PHRM 311 Lecture Notes - Lecture 3: Duloxetine, Bipolar Disorder, Anhedonia
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Escitalopram (cid:894)cipralex(cid:895) (cid:910)vor(cid:415)o(cid:454)e(cid:415)ne (cid:894)trintellix(cid:895) recen(cid:410)l(cid:455) appro(cid:448)ed in canada for mdd (cid:882) (cid:882) (cid:882) (cid:882) Blocks (cid:1009)(cid:882)ht uptake (cid:894)? (cid:895)(cid:910) (cid:910)the canmat guidelines t vor(cid:415)oxe(cid:415)ne into its own class. In depression, (cid:882) (cid:882) (cid:882) (cid:1009)(cid:882)ht neurons are thought to (cid:437)preg(cid:437)late (cid:1009)(cid:882)ht pre(cid:882) and postsynap(cid:415)c receptors (cid:1009)(cid:882)ht(cid:1005)a autoreceptors are upregulated (cid:884) inhibit cell ring when agonized . Ssri acutely blocks the (cid:1009)(cid:882)ht reuptake pumps (cid:884) (cid:1009)(cid:882)ht levels (cid:1112) preferen(cid:415)ally in the soma(cid:882)dendri(cid:415)c area vs. the axon terminals. Compensator(cid:455) do(cid:449)nreg(cid:437)la(cid:415)on of postsynap(cid:415)c (cid:1009)(cid:882)ht receptors occurs when ssri therapy is maintained (cid:894) red circle (cid:1006) , above right figure(cid:895) Side e ects (cid:882) generally, ssris are be(cid:425)er tolerated than tcas (cid:1111) less an(cid:415)cholinergic, seda(cid:415)on and dizziness (cid:1111) may cause more insomnia, anxiety, agita(cid:415)on (cid:882) gi distress (cid:894)cons(cid:415)pa(cid:415)on, diarrhea(cid:895) (cid:882) (cid:882) Time to reach steady state varies depending on half(cid:882)life, making (cid:415)tra(cid:415)on of the dose more di cult (cid:884) the converse can be advantageous for tapering certain agents.
