coma, Cardiotoxicity, Respiratory Depression, Hyperpyrexia, Prolonged QRS, weight gain, sedation
- Cholinergic rebound on discontinuation (flu like)
- Delirium (amitriptyline)
- Seizures (2% clomipramine)
- Acute Hepatitis (0.1%)
- CI: Narrow-angle Glaucoma
- MOA: Block NE and serotonin reuptake at synapse, some block Dopamine reuptake
- Secondary Amines
- General
- High affinity for blocking NE reuptake (NE ≥ 5HT)
- Fever, anticholinergic effects, weight gain
- Desipramine (Norpramin)
- Dose: 25-50mg daily up to 100-300mg daily
- Least sedating TCA (most noradrenergic)
- SE: LFT elevation (AST≥≥≥ALT)
- Maprotiline (Ludiomil)
- Dose: 25mg TID, max 225mg daily
- Lacks 5HT reuptake inhibition (mainly NE reuptake)
- SE: Sedating
- Nortriptyline (Pamelor)
- Dose: 25-50mg daily up to 150-200mg daily
- Use: Elderly depression, cardiac diseases, pruritus, smoking cessation, QTc Prolongation
- Least likely to cause orthostatic hypotension (low acnticholinergic)
- General
- Tertiary Amines
- Notes:
- 5HT ≥ NE
- Have more anticholinergic side effects and sedation
- Agitation, blurry vision, fever, constipation, urinary retention, confusion
- Myotonic jerking, delirium, sedation, coma
- Amitriptyline (Elavil)
- Dose: 25-50mg daily up to 100-200mg daily
- Use: Depression w/insomnia, chronic pain
- SE: Orthostatic hypotension (causing falls), Sedating
- Semiannual EKG due to risk of QT prolongation
- Most anticholinergic
- Amoxapine (Asendin)
- Dose: 50mg BID, max 400mg daily
- MOA: D2 blocker (5HT = NE, weak DA)
- Blockade of NE and 5-HT reuptake
- Use: MDD w/Psychotic Features
- Dopamine receptor blockade (antidepressant)
- Anti-dopaminergic effects (Parkinson’s, ED)
- Unique to drug in class (may cause EPS)
- Dopamine receptor blockade (antidepressant)
- SE: higher seizure risk, TD
- Most dangerous in overdose
- Clomipramine (Anafranil)
- Dose: 25mg daily, max 250mg daily
- Most serotoninergic, most sexual effects
- Use: OCD
- Doxepin (Sinequan)
- Dose: 25-75mg daily up to 100-300mg daily
- MOA: 5HT = NE, highly sedation
- Most antihistamine
- Use: GAD, PUD, pruritis
- SE: Sedating, antihistaminergic, anticholinergic
- Imipramine (Tofranil)
- Dose: 25-50mg daily up to 100-200mg daily
- MOA: 5HT = NE
- Use: Panic disorder with agoraphobia, enuresis, eating disorders, but has a high relapse rate
- SE: Orthostatic hypotension, prolonged QT, LFT elevation (AST≥≥≥ALT)
- Protriptyline (Vivactil)
- Less sedating than doxepin, nor/amitriptyline, imipramine
- Good for job alertness
- Notes:
- General