Name
Indication, starting dose,
target symptoms, and
affected neurotransmitters
Half-life (T1/2)
CYP450 enzyme
Notes/Notable side
... [Show More] effects/Precautions
SSRIs
Citalopram
(Celexa)
Indication
Depression
PMDD
OCD
Panic d/o
GAD
PTSD
Social anxiety d/o
Neurotransmitter
Serotonin
Target symptoms
Depressed mood
Anxiety
Panic attacks,
avoidant behavior,
reexperiencing,
hyperarousal
Sleep disturbance,
insomnia and
hypersomnia
Half-life
23-45 hour
CYP450
Weak
inhibitor of
CYP450 2D6
Metabolized
by CYPf450
3A4 and
2C19
Sexual dysfunction
Decreased appetite, n/d, constipation, dry mouth
Dose dependent insomnia, sedation, agitation,
tremors, headache,dizzy
Pt with bipolar or psychotic d/o may be more
vulnerable to CNS-activating actions of SSRIs
Sweating
Bruising and rare bleeding
Rare hyponatremia
Syndrome of inappropriate antidiuretic hormone
secretion
Rare seizures, induction of mania, activation of
suicidal ideation
Escitalopram
(Lexapro)
Indication
MDD 12+
GAD
Panic d/o
OCD
PTSD
Social anxiety d/o
PMDD
Neurotransmitter
Serotonin
Half-life
27-32 hours
CYP450
Substrate for CYP450
and 3A4
No significant actions
on CYP450 enzymes
Sexual dysfunction ED, delayed ejaculation, decreased
sexual desire, anorgasmia
Decreased appetite, n/d, constipation, dry mouth
Insomnia and sedation, agitation, tremors, headache,
dizzy
Pt with bipolar or psychotic d/o may be more
vulnerable to CNS-activating actions of SSRIs
Sweating
Rare hyponatremia
Syndrome of inappropriate antidiuretic hormone
biol health care
Target symptoms
Depressed mood
Anxiety
Panic attacks,
avoidant behavior,
reexperiencing,
hyperarousal
Sleep disturbance,
insomnia and
hypersomnia
secretion
Rare seizures, induction of mania, activation of
suicidal ideation
Fluoxetine
(Prozac)
Indication
MDD 8+
OCD 7+
PMDD
Bulimia nervosa
Panic d/o
bipolar depression
used with
olanzapine
treatment resistant
depression used
with olanzapine
social anxiety d/o
PTSD
Neurotransmitter
Serotonin
NE
DA
Target symptoms
Depressed mood
Energy, motivation,
and interest
Anxiety (can
increase anxiety
Half-life
Active
metabolite 2
week
Parent drug
2-3 d.
CYP450
Inhibits
CYP450 2D6
Inhibits
CYP450 3A4
Sexual dysfunction ED, delayed ejaculation, decreased
sexual desire, anorgasmia
Decreased appetite, n/d, constipation, dry mouth
Insomnia and sedation, agitation, tremors, headache,
dizzy
Pt with bipolar or psychotic d/o may be more
vulnerable to CNS-activating actions of SSRIs
Sweating
Bruising and rare bleeding
Syndrome of inappropriate antidiuretic hormone
secretion
Rare seizures, induction of mania, activation of
suicidal ideation
short-term)
Insomnia and
hypersomnia –
short-term can
cause insomnia
Fluvoxamine
(Luvox)
Indications
OCD
Social anxiety d/o
Depression
Panic d/o
GAD
PTSD
Neurotransmitter
Serotonin
Target symptoms
Depressed mood
anxiety
Half-life
Parent drug
2-28 hours
CYP450
Inhibits
CYP450
1. 3A4
2. 1A2
3. 2C9/
2C19
Sexual dysfunction ED, delayed ejaculation, decreased
sexual desire, anorgasmia
Decreased appetite, n/d, constipation, dry mouth
Insomnia and sedation, agitation, tremors, headache,
dizzy
Pt with bipolar or psychotic d/o may be more
vulnerable to CNS-activating actions of SSRIs
Sweating
Bruising and rare bleeding
Rare hyponatremia
Paroxetine
(Paxil)
Indications
MDD
OCD
Panic d/o
Social anxiety d/o
PTSD
GAD
PMDD
Vasomotor
symptoms
(brisdelle)
Neurotransmitter
Serotonin
Anticholinergic
NE
Target symptoms
Depressed mood
Half-life
24 hours
CYP450
Inhibits
CYP450 2D6
Sexual dysfunction ED, delayed ejaculation, decreased
sexual desire, anorgasmia
Decreased appetite, n/d, constipation, dry mouth
Insomnia and sedation, agitation, tremors, headache,
dizzy
Weight gain
Pt with bipolar or psychotic d/o may be more
vulnerable to CNS-activating actions of SSRIs
Sweating
Bruising and rare bleeding
Syndrome of inappropriate antidiuretic hormone
secretion
Anxiety
Sleep disturbance,
especially insomnia
Obsession,
compulsion
panic attacks,
avoidant behaavior,
re-experiencing,
hyperarousal
Sertraline
(Zoloft)
Indications
MDD
PMDD
Panic d/o
PTSD
Social anxiety d/o
OCD
GAD
Neurotransmitter
Serotonin
DA
Target symptoms
Depressed mood
Anxiety
Obsession,
compulsion
panic attacks,
avoidant behaavior,
re-experiencing,
hyperarousal
Insomnia and
hypersomnia –
short-term can
cause insomnia
Half-life
Parent drug
22-36 h
Metabolite
62-104 h
CYP450
Inhibits
CYP450 2D6
(weak at low
dose)
Inhibits
CYP450 3A4
weak @ low
dose
Sexual dysfunction ED, delayed ejaculation, decreased
sexual desire, anorgasmia
Decreased appetite, n/d, constipation, dry mouth
Insomnia and sedation, agitation, tremors, headache,
dizzy
Pt with bipolar or psychotic d/o may be more
vulnerable to CNS-activating actions of SSRIs
Sweating
Bruising and rare bleeding
Syndrome of inappropriate antidiuretic hormone
secretion
Rare hypotension
SNRIs
Venlafaxine
(Effexor)
Indications
Depression
GAD
Social anxiety d/o
Panic d/o
PTSD
PMDD
Neurotransmitter
Serotonin
NE
DA
Target symptoms
Depressed mood
Energy, motivation,
and interest
Sleep disturbance
Anxiety
Half-life
Parent drug
3-7h
Active
metabolite 9-
13h
CYP450
Most SE increase with higher dose (at least
transiently)
Headache, nervous, insomnia, sedation\
n/d, decreased appetite
abnormal ejaculatin/orgasm, impotence
asthenia, sweating
SIADH
Hyponatremia
Hypotension r/t dose
Desvenlafaxine
(Pristiq)
Indications
MDD
Vasomotor
symptoms
Fibromyalgia
GAD
Social anxiety d/o
Panic d/o
PTSD
PMDD
Neurotransmitter
Serotonin
NE
DA
Target symptoms
Depressed mood
Energy, motivation,
Half-life
9-13h
CYP450
Minimally
metabolized
by 3A4
Most SE increase with higher dose (at least
transiently)
Insomnia, sedation, anxiety, dizzy
n/v, constipatin, decreased appetite
abnormal ejaculation/orgasm, impotence
sweating
SIADH
Hyponatremia
Hypertension
and interest
Sleep disturbance
Physical symptoms
Pain
Duloxetine
(Cymbalta)
Indications
MDD
Diabetic peripheral
neuropathic pain
Fibromyalgia
GAD,
acute&maintenanc
e
Chronic
musculoskeletal
pain
Stress urinary
incontinence
Neuropathic
pain/chronic pain
Other anxiety d/o
Neurotransmitter
Serotonin
NE
DA
Target symptoms
Depressed mood
Energy, motivation
and interest
Sleep disturbance
Anxiety
Physical symptoms
Pain
Half-life
Elimination
half-life
approximatel
y 12h
CYP450
Metabolized
2D6
1A2
Inhibitor of
2D6
(probably
clinically
significant)
1A2
(probably not
clinically sig.)
n/d, decreased appetite, dry mouth, constipation
(dose-dependant)
insomnia, sedation, dizziness
abnormal ejaculation/orgasm, impotence, decreased
libido, women-abnormal orgasm
sweating
increase in blood pressure
urinary retention [Show Less]