Antidepression & Anti Anxiety Medicines At Best Prices : Xrite Pharmacy

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ANTIDEPRESSANTS

• No Worry Of Prescription, Get Your Medicines At
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DEPRESSION

• Types
• Symptoms
• Diagnosis
• Causes
• Treatment

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TYPES OF DEPRESSION

• Major depression
• Chronic depression (Dysthymia)
• Atypical depression
• Bipolar disorder/Manic depression
• Seasonal depression (SAD)

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SYMPTOMS

• persistently sad, anxious, or empty moods
• loss of pleasure in usual activities (anhedonia)
• feelings of helplessness, guilt, or worthlessness
• crying, hopelessness, or persistent pessimism
• fatigue or decreased energy
• loss of memory, concentration, or decision-making
  capability
• restlessness, irritability
• sleep disturbances
• change in appetite or weight
• physical symptoms that defy diagnosis and do not
  respond to treatment (especially pain and
  gastrointestinal complaints)
• thoughts of suicide or death, or suicide attempts
• poor self-image or self-esteem (as illustrated,
  for example, by verbal self-reproach)

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DIAGNOSIS

• Extensive patient and family history
• Blood test for hypothyroidism
• Current medication
• DSM-IV
• One of the first two symptoms
• Five other symptoms

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CAUSES OF DEPRESSION

• Genetics
• Death/Abuse
• Medications

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TREATMENT FOR DEPRESSION

• Psychotherapy
• Electroconvulsive therapy
• Natural alternatives
• Medication
• SSRIs
• MAOIs
• TCAs
• SNRIs
• NDRIs
• TeCAs

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NEUROTRANSMITTERS AND THE CATECHOLAMINE HYPOTHESIS

• Neurotransmitters pass along signal
• Smaller amount of neurotransmitters causes
  depression

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MONOAMINE OXIDASE (MAO) AND DEPRESSION

• MAO catalyze deamination of intracellular
  monoamines
• MAO-A oxidizes epinephrine, norepinephrine,
  serotonin
• MAO-B oxidizes phenylethylamine
• Both oxidize dopamine nonpreferentially
• MAO transporters reuptake extracellular monoamine

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MONOAMINE OXIDASE INHIBITORS (MAOIS)

• History
• Isoniazid
• Iproniazid
• Current Drugs
• Mechanism of Action
• Side Effects

Isoniazid
Iproniazid
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MAOIS ON THE MARKET

• MAO Inhibitors (nonselective)
• Phenelzine (Nardil)
• Tranylcypromine (Parnate)
• Isocarboxazid (Marplan)
• MAO-B Inhibitors (selective for MAO-B)
• Selegiline (Emsam)

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MAOIS MECHANISM OF ACTION

• MAO contains a cysteinyl-linked flavin
• MAOIs covalently bind to N-5 of the flavin
  residue of the enzyme

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THE RECEPTOR SENSITIVITY HYPOTHESIS

• Supersensitivity and up-regulation of
  post-synaptic receptors leads to depression
• Suicidal and depressed patients have increased
  5HT-a2 receptors

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TRICYCLIC ANTIDEPRESSANTS (TCAS)

• History
• Imipramine
• Current Drugs
• Mechanism of Action
• Side Effects

Imipramine
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TCAS ON THE MARKET

• Amitriptyline
• Desipramine (Norpramin)
• Doxepin (Sinequan)
• Imipramine (Tofranil, Tofranil-PM)
• Nortriptyline (Pamelor)
• Protriptyline (Vivactil)
• Trimipramine (Surmontil)

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TCAS MECHANISM OF ACTION

• TCAs inhibit serotonin, norepinephrine, and
  dopamine transporters, slowing reuptake
• TCAs also allow for the downregulation of
  post-synaptic receptors
• All TCAs and SSRIs contain an essential amino
  group that appears to interact with Asp-98 in
  hSERT

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TETRACYCLIC ANTIDEPRESSANTS (TECAS)

• Current Drugs
• Mirtazapine (Remeron)
• Mechanism of Action
• Same as TCAs
• Side Effects

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SELECTIVE SEROTONIN REUPTAKE INHIBITORS

• Most commonly prescribed class
• Current drugs
• Mechanism of action
• Side effects

Serotonin
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SSRIS ON THE MARKET

• citalopram (Celexa)
• dapoxetine (Priligy)
• escitalopram (Lexapro)
• fluoxetine (Prozac)
• fluvoxamine (Luvox)
• paroxetine (Paxil)
• sertraline (Zoloft)
• zimelidine (Zelmid) (discontinued)
• indalpine (Upstene) (discontinued)

Fluoxetine 11
Sertraline
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SSRIS MECHANISM OF ACTION

• Exact mechanism remains uncertain
• Ser-438 residue in the human serotonin
  transporter (hSERT) appears to be a determining
  factor in SSRI potency
• Antidepressants interact directly with hSERT

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SEROTONIN-NOREPINEPHRINE REUPTAKE INHIBITORS
(SNRIS)

• Slightly greater efficacy than SSRIs
• Slightly fewer adverse effects than SSRIs
• Current drugs
• Venlafaxine (Effexor)
• Duloxetine (Cymbalta)
• Mechanism of Action
• Very similar to SSRIs
• Works on both neurotransmitters
• Side effects
• Similar to SSRIs
• Suicide

Venlafaxine 11 Duloxetine
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NOREPINEPHRINE-DOPAMINE REUPTAKE INHIBITORS
(NDRIS)

• Current drugs
• Bupropion (Wellbutrin)
• Mechanims of Action
• Similar to SSRIs and SNRIs
• More potent in inhibiting dopamine
• Also ana3-ß4 nicotinic antagonist
• Adverse effects
• Lowers seizure threshold
• Suicide
• Does not cause weight gain or sexual dysfunction
  (even used to treat the two)

Bupropion 11
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Xrite Pharmacy
1400 NW 65th St, Fort Lauderdale, FL 33309,USA
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