Antidepressants classification Flashcards by Nihal Afsheen

What does “mechanism of action” mean in antidepressants (explain 4 core ideas)?

• How the drug alters neurotransmitter systems 🧠🔧 • Identifies targets (receptors, transporters, enzymes) 🎯 • Explains which neurotransmitters increase 🌈 • Predicts clinical effects + side-effects 🔗

How well did you know this?

Not at all

Perfectly

Why classify antidepressants by MOA (give 3 key reasons)?

• Predicts therapeutic effects 🎯 • Predicts side-effects (sedation vs activation) • Helps match drug to symptom profile

How well did you know this?

Not at all

Perfectly

Which neurotransmitters are most central to antidepressant action (name 3 transmitters)?

• Serotonin (5-HT) → mood and anxiety 🌈 • Noradrenaline (NE) → energy and focus ⚡ • Dopamine (DA) → motivation and reward 🎉

How well did you know this?

Not at all

Perfectly

What improves when serotonin increases (state 3 clinical effects)?

• Improved mood 😊 • Reduced anxiety 🧘 • Better sleep regulation 😴

How well did you know this?

Not at all

Perfectly

What improves when noradrenaline increases (state 3 clinical effects)?

• ↑ Energy ⚡ • ↑ Alertness 🧠 • ↑ Concentration 🎯

How well did you know this?

Not at all

Perfectly

What improves when dopamine increases (state 3 clinical effects)?

• ↑ Motivation 🚀 • ↑ Pleasure/reward 🎉 • ↓ Anhedonia 🎯

How well did you know this?

Not at all

Perfectly

How well did you know this?

Not at all

Perfectly

What are the three broad MOA categories of antidepressants (list 3 mechanisms)?

• Reuptake inhibition 🚫🌀 • Receptor antagonism/modulation 🎯🚫 • Enzyme inhibition 🔧

How well did you know this?

Not at all

Perfectly

What is reuptake inhibition (give 3 core features)?

• Blocks SERT/NET/DAT transporters • ↑ synaptic neurotransmitter levels 📈 • Prolongs post-synaptic signalling 🔄

How well did you know this?

Not at all

Perfectly

Why does reuptake inhibition act quickly (name 2 reasons)?

• Immediate ↑ 5-HT/NE/DA ⚡ • Transporter blockade is rapid onset

How well did you know this?

Not at all

Perfectly

What is receptor antagonism (name 3 mechanisms)?

• Blocks postsynaptic receptors (e.g., 5HT2A) • Blocks autoreceptors (e.g., α2) • Alters neurotransmitter release

How well did you know this?

Not at all

Perfectly

What is enzyme inhibition (give 2 features)?

• Inhibits MAO-A/B 🧬 • Prevents neurotransmitter breakdown

How well did you know this?

Not at all

Perfectly

How well did you know this?

Not at all

Perfectly

Which antidepressants use reuptake inhibition (give 4 classes)?

• SSRIs, SNRIs, NARIs, DARIs

How well did you know this?

Not at all

Perfectly

Which classes act via receptor antagonism (give 2 classes)?

• NaSSAs • SARIs

How well did you know this?

Not at all

Perfectly

Which class acts via enzyme inhibition (give 1 class)?

• MAOIs / RIMAs

How well did you know this?

Not at all

Perfectly

How well did you know this?

Not at all

Perfectly

What is the mechanism of SSRIs (name 2 core mechanisms)?

• Block SERT • ↑ serotonin (5-HT) 🎯

How well did you know this?

Not at all

Perfectly

Why do SSRIs treat depression AND anxiety (give 3 explanations)?

• ↑ 5-HT in limbic circuits 🧠 • ↓ amygdala fear output • Stabilises PFC mood pathways

How well did you know this?

Not at all

Perfectly

Which symptoms SSRIs help most (list 3 domains)?

• Anxiety 😥 • Obsessions 🔄 • Depression 😔

How well did you know this?

Not at all

Perfectly

Name five SSRI antidepressants (give 5 examples).

• Sertraline • Fluoxetine • Paroxetine • Citalopram • Escitalopram

How well did you know this?

Not at all

Perfectly

What are the typical SSRI side-effects (name 3 effects)?

• GI upset 🍃 • Sexual dysfunction ❤️ • Initial agitation

How well did you know this?

Not at all

Perfectly

How well did you know this?

Not at all

Perfectly

What is the mechanism of SNRIs (state 3 mechanisms)?

• Block SERT → ↑ 5-HT • Block NET → ↑ NE ⚡ • Improve mood + energy

How well did you know this?

Not at all

Perfectly

Why are SNRIs energising (give **2 reasons**)?

• NE ↑ **alertness**
• NE ↑ **motivation** 🔥

Which symptoms SNRIs treat best (list **3 domains**)?

• **Fatigue**
• **Poor concentration**
• **Pain disorders**

Name three SNRI antidepressants (give **3 examples**).

• **Venlafaxine**
• **Duloxetine**
• **Milnacipran**

What is the mechanism of NARIs (state **2 mechanisms**)?

• Block **NET**
• Markedly ↑ **noradrenaline** ⚡

Why are NARIs activating (give **2 reasons**)?

• NE = **arousal neurotransmitter**
• ↑ alertness + activation

Name a NARI antidepressant (give **1 example**).

• **Reboxetine**

What does dis-inhibition mean in NDDIs (give **2 explanations**)?

• Block **5HT2C inhibitory receptors**
• Releases suppressed **DA + NE**

Which symptoms NDDIs help (give **2 domains**)?

• **Atypical depression**
• **Circadian/sleep problems** 🌙

Name an NDDI antidepressant (give **1 example**).

• **Agomelatine**

What is the NaSSA mechanism (list **3 mechanisms**)?

• Block **α2** → ↑ NE + 5-HT
• Block **5HT2** → sedation
• Block **5HT3** → appetite ↑

Why do NaSSAs increase sleep + appetite (state **2 reasons**)?

• **5HT2 block** → sedation 😴
• **5HT3 block** → appetite ↑ 🍽️

Name two NaSSA antidepressants (give **2 examples**).

• **Mirtazapine**
• **Mianserin**

What is the NaSSA mnemonic (give **1 memory hook**)?

• **Mood + Meals + Mattress** 😄🍽️🛌

What is the mechanism of DARIs (state **2 mechanisms**)?

• Block **DAT** → ↑ dopamine ⚡
• ↑ reward-circuit activation

Why are DARIs energising (give **2 reasons**)?

• ↑ **motivation** 🎯
• ↓ **anhedonia**

Name a DARI antidepressant (give **1 example**).

• **Bupropion**

When is bupropion most useful (give **2 indications**)?

• **Low energy** / low drive ⚡
• **SSRI sexual dysfunction**

What is the RIMA mechanism (state **2 mechanisms**)?

• Reversible **MAO-A inhibition** 🧬
• ↑ **5-HT + NE** safely

Why are RIMAs safer than classical MAOIs (give **2 reasons**)?

• Reversible with **tyramine** 🛡️
• Fewer diet restrictions

Name a RIMA antidepressant (give **1 example**).

• **Moclobemide**

What is the SARI mechanism (list **3 mechanisms**)?

• Block **5HT2A** → sedation 🌙
• Mild **SERT inhibition**
• Improves **sleep architecture**

Why do SARIs help insomnia (give **2 reasons**)?

• 5HT2A block ↓ **arousal**
• Promotes **slow-wave sleep**

Name two SARI antidepressants (give **2 examples**).

• **Trazodone**
• **Nefazodone**

What is the NMDA antagonist mechanism (state **2 mechanisms**)?

• Block **NMDA receptors** ⚡
• ↑ **synaptic plasticity** → rapid effect

Why is ketamine unique (give **2 reasons**)?

• Works within **hours** ⚡
• Effective in **treatment-resistant depression**

Name an NMDA antagonist antidepressant (give **1 example**).

• **Ketamine / Esketamine**

What is the easiest MOA mnemonic (give **1 mnemonic**)?

• **S-S-N-N-D-R-S-K** → SSRI, SNRI, NARI, NDDI, DARI, RIMA, SARI, Ketamine

Best mechanism for insomnia + weight loss (give **1 answer**)?

• **NaSSA (mirtazapine)** 😴🍽️

Best mechanism for low energy + anhedonia (give **1 answer**)?

• **DARI (bupropion)** ⚡

Best mechanism for anxiety disorders (give **1 answer**)?

• **SSRIs** 🧘

Safest mechanism medically (give **1 answer**)?

• **RIMA (moclobemide)** 🛡️

Fastest antidepressant effect (give **1 answer**)?

• **Ketamine** ⚡

What unifies all antidepressant mechanisms (state **2 principles**)?

• **Structure determines target** (receptors, transporters, enzymes) 🔬
• Target determines **clinical effects + side-effects** 🎯

Antidepressants classification Flashcards

(66 cards)