Use: ADHD

Mech: increases presynaptic NE vesicular release(like amphetamines)

Tox:

Antipsychotics

(Haloperidol + -azines: trifluoperazine, fluphenazine, thioridazine, chlorpromazine)

Use: Schizo (+ sx), psychosis, acute mania, Tourette's

Mech: Block D2 receptors

Tox:

1. EPS side effects (acute dystonia--akinesia--akathisia--tarditive dyskinesia)

2. Endocrine: hyperprolactinemia

3. SEs from blocking other receptors: muscarinic--dry mouth and constipation, alpha--hypotension, histamine--sedation

Neuroleptic Malignant Syndrome - rigidity, myoglobinuria, autonomic instability, hyperpyrexia (tx with bromocriptine)

Atypical Antipsychotics

Clozapine, Olanzipine, Risperidone, Aripiprazole

Use: Scizophrenia (+ and -), olanzipine for OCD, anxiety, depression, mania, Tourettes

Mech: Block 5HT2, alpha, H1 and dopamine receptors

Tox:

Clozapine -- agranulocytosis

Use: Mood stabilizer for bipolar disorder; SIADH (ADH antagonist)

Mech: ? (inhibition of phosphoinositol cascade)

Tox:

Movement (tremor)

Nephrogenic DI (polyuria)

hypOthyroidism

Pregnancy problems (heart defects)

Use: Generalized anxiety disorder (no sedation on addiction and doesn't interact w/ alcohol)

Mech: Stimulates 5HT1a receptors

Tox:

Tricyclic Antidepressants

Imipramine, amitriptyline, desipramine, nortriptyline, clomipramine, doxepin, amoxapine

Use:Major depression, bedwetting (imipramine), OCD (clomipramine)

Mech: Block reuptake of NE and serotonin

SEs: sedation (desipramine is least), alpha blocking effects, atropine-like (anticholinergic) side effects (tachycardia, urinary retention)

Tox: Convulsions, Coma, Cardiotox (tx NaHCO3), resp depression, hyperpyrexia

Nortryptiline

-they get confusion and hallucinations due to anticholinergic side effect

tertiary TCAs( amitryptiline) have more anticholinergic effects that secondary TCAs (nortryptiline)

SSRIs

Sluoxetine, paroxetine, sertraline, citalopram

Use:Depression, OCD

Mech:serotonin specific reuptake inhibitors

Tox:GI distress, sexual dysfunction

Serotonin syndrome: hyperthermia, muscle rigidity, cardiovascular collapse, flushing, diarrhea

Use:antidepressant and smoking cessation

Mech:Inc NE and dopamine

Tox:stimulant effects (tachycardia, insomnia), HA, seizures in bullemics

Use:antidepressant, generalized anxiety disorder

Mech:inhibits serotonin and NE reuptake

Tox:Inc BP, stimulant effects, sedation, nausea

Use:antidepressant, diabetic peripheral neuropathy

Mech:inhibits serotonin and NE reuptake

Tox:Inc BP, stimulant effects, sedation, nausea

Use:antidepressant,

Mech:alpha-2 agonist (inc release of NE and serotonin) and 5HT2 and 5HT3 receptor antagonist

Tox:sedation, inc appetite, weight gain, dry mouth

Use:antidepressant

Mech:block NE reuptake

Tox:sedation, orthostatic hypotension

Use:antidepressant, insomnia

Mech:inhibit serotonin reuptake

Tox:sedation, nausea, priapism, postural hypotension

Use:atypical depression, anxiety, hypochondriasis

Mech:nonselective MOA inhibition -- increase levels of amine NTs

Tox:Hypertensive crisis with tyramine ingestion (foods) and beta-agonists; CNS stimulation

Contraindication with SSRIs or meperidine (to prevent serotonin syndrome