Using your textbooks, draw up a classification of the drugs that are used as antidepressants.

Tricyclic antidepressants

Imipramine

Mono amine oxidase inhibitors

Phenelzine

Tranylcypromine

Selegiline

Serotonin noradrenaline reuptake inhibitors

Duloxetine

Venlafaxine

Levomilnacipran

Serotonin Modulators

Nefazodone

Trazodone

Vortioxetine

Noradrenalin receptor inhibitors

Reboxetine

Tetracyclic and unicyclic antidepressants

Bupropion

Amoxapine

Maprotiline

Mirtazapine

Mianserin

Cascadic rhythm regulators      

Agomelatine

Selective serotonin reuptake inhibitors

Fluoxetine

Citalopram

Escitalopram

Paroxetine

Sentraline

What do the existing drugs all have in common regarding their mechanisms of action?

All drugs that treat depression has an effect on the neurotrophic and endocrine factors within the brain.

How long does it take for the anti-depressive effects of these drugs to appear? What is the reason for this?

14-21 days or even longer because it takes up to two weeks or more for neurotrophic factors to be synthesised

How do the TADs and the selective serotonin reuptake inhibitors (SSRI’s) differ in respect of:

• Efficacy

TAD’s has an high affinity for the serotonin and noradrenaline re-uptake transport receptor because of their structure while SSRis only has an affinity for blocking the re uptake of serotonin.

• side effects

They have a large amount of side effects anticholinergic side effects such as sedation, weight gain , alpha receptor blockage, arrythmia and seizures if high doses is administered while SSRI causes sexual dysfunction and increases risk for serotonin syndrome if co administered with monoamine oxidase inhibitors

• safety?

It as a long half life and causes convulsions at high doses while SSRI’s as the risk for serotonin syndrome is used with other drugs. SSRI’s is first line treatment thus its is relatively safe at recommended dosage.

• What is the action of mirtazapine?

Block alpha 2 receptors and both Noradrenaline(autoreceptors) and serotonin release (heteroreceptors) which stimulates serotonin 1A indirectly and serotonin 2  an 3 blockage

• What is the action of venlafaxine?

Block both Serotonin and Noradrenaline re uptake

• What is the action of agomelatine?

Is a agonist of both melatonin 1 and 2 receptors and serotonin 2 C antagonist