100 Section 2/ Drugs Acting on CNSlar catecholamines present in the non-granu-
lar cytoplasmic pool. It also causes oxida-
tive deamination of 5-hydroxytryptamine.
Their antidepressant action may be related
to increase in the brain catecholamines con-
tent.
MAO inhibitors increase the catechola-
mine content of various organs so that more
catecholamine is to be released by indirectly
acting sympathomimetic amines.
Adverse effects include tremor, insom-
nia, delirium, convulsion, postural hypoten-
sion, dry mouth, constipation, difficulty inmicturition, impotence, constipation. The
serious side effects include peripheral neu-
ropathy and jaundice due to hepatocellular
injury.Interaction with Other Drugs and Foods- Hypertensive crisis: MAO inhibitors
with ingestion of tyramine containing
food e.g. cheese, beer, red wine or fer-
mented food can cause intracranial
haemorrhage due to hypertensive cri-
sis because of release of noradrenaline
from adrenergic nerve endings by
unmetabolised tyramine.
Table 2.5.3: Classification of antidepressant drugs.
I. MAO inhibitors
i. Non-selective
Phenelzine
Isocarboxazid
Pargyline
ii. Selective
Moclobemide (RIMAPREX) 150-600 mg/day
II. Tricyclic and related compounds
i. Tricyclic antidepressants
Imipramine (DEPSONIL) 50-200 mg/day
Amitriptyline (AMIXIDE) 150-225 mg/day
Nortriptyline (PRIMOX) 50-150 mg/day
Trimipramine (SURMONTIL) 50-150 mg/day
Doxepin (DOXIN) 25-150 mg/day
Dothiepin (EXODEP) 75-150 mg/day
ii. Tetracyclic antidepressants
Mianserin (SERIDAC) 30-100 mg/day
Mirtazapine (MIRTAZ) 15-45 mg/day
III.Serotonin reuptake inhibitors
Sertraline (SERNATA) 50-200 mg/day
Citalopram (CITADEP) 20-40 mg OD
Paroxetine (PAROTIN) 20-50 mg/day
Fluoxetine (FLUDAC) 20-60 mg/day
IV.Mood stabilizers (Antimania drugs)
Lithium carbonate (LITHOSUN) 600-1000 mg/day