Description
NR546 Week 5 Antidepressant and Mood Stabilizer Medication Table
Assignment
Purpose
A strong foundational understanding of the unique properties of medications, including half-life, mechanism of action, and how medications impact neurotransmitters are required to appropriately prescribe psychotherapeutic medications. The purpose of this activity is to complete an information table for psychotherapeutic medications commonly prescribed to clients. Students will download and complete the attached table. The completed medication table will be a valuable study guide and future resource for practicum and certification review.
Course Outcomes
This assignment enables the student to meet the following course outcomes:
- CO 1: Examine the neurophysiological and neuroanatomical basis of psychopharmacologic interventions commonly applied in mental health practice. (PO 1)
- CO 2: Associate brain structure and function to the pathophysiology of acute and chronic mental health diagnoses commonly seen in mental health practice. (PO 1)
- CO 3: Apply knowledge of pharmacokinetics and pharmacodynamics in prescribing psychopharmacotherapy. (PO 1)
- CO 5: Identify the most commonly prescribed agents in the major psychopharmacologic drug classes. (POs 1, 2)
- CO 6: Analyze client indicators of therapeutic, ineffective, adverse responses and side effects to psychopharmacotherapy. (PO 1)
Solution: NR546 Week 5 Antidepressant and Mood Stabilizer Medication Table
| Name | Indication, starting dose, target symptoms, and affected neurotransmitters | Half-life (T1/2)
CYP450 enzyme |
Notes/Notable side effects/Precautions |
| SSRIs | |||
| Citalopram
(Celexa)
|
Indication: Major depressive disorder (MDD).
Starting Dose: 20 mg/day; Max: 40 mg/day (20 mg/day in elderly >60 years due to QT prolongation risk)
Target Symptoms: Depressed mood, anhedonia, sleep disturbances, appetite changes, guilt, concentration difficulties, suicidal ideation
Affected Neurotransmitters: Serotonin (5-HT) – Selectively inhibits serotonin reuptake transporter (SERT), increasing synaptic serotonin availability (Shoar et al., 2023). |
Half-life: 35 hours (allows once-daily dosing)
CYP450 Metabolism: CYP2C19 (major), CYP2D6, CYP3A4 (minor involvement) (Shoar et al., 2023). |
QT prolongation – DOSE-DEPENDENT (highest risk among SSRIs; FDA max dose 40 mg, 20 mg in elderly)
Nausea, diarrhea (5-HT3 activation in GI tract) Sexual dysfunction – decreased libido, anorgasmia, delayed ejaculation (increased 5-HT at 5-HT2 receptors) Insomnia or somnolence (serotonergic effects on sleep-wake cycle) Least drug interactions among SSRIs – weak CYP inhibition Hyponatremia/SIADH (serotonergic effect on ADH) Discontinuation syndrome if stopped abruptly (serotonin withdrawal) Escitalopram is the active S-enantiomer – often preferred. |
| Escitalopram (Lexapro)
|
Indication: Major depressive disorder, generalized anxiety disorder
Starting Dose: 10 mg/day; Target: 10-20 mg/day
Target Symptoms: Depressed mood, anxiety, anhedonia, sleep/appetite disturbances, concentration problems, worry
Affected Neurotransmitters: Serotonin – Highly selective SERT inhibitor (Wang et al., 2021). |
Half-life: 27-32 hours.
CYP450 Metabolism: CYP2C19 (major), CYP3A4 (minor); LEAST drug interaction potential of all SSRIs (Wang et al., 2021). |
Nausea (5-HT3 activation)
Sexual dysfunction (5-HT2 receptor activation) Insomnia or fatigue (serotonergic modulation) QT prolongation (less than citalopram but still monitor at high doses) Hyponatremia/SIADH (SERT effects on ADH) Most selective SSRI – fewest off-target effects Best tolerability profile among SSRIs Discontinuation syndrome possible First-line for anxiety and depression (Wang et al., 2021). |
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Related: (Completed) NR546 Week 3 Antipsychotic Medications Table
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