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Antidepressant Medications
Indication, starting dose, Half-life (T1/2) Notes/Notable side effects/Precautions
Name target symptoms, and CYP450 enzyme
affected
neurotransmitters
SSRIs
Citalopram Indication: Half-life: Notable Side effects:
(Celexa) -Depression
-OCD Parent drug has -Sexual dysfunction
-Panic Disorder 23-45 hour half-
Starting dose: life. - gastrointestinal,
20 mg/day, increase by -mostly CNS,
20 mg/day after 1 or
more weeks, mx 40 CYP450 enzyme: -activation,
mg/day, single-dose,
morning or evening -sweating,
Weak inhibitor of
Target symptoms: CYP450 2D6, -bruising and rare bleeding
-Depressed Mood metabolized by
-Anxiety CYP450 3A4 and -rare hyponatremia
-Panic attacks, avoidant 2C19.
behavior,reexperiencing -SIADH
,
Hyperarousal Precautions
-Sleep disturbance, both -Use with caution in patient with history of seizures
Insomnia and - bipolar disorder unless treated with concomitant mood-
hypersomnia stabilizing agent.
-When treating children carefully weigh the risks and benefits of
Affected pharmacological treatment against the risks and benefits on non
neurotransmitters: treatment with antidepressants. Warn about possible side effects
Serotonin and to report immediately. Monitor for suicidal ideations
-Monitor patients for activation of suicidal ideation, especially
children and adolescents
Escitalopram (Lexapro) Indication: Half-life: Notable Side effects:
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-MDD (12yrs and older)
- Generalized Anxiety 27-32 hours,
Disorder -Sexual dysfunction (men: delayed ejaculation, erectile
CYP450 enzyme: dysfunction; men and women: decreased sexual desire,
Starting dose: anorgasmia)
10mg-20mg/day CYP450 3A4
-Gastrointestinal (decreased appetite, nausea, diarrhea,
-Initial 10mg/day, No significant constipation, dry mouth)
increase to 20mg/day if actions on
necessary,single-dose CYP450 enzymes -Mostly central nervous system (insomnia but also sedation,
administration morning agitation, tremors, headache, dizziness)
or evening.
-Autonomic (sweating) Bruising and rare bleeding
Target symptoms:
-Rare hyponatremia (mostly in elderly patients and generally
-Insomnia reversible on discontinuation of escitalopram
-Depressed moods -SIADH (syndrome of inappropriate antidiuretic hormone
secretion
-Panic attack, avoidant
behavior, Precautions
reexperiencing, -Use with caution in patient with history of seizures
hyperarousal - Bipolar disorder unless treated with concomitant mood-
stabilizing agent.
-Anxiety -When treating children carefully weigh the risks and benefits of
pharmacological treatment against the risks and benefits on non
Affected treatment with antidepressants
neurotransmitters:
Serotonin
Fluoxetine Indication: Half-life: Notable Side effects:
(Prozac)
Major depressive - Active -Sexual dysfunction (men: delayed ejaculation, erectile
disorder (ages 8 and metabolite dysfunction; men and women: decreased sexual desire,
older) (norfluoxetine) anorgasmia)
has
Stabilizer_Medication_Table_Tamara_Sago_2_11_24.docx
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-Obsessive- compulsive 2 week half-life -Gastrointestinal (decreased appetite, nausea, diarrhea,
disorder (OCD) (ages 7 Parent drug has constipation, dry mouth)
and older) 2–3 day half-life
-Mostly CNS (insomnia but also sedation, agitation, tremors,
-Premenstrual dysphoric CYP450 enzyme: headache, dizziness)
disorder (PMDD)
-Note: patients with diagnosed or undiagnosed bipolar or
-Bulimia nervosa Panic Inhibits CYP450 psychotic disorders may be more vulnerable to CNS-activating
disorder 2D6 actions of SSRIs
Inhibits CYP450 -Autonomic (sweating)
Starting dose: 3A4
-Bruising and rare bleeding
0-80 mg for
depression/anxiet y -SIADH (syndrome of inappropriate antidiuretic hormone
60-80 mg for Bulimia secretion)
Target symptoms:
-Depressed Mood Precautions
-Energy ,motivation,and -Add or initate other antidepressants with caution for up to 5
interest weeks after discontinuing fluoxetine.
-Anxiety (eventually, but -Use with caution in patient with history of seizures
can actually increase -Use with caution in patients with bipolar disorder unless treated
anxiety, especially short- with concomitant mood- stabilizing agent.
term) - When treating children carefully weigh the risks and benefits of
-Sleep disturbance, both pharmacological treatment against the risks and benefits on non
insomnia and treatment with antidepressants
hypersomnia
Affected
neurotransmitters:
Serotonin Reuptake
Inhibitor
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Antidepressant Medications
Indication, starting dose, Half-life (T1/2) Notes/Notable side effects/Precautions
Name target symptoms, and CYP450 enzyme
affected
neurotransmitters
SSRIs
Citalopram Indication: Half-life: Notable Side effects:
(Celexa) -Depression
-OCD Parent drug has -Sexual dysfunction
-Panic Disorder 23-45 hour half-
Starting dose: life. - gastrointestinal,
20 mg/day, increase by -mostly CNS,
20 mg/day after 1 or
more weeks, mx 40 CYP450 enzyme: -activation,
mg/day, single-dose,
morning or evening -sweating,
Weak inhibitor of
Target symptoms: CYP450 2D6, -bruising and rare bleeding
-Depressed Mood metabolized by
-Anxiety CYP450 3A4 and -rare hyponatremia
-Panic attacks, avoidant 2C19.
behavior,reexperiencing -SIADH
,
Hyperarousal Precautions
-Sleep disturbance, both -Use with caution in patient with history of seizures
Insomnia and - bipolar disorder unless treated with concomitant mood-
hypersomnia stabilizing agent.
-When treating children carefully weigh the risks and benefits of
Affected pharmacological treatment against the risks and benefits on non
neurotransmitters: treatment with antidepressants. Warn about possible side effects
Serotonin and to report immediately. Monitor for suicidal ideations
-Monitor patients for activation of suicidal ideation, especially
children and adolescents
Escitalopram (Lexapro) Indication: Half-life: Notable Side effects:
Stabilizer_Medication_Table_Tamara_Sago_2_11_24.docx
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-MDD (12yrs and older)
- Generalized Anxiety 27-32 hours,
Disorder -Sexual dysfunction (men: delayed ejaculation, erectile
CYP450 enzyme: dysfunction; men and women: decreased sexual desire,
Starting dose: anorgasmia)
10mg-20mg/day CYP450 3A4
-Gastrointestinal (decreased appetite, nausea, diarrhea,
-Initial 10mg/day, No significant constipation, dry mouth)
increase to 20mg/day if actions on
necessary,single-dose CYP450 enzymes -Mostly central nervous system (insomnia but also sedation,
administration morning agitation, tremors, headache, dizziness)
or evening.
-Autonomic (sweating) Bruising and rare bleeding
Target symptoms:
-Rare hyponatremia (mostly in elderly patients and generally
-Insomnia reversible on discontinuation of escitalopram
-Depressed moods -SIADH (syndrome of inappropriate antidiuretic hormone
secretion
-Panic attack, avoidant
behavior, Precautions
reexperiencing, -Use with caution in patient with history of seizures
hyperarousal - Bipolar disorder unless treated with concomitant mood-
stabilizing agent.
-Anxiety -When treating children carefully weigh the risks and benefits of
pharmacological treatment against the risks and benefits on non
Affected treatment with antidepressants
neurotransmitters:
Serotonin
Fluoxetine Indication: Half-life: Notable Side effects:
(Prozac)
Major depressive - Active -Sexual dysfunction (men: delayed ejaculation, erectile
disorder (ages 8 and metabolite dysfunction; men and women: decreased sexual desire,
older) (norfluoxetine) anorgasmia)
has
Stabilizer_Medication_Table_Tamara_Sago_2_11_24.docx
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-Obsessive- compulsive 2 week half-life -Gastrointestinal (decreased appetite, nausea, diarrhea,
disorder (OCD) (ages 7 Parent drug has constipation, dry mouth)
and older) 2–3 day half-life
-Mostly CNS (insomnia but also sedation, agitation, tremors,
-Premenstrual dysphoric CYP450 enzyme: headache, dizziness)
disorder (PMDD)
-Note: patients with diagnosed or undiagnosed bipolar or
-Bulimia nervosa Panic Inhibits CYP450 psychotic disorders may be more vulnerable to CNS-activating
disorder 2D6 actions of SSRIs
Inhibits CYP450 -Autonomic (sweating)
Starting dose: 3A4
-Bruising and rare bleeding
0-80 mg for
depression/anxiet y -SIADH (syndrome of inappropriate antidiuretic hormone
60-80 mg for Bulimia secretion)
Target symptoms:
-Depressed Mood Precautions
-Energy ,motivation,and -Add or initate other antidepressants with caution for up to 5
interest weeks after discontinuing fluoxetine.
-Anxiety (eventually, but -Use with caution in patient with history of seizures
can actually increase -Use with caution in patients with bipolar disorder unless treated
anxiety, especially short- with concomitant mood- stabilizing agent.
term) - When treating children carefully weigh the risks and benefits of
-Sleep disturbance, both pharmacological treatment against the risks and benefits on non
insomnia and treatment with antidepressants
hypersomnia
Affected
neurotransmitters:
Serotonin Reuptake
Inhibitor
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