Diziness

Vertigo

Nausea

Vomiting

Diarrhea

Fatigue

Myualgia

chills

Paresthesia

insomnia

vivid dreams

What does Remeron (mirtazapine) block?

• The reuptake of NE and Serotonin (5HT₁₎: Antidepressant Effects
• Blocks the 5-HT₂ and 5-HT₃ Receptor Sites

By Blocking the reuptake of 5HT1 Remeron decreases

Remeron Blocks the 5-HT₂ and 5-HT₃ Receptor Sites resulting in:

• Fewer Activatoin Side Effects
• Fewer Sexual Side Effects
• Less Nausea, Headaches
• Can be sedating
• Increase appetite and weight gain

What are some negative effects of Children/Adolexcents & Antidepressants

Increase chance of becoming suicidal

• 2 times as likely to develop suicidal thoughts.
• FDA has a black box warning
• Benefit to risk ratios unfavorable
  • Paxil
  • Zoloft
  • Effexor

Antidipressant Effects throught the inhibition of MAO

• MAOI's are used on a limited basis because of their interaction with certain medications and foods containing Tyramine

It increases the release of NE and slows down the enzymes that destroy it overloding the synops.

9 years of their life

14 years of funtional activity

12 years of normal health

• Marked increase of suicide
• High rate of divorce
• high rate of job loss
• Increased likelihood of substance abuse (55%+)

• Without full inter-episodic recovery (between cycles)
• With Full inter-episodic recovery

• Lithium, lightest of the alkali metals, similar to sodium
• Has no effect on the brain except in relation to mania
• Action is not completely understood, may alter neuronal sodium transport
• Effective in 60-80 percent of acute hypomanic and manic episodes

• 1.5 to 2.0 mEq/L blood levels
• Nausea/vomiting
• Diarrhea
• Abdominal pain
• Mild Tremor
• Lethargy
• Impaired concentration

  Antidepressant Effects - promote blocking of re-uptake

 - Causes activation Side Effects

Aggitation

Restlessness

Sexual Disfunction

Side Effects -

Nausea

Headaches

Vomiting

prozac(fluoxitine)

Remeron(mirtazapine)

paroxetine - Paxil

setraline - Zoloft

venlafaxine - Effexor

bonds with the enzyme and don't let it go

enzyme is screwed

Edronax/Vestra (reboxetine)

stimulant

ADHD - Strattera (atomoxitine)

Cyclothymia - weakest

Bipolar II

Bipolar I - worst

- patients with a single manic episode have 70%

- likelihood of just one manic episode is a full lifetime is near 0%

DSM characteristics

Mania - 3 of 7 bullets

With seasonal patterns

- last two years, onset of depressive episode only, fall-winter

constant cycle change a particular time of the year

with rapid cycling

- not ups and downs the same day

- specifier not a category

- 4 episodes in one year; mixed, manic, depressive

- Absorbed very differently by people 

- It has a narrow therapuetic window

- It can be toxic

- Regular blood tests important

- Because lithium resembles table salt,

when a patient lowers salt intake,

lithium blood levels can rise.

- Also being dehydrated

Adverse effects -

- Leukopenia - reduction of white blood cells

- potentially teratogenic (can effect fetus)

- Does not alter the kinetics of lithium

- 

- many lose weight

- appears to work good

- success with schizoaffective as well

If over weight, may be good drug to go with

Diarrhea

Hypertension

Tachycardia (racing heart)

Ataxia ( muscle in coordination)

Increased reflexes

Myoclonus (muscle jerking)

Disoriented

Confusion

Hypomania

Agitation/restlessness

Fever

Chills

Sweating