Pharmacology · MU Sofia

34. Antidepressants. Antimanic drugs.

Covers the main antidepressant classes (tricyclics, SSRIs, SNRIs and MAOIs) with example drugs for each, plus lithium as the antimanic agent. Explains how each group acts on neurotransmitter reuptake or breakdown, then summarises absorption, metabolism and excretion, common and class-specific side effects, and key drug and food interactions. Closes with the therapeutic uses and a short set of recap questions.

Inside: 8 sections · 6 labelled pictures · 10 flashcards · 4 min

Topic 33 of 93 in the MU Sofia syllabus for Pharmacology (Medicine, Year 3). The free AceMed note covers it in 8 sections, about 590 words (4 min of reading), with 10 flashcards.

In this note

  1. Antidepressants & Antimanic Drugs
  2. Classification
  3. Pharmacodynamics
  4. Pharmacokinetics
  5. Side Effects
  6. Drug Interactions
  7. Therapeutic Uses
  8. Key Recap

Antidepressants & Antimanic Drugs

Antidepressant drugs are primarily used to treat depressive disorders and anxiety disorders, but can also be effective for a range of other conditions. They work by altering the balance of neurotransmitters in the brain to improve mood, reduce anxiety, and alleviate other related symptoms. Antimanic drugs like lithium are also used to manage mania in bipolar disorder.

Classification

  1. 1. Tricyclic Antidepressants (TCAs): Amitriptyline, Nortriptyline, Imipramine, Clomipramine
  2. 2. Selective Serotonin Reuptake Inhibitors (SSRIs): Fluoxetine, Sertraline, Paroxetine
  3. 3. Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs): Venlafaxine, Duloxetine, Desvenlafaxine
  4. 4. Monoamine Oxidase Inhibitors (MAOIs): Phenelzine, Tranylcypromine, Isocarboxazid
  5. 5. Lithium (for Antimanic effects)

Pharmacodynamics

  • Tricyclic Antidepressants (TCAs):
  • Inhibit the reuptake of serotonin and norepinephrine into the presynaptic neuron, increasing their levels in the synaptic cleft.
  • Block histamine and muscarinic receptors, contributing to side effects like sedation and dry mouth.
  • SSRIs:
  • Inhibit the reuptake of serotonin into the presynaptic neuron, leading to increased serotonin levels and enhancing serotonergic neurotransmission.
  • SNRIs:
  • Inhibit the reuptake of both serotonin and norepinephrine, increasing both neurotransmitter levels in the synaptic cleft.
  • MAOIs:
  • Inhibit the monoamine oxidase enzyme, which breaks down serotonin, norepinephrine, and dopamine, leading to increased levels of these neurotransmitters in the brain.
  • Lithium (for Antimanic Effects):
  • Modulates neurotransmitter activity, stabilizes neuronal membranes, and affects intracellular signaling pathways to help prevent manic and depressive episodes.

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