10 Antidepressants Commonly Used: doses, side effects, and uses

The Most Famous 10 Antidepressants Commonly Used: doses, side effects, and uses:

1- Citalopram 💊

2-Escitalopram 💊 

3-FLUoxetine 💊

4-Sertraline 💊

5-TraZODone 💊

6-BuPROPion💊

7-DULoxetine 💊

8-Mirtazapine💊

9-Paroxetine 💊

10-Venlafaxine 💊

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Citalopram

• Brand Names: CeleXA
• Therapeutic Category: Antidepressants, Selective Serotonin Reuptake Inhibitors
• Dosage Forms: Oral / Tablet, Solution
• Use: Labeled Indications:
• Treatment of the unipolar major depressive disorder
• Off Label: Aggressive or agitated behaviour associated with dementia/ Binge eating disorder/ Generalized anxiety disorder/ Obsessive-compulsive disorder/  Panic disorder/ Posttraumatic stress disorder
• Dosing: Adult : Oral: Initial: 10 mg once daily; increase to 20 mg once daily after ≥3 days. In adults ≤60 years, may further increase the dose based on response and tolerability up to 30 mg/day, for adults >60 years, do not exceed the maximum amount of 20 mg/day.
• Pediatric: Children 7 to ≤11 years: Initial: 5 to 10 mg/day given once daily; increase the dose slowly by 5 mg/day every two weeks as clinically needed; dosage range: 10 to 40 mg/day
• Children and Adolescents ≥12 years: Initial: 10 to 20 mg/day given once daily; increase the dose slowly by 10 mg/day every two weeks as clinically needed; dosage range: 10 to 40 mg/day
• Dose Adjustments
• Renal Impairment: no dosage adjustments
• Hepatic Impairment: Maximum recommended dose: 20 mg daily due to decreased clearance and the risk of QT prolongation
• Adverse Drug Interaction:
  Drowsiness, insomnia, Diaphoresis, Nausea, xerostomia
• Pharmacodynamics/Kinetics:
• Onset of action: Depression: The onset of action is 1 to 4 weeks
• Duration: 1 to 2 days
• Half-life elimination: 24 to 48 hours
• Important Notes:
• Antidepressants increased the risk of suicidal thinking and behaviour (suicidality) compared with placebo in short-term studies in children, adolescents, and young adults with major depressive disorder and other psychiatric disorders.
• Pregnancy & Lactation: Pregnancy Risk factor C / present in breast milk
• Medication Safety Issues:CeleXA may be confused with CeleBREX, Cerebyx, Ranexa, and ZyPREXA.

 

 

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Escitalopram

 

• Brand Names: Lexapro
• Therapeutic Category: Antidepressants, Selective Serotonin Reuptake Inhibitors
• Dosage Forms: Oral / Tablet, Solution
• Use: Labeled Indications:
• Major depressive disorder (unipolar)/ Generalized anxiety disorder
• Off Label: Binge eating disorder/ Body dysmorphic disorder/ Bulimia nervosa/ Obsessive-compulsive disorder (OCD)/ Panic disorder
• Dosing: Adult : Oral: Initial: 10 mg once daily; dose may be increased in 10 mg increments at intervals ≥1 week up to 40 mg once daily
• Pediatric: Children <12 years: Limited data available; only one randomized, placebo-controlled trial has been published; efficacy was not demonstrated for children <12 years of age
• Children and Adolescents ≥12 years: Initial: 10 mg once daily; may be increased to 20 mg/day after at least three weeks
• Dose Adjustments
• Renal Impairment: Severe impairment: CrCl <20 mL/minute: Use with caution.
• Hepatic Impairment: 10 mg once daily
• Adverse Drug Interaction:
  Headache, insomnia, drowsiness, Nausea, diarrhoea, Ejaculatory disorder
• Pharmacodynamics/Kinetics:
• Onset of action: Depression: The onset of action is within a week
• Bioavailability: 80%
• Half-life elimination: Mean: Adolescents: 19 hours
• Important Notes:
• Antidepressants increased the risk compared with placebo of suicidal thinking and behaviour (suicidality) in children, adolescents, and young adults in short-term studies of major depressive disorder (MDD) and other psychiatric disorders
• Pregnancy & Lactation: Pregnancy Risk factor C / present in breast milk
• Medication Safety Issues:

Lexapro may be confused with Loxitane

 

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FLUoxetine

• Brand Names: PROzac
• Therapeutic Category: Antidepressants, Selective Serotonin Reuptake Inhibitors
• Dosage Forms: Oral / Tablet, Capsule, Concentrate
• Use: Labeled Indications:
• Bipolar major depression/ Major depressive disorder (unipolar)/ Bulimia nervosa/ Panic disorder/ Treatment-resistant depression
• Off Label: Binge eating disorder/ Body dysmorphic disorder/ Fibromyalgia / Generalized anxiety disorder/Premature ejaculation
• Dosing: Adult : Oral: Initial: 20 mg once daily in the evening in combination with olanzapine or another second-generation antipsychotic; may increase the dose gradually in 10 to 20 mg increments (usual dose range: 20 to 60 mg/day
• Pediatric: Children ≥12 years and Adolescents: Oral: Initial: 20 mg once daily for three days, then 40 mg once daily for three days, then 60 mg once daily
• Dose Adjustments
• Renal Impairment: accumulation of fluoxetine or norfluoxetine may occur in patients with severely impaired renal function.
• Hepatic Impairment: Cirrhosis patient: Administer a lower dose or less frequent dosing interval.
• Compensated cirrhosis without ascites: Administer 50% of the normal dose.
• Adverse Drug Interaction:
  Insomnia, headache, drowsiness, anxiety, nervousness, yawning, Decreased libido
• Pharmacodynamics/Kinetics:
• Onset of action: Depression: The onset of action is within a week
• Half-life elimination: Adults: Parent drug: 1 to 3 days
• Time to peak, serum: 6 to 8 hours
• Important Notes:
• Antidepressants increase the risk of suicidal thinking and behaviour in children, adolescents, and young adults (18 to 24 years of age) with major depressive disorder (MDD) and other psychiatric disorders
• Pregnancy & Lactation: Pregnancy Risk factor C / present in breast milk
• Medication Safety Issues:

PROzac may be confused with Paxil, Prelone, PriLOSEC, Prograf, Proscar, ProSom, Provera

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Sertraline

• Brand Names: Zoloft
• Therapeutic Category: Antidepressant, Selective Serotonin Reuptake Inhibitor
• Dosage Forms: Oral / Tablet, Concentrate
• Use: Labeled Indications: Antidepressants
• Major depressive disorder (unipolar)/ Obsessive-compulsive disorder/ Panic disorder/ Posttraumatic stress disorder/ Social anxiety disorder
• Off Label: Binge eating disorder/ Body dysmorphic disorder/ Bulimia nervosa/ Generalized anxiety disorder/Premature ejaculation
• Dosing: Adult : Oral: Initial: 50 mg once daily; may increase the dose based on response and tolerability in increments of 25 to 50 mg once weekly to a maximum of 200 mg/day
• Pediatric: Children 6 to 12 years: Initial: 25 mg once daily; titrate dose upwards if clinically needed; increase by 25 to 50 mg/day increments at intervals of at least one week; maximum daily dose: 200 mg/day
• Adolescents 13 to 17 years: Initial: 50 mg once daily; titrate dose upwards if clinically needed; increase by 50 mg/day increments at intervals of at least one week; maximum daily dose: 200 mg/day
• Dose Adjustments
• Renal Impairment: No dosage adjustment
• Hepatic Impairment: Mild impairment (Child-Pugh class A): Reduce dose to 50% of the usual dose.
• Moderate to severe impairment (Child-Pugh class B or C): Use is not recommended: No dosage adjustment
• Adverse Drug Interaction:
  Insomnia, dizziness, fatigue, drowsiness, Nausea, diarrhoea, xerostomia
• Pharmacodynamics/Kinetics:
• Bioavailability: Bioavailability of tablets and solutions are equivalent
• Half-life elimination: Sertraline: Mean: 26 hours
• Time to peak, plasma: Sertraline: 4.5 to 8.4 hours
• Important Notes:
• When discontinuing antidepressant treatment that has lasted for >3 weeks, gradually taper the dose (eg, over 2 to 4 weeks) to minimize withdrawal symptoms and detect reemerging symptoms
• Pregnancy & Lactation: Pregnancy Risk factor C / present in breast milk
• Medication Safety Issues:

Sertraline may be confused with cetirizine, selegiline, Serevent, Soriatane

Zoloft may be confused with Zocor

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TraZODone

• Brand Names: Oleptro
• Therapeutic Category: Antidepressant, Serotonin Reuptake Inhibitor/Antagonist
• Dosage Forms: Oral / Tablet
• Use: Labeled Indications: Antidepressants
• Treatment of the unipolar major depressive disorder
• Off Label: Aggressive or agitated behaviour associated with dementia/ Insomnia
• Dosing: Adult: Immediate release: Initial: 50 mg twice daily; may increase in increments of 50 mg/day every 3 to 7 days to a target dose of 75 to 150 mg twice daily. Thereafter may further increase by 50 to 100 mg/day every 2 to 4 weeks based on response and tolerability; the usual dosage range is 200 to 400 mg/day; maximum of 600 mg/day.
• Pediatric: Children 3 to 5 years: Initial 50 mg/dose at bedtime; may increase the dose at 2-week intervals in 25 mg increments; maximum dose: 150 mg/dose
• Children >5 years and Adolescents: Initial: 0.75 to 1 mg/kg/dose or 25 to 50 mg at bedtime; reported range: 0.5 to 2 mg/kg/day (do not to exceed adult dosing: 200 mg/day)
• Dose Adjustments
• Renal Impairment: no dosage adjustments
• Hepatic Impairment: no dosage adjustments
• Adverse Drug Interaction:
  Drowsiness, dizziness, headache, nervousness, fatigue, Xerostomia, nausea and vomiting
• Pharmacodynamics/Kinetics:
• Onset of action: Therapeutic (antidepressant): Up to 6 weeks
• Bioavailability: 100%
• Half-life elimination: 5 to 9 hours, prolonged in obese patients
• Important Notes:
• Antidepressants increase the risk of suicidal thoughts and behaviours in pediatric and young adult patients in short-term studies. Closely monitor all antidepressant-treated patients for clinical worsening, and emergence of suicidal thoughts and behaviours. Trazodone is not approved for use in pediatric patients.
• Pregnancy & Lactation: Pregnancy Risk factor C / present in breast milk
• Medication Safety Issues:

TraZODone may be confused with traMADol, ziprasidone

 

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