Updated: 12/15/2016

Atypical Antidepressants

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  • Psychiatric Drug Introduction
    • Psychiatric medications can be broken down into the following categories
      • Antidepressants
      • Antipsychotics
      • Bipolar Medications
      • Anxiolytics
  • Overview
    • Buproprion
      • mechanism
        • ↑ NE and dopamine via unknown mechanism
      • other uses
        • smoking cessation
      • toxicity
        • stimulant effects (tachycardia, insomnia)
        • headache
        • seizure in bulimic patients
        • no sexual side effects
    • Mirtazapine
      • mechanism
        • α2 receptor antagonist
          • ↑ release of NE and serotonin
        • 5-HT2 and 5-HT3 receptor antagonist
      • other uses
        • depression + anorexia nervosa
          • due to weight gain side effect
      • toxicity
        • sedation, ↑ appetite, weight gain, dry mouth
    • Amoxapine
      • mechanism
        • antagonism of dopamine receptor
      • toxicity
        • EPS, seizures, cardiotoxicity
    • Maprotiline
      • mechanism
        • blocks NE reuptake
      • toxicity
        • sedation, orthostatic hypotension, seizures, cardiotoxicity
    • Trazodone
      • mechanism
        • primarily inhibits serotonin reuptake
      • other uses
        • causes sedation
          • therefore used for insomnia
        • high doses are needed for antidepressant effects
      • toxicity
        • sedation, nausea, priapism in adolescent boys, orthostatic hypotension

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(M1.PY.15.75) A 23-year-old Caucasian male presents to the emergency department with a persistent penile erection for the last 6 hours. He recently began outpatient treatment for depression with associated insomnia. He traveled to Mexico 5 months ago. His medical history is otherwise unremarkable.

Which of the following is the most likely precipitating factor for priapism in this patient?

QID: 106857

Depression treatment with bupropion

8%

(12/151)

Depression treatment with venlafaxine

9%

(13/151)

Depression treatment with trazodone

78%

(118/151)

Sickle cell disease

3%

(4/151)

Infection acquired in Mexico

1%

(1/151)

M 3 C

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