Anti depressants important topic in psychiatry

Anti depressants important topic in psychiatry

1. ANTIDEPRESSANTS

2. INTRODUCTION Classification Mechanism of action Uses Side effects

3. CLASSIFICATION

4. SELECTIVE SEROTONIN REUTAKE INHIBITORS Fluoxetine Fluvoxamine Paroxetine Sertaline Citalopam Escitalopam Dapoxetine

5. MECHANISM OF ACTION The actual mechanism of ssri are unknown They increase the extracellular level of serotonin by limiting its reabsoption in to the presynaptic receptor There will be large amount of serotonin in the synaptic cleft and available for postsynaptic receptor

6. PHARMACODYNAMICS SERT are glycoprotien with 12 membrane regions embded in axon terminaland cellbody membrane of seronergic neurons When extracellular serotonin binds to receptor on the transporter conformational changes occurs and moved to cell Combing with k+ results in release of serotonin SSRI’S inhibit the transport by binding with SERT receptor other than the serotonin binding site

7. FLOUXETINE Bicyclic compund First ssri Metabolised to norfluoxetine Inhibitor of CYP2D6 isoenzyme Plasma t ½ is 2 days Can’t be used in patients needed rapid effects Side effects are agitation and deramatological changes

8. FLUVOXAMINE Shorter acting T ½ of 18 hrs Used for OCD treatment Nausea, dyspepsia

9. PAROXETINE T ½ of 20 hours Short acting Sexual side effects and more of gasrtic side effects

10. SERTALINE Used in anxiety and post traumatic disoder T ½ is 20 hrs

11. CITALOPRAM T ½ is 33 hrs Death can occur in overdosage Used in mood changes in premenstrual syndrome

12. ESCITALOPRAM AND DAPOXETINE Esictalopam have same uses of citalopam Dapoxetine are ssri made to improve the sexual side effects of ssri’s

13. INDICATIONS OCD PANIC DISODERS PHOBIA EATING DISODERS PREMENSRTUAL DYSPHORIC DISODER AND PTSD

14. INTERACTIONS Fluoxetine and paroxetine increase level of TCA and causes much symptoms Flouxamine elevate diltiazem causes bradycardia or hypotension

15. ADVERSE EFFECTS Mainly gastric side effects Sexual side effects Headche and hypersomnia SEROTONIN SYNDROME

16. CONCLUSION SSRI’S are less cardiotoxic More used now in depression than TCA

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