Psych Medications: Antidepressants

I. Selective Serotonin Re-uptake Inhibitors
SSRIs (Lexapro, Celexa, Prozac, Paxil, Zoloft, Luvox)

  • [Luv Zolo Proz, Lexa Cel Pax] “Love solo pros. Lexa sells packs.”
  • SSRIs are FIRST LINE for depression
  • has fewer side effects than TCAs or MAOIs
  • no anticholinergic side effects, usual S&S include nausea, insomnia, sexual dysfunction

II. Atypical Antidepressants (new generation) (Cymbalta, Desyrel, Effexor, Remeron, Wellbutrin, Pristiq)

  • [Cymba Des Well Effex. Remer is imPrist] “Cymba does well effects. Rem is impressed.”
  • DESYREL can also be used for insomnia
  • EFFEXOR and CYMBALTA may cause HTN
  • CYMBALTA also used for neuropathic pain
  • WELLBUTRIN also used for smoking cessation

III. Tricyclic Antidepressants (Elavil, Anafranil, Norpramin, Tofranil, Vivactil, Pamelor, Sinequan)

  • Sounds like female names: Ela, Ana, Pam, Viv …; some end in -FRANIL or -IL
  • may take about 1-3w for effect and 6-8w for max response
  • have strong ANTICHOLINERGIC EFFECTS, so use with caution in elderly patients or patients with constipation, glaucoma or BPH
  • these medications also have strong CARDIOTOXIC effects
  • NORPRAMINE has low anticholinergic effects, which would be appropriate for the above
  • once daily dosing at bedtime helps to promote sleep through sedation effects and reduce daytime sleepiness
  • check the patient for HOARDING, especially if they are at RISK FOR SUICIDE

IV. Monamine Oxidase Inhibitors (MAOIs) (Nardil, Marplan, Parnate, EMSAM-patch)

  • [PaNaMA] or [No Popular Meds (N.P.M.)]
  • only used as a 2nd or 3rd choice for treatment of depression b/c of dietary restrictions and SE
  • dietary restriction of foods high in TYRAMINE (dried fruits, almost all cheeses, processed meats, soy products, avocados)
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