Imipramine

Tofranil®

Mechanism of Action: Inhibits NE and 5HT reuptake in the presynaptic nerve terminal; antagonizes 5-HT (presynaptic), α-adrenergic, histamine and muscarinic receptors

Side Effects: Anticholinergic SE, aggravation of glaucoma and epilepsy, cardiac overstimulation, orthostatic hypoTN, sedation, manic behavior

Metabolism: Oxidation at 2 follow by glucuronidation

TCA

**Note: Used for bedwetting in kids**

Desipramine

Norpramin®

Mechanism of Action: Inhibits NE and 5HT reuptake in the presynaptic nerve terminal; antagonizes 5-HT (presynaptic), α-adrenergic, histamine and muscarinic receptors

Side Effects: Anticholinergic SE, aggravation of glaucoma and epilepsy, cardiac overstimulation, orthostatic hypoTN, sedation, manic behavior

Metabolism: 2 –hydroxylation follow by gluc

TCA 

Amitriptyline

Elavil®

Mechanism of Action: Inhibits NE and 5HT reuptake in the presynaptic nerve terminal; antagonizes 5-HT (presynaptic), α-adrenergic, histamine and muscarinic receptors

Side Effects: Anticholinergic SE, aggravation of glaucoma and epilepsy, cardiac overstimulation, orthostatic hypoTN, sedation, manic behavior

Metabolism: Hydroxylation at 10 and 5 position followed by conjugation; N-demethylation

TCA

Nortriptyline

Pamelor®, Aventyl®

Mechanism of Action: Inhibits NE and 5HT reuptake in the presynaptic nerve terminal; antagonizes 5-HT (presynaptic), α-adrenergic, histamine and muscarinic receptors

Side Effects: Anticholinergic SE, aggravation of glaucoma and epilepsy, cardiac overstimulation, orthostatic hypoTN, sedation, manic behavior

Metabolism:N-demethylation, 10-hydroxylation

TCA

Protriptyline

Vivactyl®

Mechanism of Action: Inhibits NE and 5HT reuptake in the presynaptic nerve terminal; antagonizes 5-HT (presynaptic), α-adrenergic, histamine and muscarinic receptors

Side Effects: Anticholinergic SE, aggravation of glaucoma and epilepsy, cardiac overstimulation, orthostatic hypoTN, sedation, manic behavior

Metabolism: Not Specified

TCA

Doxepin

Sinequan®

Mechanism of Action: Inhibits NE and 5HT reuptake in the presynaptic nerve terminal; antagonizes 5-HT (presynaptic), α-adrenergic, histamine and muscarinic receptors

Side Effects: Anticholinergic SE, aggravation of glaucoma and epilepsy, cardiac overstimulation, orthostatic hypoTN, sedation, manic behavior

Metabolism: Not specified

TCA

Clomipramine

Anafranil®

Mechanism of Action: Inhibits NE and 5HT reuptake in the presynaptic nerve terminal; antagonizes 5-HT (presynaptic), α-adrenergic, histamine and muscarinic receptors

Side Effects: Anticholinergic SE, aggravation of glaucoma and epilepsy, cardiac overstimulation, orthostatic hypoTN, sedation, manic behavior

Metabolism: Not specified

TCA

Trimipramine

Surmontil®

Mechanism of Action: Inhibits NE and 5HT reuptake in the presynaptic nerve terminal; antagonizes 5-HT (presynaptic), α-adrenergic, histamine and muscarinic receptors

Side Effects: Anticholinergic SE, aggravation of glaucoma and epilepsy, cardiac overstimulation, orthostatic hypoTN, sedation, manic behavior

Metabolism: Not specified

TCA

Trazodone

Desyrel®

Metabolism: N-Dealkylation to m-chloropiperazine active metabolite

5HT-2 Antagonist

Nefazodone

Serzone®

Metabolism: Not specified

5HT-2 Antagonist

Isocarboxazid

Marplan®

Mechanism of Action: Inhibits MAO and causes accumulation of 5-HT, NE, & DA in CNS and periphery

SE: CNS stimulation, restlessness, anxiety, tremors, othostatic hypotension

Metabolism: Not specified

MAOI (Irreversible MAOa inhibitor)

**Note: Avoid tyramine containing foods (Beer, wine, cheese, chicken liver, avacodos, chocolate, bananas)**

Phenelzine

Nardil®

Mechanism of Action: Inhibits MAO and causes accumulation of 5-HT, NE, & DA in CNS and periphery

SE: CNS stimulation, restlessness, anxiety, tremors, othostatic hypotension

Metabolism: Not specified

MAOI (Irreversible MAOa inhibitor)

**Note: Avoid tyramine containing foods (Beer, wine, cheese, chicken liver, avacodos, chocolate, bananas)**

Tranylcypromine

Parnate®

Mechanism of Action: Inhibits MAO and causes accumulation of 5-HT, NE, & DA in CNS and periphery

SE: CNS stimulation, restlessness, anxiety, tremors, othostatic hypotension

Metabolism: Not specified

MAOI (Reversible MAOb inhibitor)

**Note: Avoid tyramine containing foods (Beer, wine, cheese, chicken liver, avacodos, chocolate, bananas)**

Selegiline

Deprenyl®

Mechanism of Action: Inhibits MAO and causes accumulation of 5-HT, NE, & DA in CNS and periphery

SE: CNS stimulation, restlessness, anxiety, tremors, othostatic hypotension

Metabolism: Not specified

MAOI (Reversible MAOb inhibitor)

**Note: Avoid tyramine containing foods (Beer, wine, cheese, chicken liver, avacodos, chocolate, bananas)**

Moclobemide

Not available in US

Mechanism of Action: Inhibits MAO and causes accumulation of 5-HT, NE, & DA in CNS and periphery

SE: CNS stimulation, restlessness, anxiety, tremors, othostatic hypotension

Metabolism: Not specified

MAOI (Reversible MAOa inhibitor)

**Note: Avoid tyramine containing foods (Beer, wine, cheese, chicken liver, avacodos, chocolate, bananas)**

Fluoxetine

Prozac®

Use: Mental depression, OCD, bulemia

Mechanism of Action: Selectively inhibits serotonin reuptake

SE: Nausea, decreased libido, anorexia, anxiety, insomnia, tremors, sleepiness, sweating

Metabolism: Not specified

SSRI

Citalopram

Celexa®

Use: Mental depression

Mechanism of Action: Selectively inhibits serotonin reuptake

SE: Nausea, decreased libido, anorexia, anxiety, insomnia, tremors, sleepiness, sweating

Metabolism: Not specified

SSRI

Fluvoxamine

Luvox®

Use: OCD

Mechanism of Action: Selectively inhibits serotonin reuptake

SE: Nausea, decreased libido, anorexia, anxiety, insomnia, tremors, sleepiness, sweating

Metabolism: Not specified

SSRI

Paroxetine

Paxil®

Use: Mental depression, panic disorder, OCD

Mechanism of Action: Selectively inhibits serotonin reuptake

SE: Nausea, decreased libido, anorexia, anxiety, insomnia, tremors, sleepiness, sweating

Metabolism: Formation of catecholamine followed by gluc.

SSRI

Sertraline

Zoloft®

Use: Mental depression

Mechanism of Action: Selectively inhibits serotonin reuptake

SE: Nausea, decreased libido, anorexia, anxiety, insomnia, tremors, sleepiness, sweating

Metabolism: N-demethylation

SSRI

Escitalopram

Lexapro®

Mechanism of Action: Selectively inhibits serotonin reuptake

SE: Nausea, decreased libido, anorexia, anxiety, insomnia, tremors, sleepiness, sweating

Metabolism: N-demethylation to active metabolite

SSRI

Duloxetine

Cymbalta®

Metabolism: Not specified

SNRI

Venlafaxine

Effexor®

Metabolism: O-demethylation to active metabolite

SNRI

Desvenlafaxine

Pristiq®

Metabolism: Not specified

SNRI

Bupropion

Wellbutrin®

Metabolism: Not specified

Tetracyclics and Unicyclics

Amoxapine

Asendin®

Metabolism: Not Specified (Active metabolite of Loxapine)

Tetracyclics and Unicyclics (Dibenzoxapin)

Maprotiline

Ludiomil®

Metabolism: N-demethylation to active metabolite

Tetracyclic and Unicyclics

Mirtazapine

Remeron®

Metabolism: N-demethylation and hydroxylation of pyridine

Tetracyclics and Unicyclics (Alpha-2 and 5HT antagonist)

Buspirone

Buspar®

Metabolism: Not specified

Partial 5-HT 1a agonist

Reboxetine

Vestra®

Metabolism: Not specified

NE Reuptake inhibitor (Not sure, but structures are similar; Not Available in US)

Atomoxetine

Strattera®

Metabolism: N-demethylation another route p-hydroxylation followed by gluc

NE Reuptake Inhibitor

Nisoxetine

Not available in US

Metabolism: Not specified

NE Reuptake Inhibitor