Antidepressant Medications
Name Indication, starting dose, target symptoms, and affected neurotransmittersHalf-life (T1/2)
CYP450 enzymeNotes/Notable side effects/Precautions
SSRIs Citalopram (Celexa) Indication
Depression
PMDD
OCD
Panic d/o
GAD
PTSD
Social anxiety d/o
Neurotransmitter
Serotonin
Target symptoms
Depressed mood
Anxiety
Panic attacks, avoidant behavior, reexperiencing, hyperarousal
Sleep disturbance, insomnia and hypersomniaHalf-life
23-45 hour
CYP450
Weak inhibitor of CYP450 2D6
Metabolized by CYPf450 3A4 and 2C19Sexual dysfunction
Decreased appetite, n/d, constipation, dry mouth
Dose dependent insomnia, sedation, agitation, tremors, headache,dizzy
Pt with bipolar or psychotic d/o may be more vulnerable to CNS-activating actions of SSRIs
Sweating
Bruising and rare bleeding
Rare hyponatremia
Syndrome of inappropriate antidiuretic hormone secretion
Rare seizures, induction of mania, activation of suicidal ideation
Escitalopram (Lexapro) Indication
MDD 12+
GAD
Panic d/o
OCD
PTSD
Social anxiety d/o
PMDD
Neurotransmitter
SerotoninHalf-life
27-32 hours
CYP450
Substrate for CYP450 and 3A4
No significant actions
on CYP450 enzymesSexual dysfunction ED, delayed ejaculation, decreased
sexual desire, anorgasmia
Decreased appetite, n/d, constipation, dry mouth
Insomnia and sedation, agitation, tremors, headache, dizzy
Pt with bipolar or psychotic d/o may be more vulnerable to CNS-activating actions of SSRIs
Sweating
Rare hyponatremia
Syndrome of inappropriate antidiuretic hormone Target symptoms
Depressed mood
Anxiety
Panic attacks, avoidant behavior, reexperiencing, hyperarousal
Sleep disturbance, insomnia and hypersomniasecretion
Rare seizures, induction of mania, activation of suicidal ideation
Fluoxetine (Prozac) Indication
MDD 8+
OCD 7+
PMDD
Bulimia nervosa
Panic d/o
bipolar depression used with olanzapine
treatment resistant depression used with olanzapine
social anxiety d/o
PTSD
Neurotransmitter
Serotonin NE
DA
Target symptoms
Depressed mood
Energy, motivation, and interest
Anxiety (can increase anxiety Half-life
Active metabolite 2 week
Parent drug 2-3 d.
CYP450
Inhibits CYP450 2D6
Inhibits CYP450 3A4Sexual dysfunction ED, delayed ejaculation, decreased
sexual desire, anorgasmia
Decreased appetite, n/d, constipation, dry mouth
Insomnia and sedation, agitation, tremors, headache, dizzy
Pt with bipolar or psychotic d/o may be more vulnerable to CNS-activating actions of SSRIs
Sweating
Bruising and rare bleeding
Syndrome of inappropriate antidiuretic hormone secretion
Rare seizures, induction of mania, activation of suicidal ideation