Drilldown: Medicines
Medicines > classes:
[[:Category:Antidepressants|Antidepressant]] 
& duration :
24 hours (HS dosing) or
24 hours (once-daily dosing)
& duration :
24 hours (HS dosing) or
24 hours (once-daily dosing) Use the filters below to narrow your results.
generic:
brand:
Celexa (1) ·
Elavil (US brand discontinued; generic widely available), Endep, Tryptizol (1) ·
Lexapro (1) ·
Pamelor (US brand discontinued; generic widely available), Aventyl (1) ·
Paxil (IR), Paxil CR (controlled-release), Brisdelle (low-dose for menopausal vasomotor symptoms), Pexeva (paroxetine mesylate) (1) ·
Remeron (US brand discontinued; generic widely available), Remeron SolTab (ODT) (1) ·
Sinequan (oral antidepressant, US brand discontinued), Silenor (low-dose for insomnia), Prudoxin / Zonalon (topical cream) (1)
classes: (Click arrow to add another value)
mechanism:
None (4) ·
'"`UNIQ--vote-00000019-QINU`"' Therapeutic plasma-level monitoring is standard practice for TCAs given the narrow therapeutic index and the established plasma-level-efficacy correlation. CYP2D6 substrate; CPIC PGx guidance applies for dose individualization'"`UNIQ--ref-0000001A-QINU`"'. (1) ·
'"`UNIQ--vote-0000001D-QINU`"' CYP2C19 + CYP3A4 metabolism, with CPIC PGx guidance: poor CYP2C19 metabolizers have ~3-fold higher exposure and benefit from a lower starting dose; ultrarapid metabolizers may have inadequate response'"`UNIQ--ref-0000001E-QINU`"'. (2)
uses:
'"`UNIQ--vote-0000001B-QINU`"', '"`UNIQ--vote-0000001C-QINU`"', '"`UNIQ--vote-0000001D-QINU`"', '"`UNIQ--vote-0000001E-QINU`"', '"`UNIQ--vote-0000001F-QINU`"' (2) ·
'"`UNIQ--vote-0000001D-QINU`"', '"`UNIQ--vote-0000001E-QINU`"', '"`UNIQ--vote-0000001F-QINU`"', '"`UNIQ--vote-00000020-QINU`"', '"`UNIQ--vote-00000021-QINU`"', '"`UNIQ--vote-00000022-QINU`"' (1) ·
'"`UNIQ--vote-0000001F-QINU`"', '"`UNIQ--vote-00000020-QINU`"', '"`UNIQ--vote-00000021-QINU`"', '"`UNIQ--vote-00000022-QINU`"', '"`UNIQ--vote-00000023-QINU`"', '"`UNIQ--vote-00000024-QINU`"', '"`UNIQ--vote-00000025-QINU`"' (3) ·
'"`UNIQ--vote-00000023-QINU`"', '"`UNIQ--vote-00000024-QINU`"', '"`UNIQ--vote-00000025-QINU`"', '"`UNIQ--vote-00000026-QINU`"', '"`UNIQ--vote-00000027-QINU`"', '"`UNIQ--vote-00000028-QINU`"', '"`UNIQ--vote-00000029-QINU`"', '"`UNIQ--vote-0000002A-QINU`"' (1)
starting dose:
10 mg PO once daily; titrate to 20 mg/day after 1-2 weeks if needed (1) ·
15 mg PO at bedtime, titrate to 30-45 mg/day after 1-2 weeks. '''Counterintuitive dose paradox''': lower doses (7.5-15 mg) are more sedating than higher doses because H1 antihistamine effect dominates at low dose (1) ·
20 mg PO once daily; titrate to 40 mg/day after 1 week if tolerated. Elderly (>60) and hepatic impairment: 20 mg/day ceiling (1) ·
Depression (rarely used now): 25-75 mg PO at bedtime, titrate to 150 mg/day. Neuropathic pain / migraine prophylaxis: 10-25 mg at bedtime, titrate by 10-25 mg weekly to 50-100 mg/day. Elderly: 10 mg at bedtime (Beers-list cautions apply) (1) ·
Depression: 25 mg PO TID-QID or 75 mg at bedtime, titrate to 75-150 mg/day. Neuropathic pain: 10-25 mg at bedtime, titrate to 50-100 mg/day. Elderly: 10 mg at bedtime (Beers-list cautions, though less than amitriptyline) (1) ·
Depression: 25-75 mg/day to start, titrate to 75-150 mg/day at bedtime. Insomnia (Silenor): 3 mg PO 30 minutes before bedtime, max 6 mg. Topical (Prudoxin): apply to affected area every 3-4 hours (1) ·
MDD/GAD: 20 mg PO once daily. Panic disorder: 10 mg titrating to 40 mg. OCD: 20 mg titrating to 40-60 mg. CR: 25 mg/day. Brisdelle: 7.5 mg at bedtime for hot flashes (1)
preparations:
Capsules 10, 25, 50, 75 mg; oral solution 10 mg/5 mL (1) ·
Capsules 10, 25, 50, 75, 100, 150 mg; oral concentrate 10 mg/mL; Silenor tablets 3, 6 mg; topical cream 5% (Prudoxin, Zonalon) (1) ·
IR tablets 10, 20, 30, 40 mg; CR tablets 12.5, 25, 37.5 mg; oral suspension 10 mg/5 mL; Brisdelle capsules 7.5 mg (1) ·
Tablets 10, 20, 40 mg; oral solution 10 mg/5 mL (1) ·
Tablets 10, 25, 50, 75, 100, 150 mg (1) ·
Tablets 5, 10, 20 mg; oral solution 1 mg/mL (1) ·
Tablets 7.5, 15, 30, 45 mg; orally disintegrating tablets (SolTab) 15, 30, 45 mg (1)
fda max:
'''20 mg/day in adults >60 years''' per FDA's 2011-2012 QT-prolongation warning; 40 mg/day in adults ≤60 (1) ·
150 mg/day; therapeutic plasma-level monitoring recommended (target 50-150 ng/mL window) (1) ·
20 mg/day (adult); 10 mg/day in elderly and in hepatic impairment (1) ·
300 mg/day (depression, hospitalized); 150 mg/day outpatient; 6 mg/day for insomnia (1) ·
300 mg/day (historical hospitalized inpatient depression); 150 mg/day outpatient typical ceiling (1) ·
45 mg/day (1) ·
50 mg/day (IR); 62.5 mg/day (CR); 60 mg/day (OCD) (1)
routes:
onset:
Antidepressant effect emerges over 1-2 weeks (1) ·
Antidepressant effect emerges over 1-2 weeks; full clinical effect 4-6 weeks (1) ·
Antidepressant effect over 1-2 weeks; full clinical effect 4-6 weeks (1) ·
Pain and migraine prophylaxis effect 1-4 weeks; antidepressant effect 4-6 weeks (1) ·
Sleep effect from first dose; analgesic and migraine-prophylaxis effect 1-4 weeks; antidepressant effect 4-6 weeks (1) ·
Sleep effect from first dose; antidepressant effect over 1-4 weeks (2)
duration: (Click arrow to add another value)
halflife:
18-44 hours'"`UNIQ--ref-00000020-QINU`"' (1) ·
20-40 hours'"`UNIQ--ref-00000023-QINU`"' (1) ·
27-32 hours'"`UNIQ--ref-00000026-QINU`"' (1) ·
Amitriptyline 10-50 hours (highly variable); nortriptyline active metabolite 18-44 hours'"`UNIQ--ref-00000026-QINU`"' (1) ·
~15 hours (parent); nordoxepin active metabolite ~30 hours'"`UNIQ--ref-00000020-QINU`"' (1) ·
~21 hours (with nonlinear pharmacokinetics from CYP2D6 autoinhibition)'"`UNIQ--ref-0000002B-QINU`"' (1) ·
~35 hours'"`UNIQ--ref-00000026-QINU`"' (1)
bioavailability:
Highly variable due to saturable first-pass metabolism'"`UNIQ--ref-0000002C-QINU`"' (1) ·
~30% (oral)'"`UNIQ--ref-00000021-QINU`"' (1) ·
~50% (oral)'"`UNIQ--ref-00000021-QINU`"' (1) ·
~50% (oral)'"`UNIQ--ref-00000027-QINU`"' (1) ·
~50% (oral; substantial first-pass)'"`UNIQ--ref-00000024-QINU`"' (1) ·
~80% (oral)'"`UNIQ--ref-00000027-QINU`"' (2)
pregnancy:
None (1) ·
'''Among the least preferred SSRIs in pregnancy.''' Observational signal for cardiac malformations (atrial and ventricular septal defects) with first-trimester exposure, and the most severe neonatal adaptation syndrome of any SSRI with third-trimester exposure'"`UNIQ--ref-0000002D-QINU`"' (1) ·
Limited human data; some observational signals reassuring relative to other antidepressants.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup> (1) ·
Observational signal for persistent pulmonary hypertension of the newborn (small absolute risk) and neonatal adaptation syndrome with third-trimester exposure.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup> (1) ·
Older agent with substantial use experience; observational signals not clearly causal.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup> (1) ·
TCA class signal; limited human data specific to doxepin.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup> (1) ·
TCA class signal; limited human data specific to nortriptyline.<sup class="pcp-cn" title="This claim needs a citation.">[[[Pharmacopedia:Citation needed|citation needed]]]</sup> (1)
legal:
[[USLegal:Prescription only|Rx-only]] in US. Carries the antidepressant '''Boxed Warning''' for suicidality in children, adolescents, and young adults'"`UNIQ--ref-00000022-QINU`"' (2) ·
[[USLegal:Prescription only|Rx-only]] in US. Carries the antidepressant '''Boxed Warning''' for suicidality in children, adolescents, and young adults'"`UNIQ--ref-00000025-QINU`"' (1) ·
[[USLegal:Prescription only|Rx-only]] in US. Carries the antidepressant '''Boxed Warning''' for suicidality in children, adolescents, and young adults'"`UNIQ--ref-00000028-QINU`"' (3) ·
[[USLegal:Prescription only|Rx-only]] in US. Carries the antidepressant '''Boxed Warning''' for suicidality in children, adolescents, and young adults'"`UNIQ--ref-0000002E-QINU`"' (1)
Showing below up to 7 results in range #1 to #7.