1. 5HT 2 : wt gain, 5HT3 (activation of post-syn) : n&v, Sexual ADR: activation of post-syn 5HT2 R
2. LICENCED INDICATIONS
   1. DEPRESSION
      1. ALL!
   2. PANIC DISORDER +/- AGORAPHOBIA
      1. Citalopram, Escitalopram, Paroxetine,
   3. OCD
      1. Fluoxetine, Fluoxamine, Paroxetine, Sertraline (specialist), Clomipramine
   4. SOCIAL ANXIETY / GAD
      1. Escitalopram, Paroxetine , Venlafax (GAD, only XL preps), ? Buspirone, NB: Pregabalin
   5. SOCIAL PHOBIA
      1. Paroxetine, Reboxetine
   6. PTSD
      1. Paroxetine, Sertraline
   7. DEPRN +/- ANXIETY
      1. Trazodone, Venlafax, SSRIs
   8. NOCTURNAL ENURESIS IN CHILDREN
      1. TCAs - Imipramine, Amitriptyline, Nortriptyline
   9. OTHER
      1. CLOMIPRAMINE - adjunct to cataplexy asso with narcolepsy
   10. BULEMIA
       1. Fluoxetine 60 mg
3. TCA ADR: Anti ch ADR: dry mth, consti, uri reten, accomod probs, glaucome Anti- hist ADR : sedation, wt gain, a-NA blck- postural hypo, sedation; wt gain (5HT2 blck); cardiotoxic (long QT, ST ele, AV blck, arry), Neurotoxic - delirium, mov disorder, convulsn ; discontinuatino synd; manic switch in BAD
4. MAO ADR: post hypo, restlessness, insomnia, peripheral edema, nausea, dizzy, sexual dysfn, sweating, tremor NB: HT CRISIS
5. SSRI ADR: n&v, agitation, akathesia, sexual dysfn, discont synd, park'ism -uncommon, sedatn, dizzy - 10-20%, convul-rare
6. Mechanisms
   1. Monoamine re-uptake inhibition
      1. 5-HT
         1. 1. SSRI 2. TCA 3.VENLAFAXINE (SNRI)
      2. NA
         1. 1. TCA 2. REBOXETINE(NARI) 3.VENLAFAXINE(SNRI)
      3. DA
         1. 1. BUPROPIONE {Also METHYLPHENIDATE, COCAINE, PCP
   2. Monoamine Receptor action
      1. Agonist
         1. 5- HT 1a
            1. BUSPIRONE
      2. Antagonist
         1. alpha 2
            1. 1. MIRTAZAPINE (NaSSa) 2. MIANSERIN
            2. ZISPIN : 5HT2, 5HT3, ANTI-HISTA, A2 BLOCKER
            3. Activates NA neurons by blocking -ve feedback of NA on pre-syn a2 R; BRAINSTEM: INC NA activity, CORTEX : INC 5HT activity (both by pre-syn a2 blc)
         2. 5-HT 2
            1. 1. NEFAZODONE , TRAZADONE 2. MIRTAZAPINE (NaSSa) 3. MIANSERIN 4. AMITRIPTYLINE
   3. MAOI
      1. A
         1. MOCLOBEMIDE (reversible i.e RIMA)
      2. B
         1. PHENELZINE
   4. Other
      1. LITHIUM , TRYPTOPHAN, ST. JONH'S WART