anti-anxiety

antidepressant

mental retardation

Insomnia

Dizziness and headache

extrapyramidal reaction

Promote itching

gastrointestinal system

circulatory system

reproductive system

skeletal system

Buspirone→post-synaptic membrane 5-HT 1A receptor→promotes DA release in the ventromedial part of the prefrontal cortex

Improve sexual function

Increase alertness

QT interval prolongation

Anti-negative symptoms and cognitive impairment

Anti-mood disorder

Anti-extrapyramidal reaction

Both blocking 5-HT 2A receptors and stimulating 5-HT 1A receptors can increase DA energy, and their three-antibody effects are similar.

antidepressant

Anti-cognitive impairment

Decreased intestinal motility

reduced sexual inhibition

Blocks 5-HT recycling (dulled emotion) > Blocks NE recycling, SSRIs > SNRIs

SSRIs block 5-HT recycling from strong to weak: paroxetine > escitalopram > sertraline > fluoxetine > citalopram > fluvoxamine

Block NE recycling (increase power) > Block 5-HT recycling

SNRIs block NE recycling from strong to weak: reboxetine > milnacipran > duloxetine > venlafaxine > fluoxetine > sertraline > fluvoxamine > citalopram

Duloxetine increases NE energy → stimulates α1 receptors → hypervigilance →

Venlafaxine increases NE energy → (excessive) stimulation of brain beta receptors → (induced mania) antidepressant

The locus coeruleus-ventral tegmental part of the midbrain excites the NE energy pathway → stimulates α1 receptors → activates D2 receptors in the limbic system → induces psychosis

Use venlafaxine with caution/not in patients with schizophrenia

Milnacipran increases NE energy → stimulates α1 receptors on cerebral blood vessels → constricts cerebral blood vessels → cerebral ischemia and hypoxia → dizziness, headache, and drowsiness

Methylphenidate increases NE energy → stimulates vascular α1 receptors → constricts vestibular blood vessels → dizziness; drivers or those operating dangerous machines should use it with caution

Constrict cochlear blood vessels → tinnitus, hearing loss

Milnacipran increases NE energy → stimulates striatal beta receptors → inhibits striatal DA energy → tremors, akathisia, bruxism, etc.

Propranolol blocks beta receptors and treats tremor, akathisia, bruxism, etc.

Bupropion increases NE energy → stimulates α1 receptors in temporal lobe cortex → hypervigilance → induces epilepsy

increase heart rate

Reduce heart rhythm variability

Myocardial ischemia

Venlafaxine increases NE energy→stimulates α1 receptors→constricts blood vessels→increases blood pressure

Use with caution: patients with coronary heart disease or cerebral hemorrhage. Contraindications: Patients with uncontrolled hypertension

Venlafaxine increases NE energy → stimulates α2 receptors in the medullary cardiovascular center → reduces NE release → orthostatic hypotension → syncope

Antipsychotics block α1 receptors → relax peripheral venous vascular smooth muscle → cause orthostatic hypotension

Duloxetine increases NE energy → enhances mesolimbic DA pathway activity → promotes DA release in the phrenic nucleus accumbens → stimulates D1 receptors → enhances sexual desire (increases the frequency of masturbation)

Impotence

vaginal dryness

Milnacipran increases NE energy→stimulates α1 receptors→increases the smooth muscle peristalsis ability of the vas deferens, seminal vesicles, and seminal ducts→increases the contraction of prostate smooth muscle→promotes sperm leakage into the urethral bulb→causing premature ejaculation and semen discharge during urination.

Chlorpromazine blocks α1 receptors → inhibits peristalsis and contraction → inhibits the leakage of semen into the bulb of the urethra → delays ejaculation

Milnacipran increases NE energy → stimulates testicular α1 receptors → contracts testicular blood vessels → testicular ischemia and pain

Atomoxetine increases NE energy→stimulates α1 receptors→constricts blood vessels→insufficient blood supply to the uterus and fetus→abortion and reduced Apgar scores in neonatal health assessment

Atomoxetine increases NE energy → inhibits salivary gland secretion/inhibits gastrointestinal motility → dry mouth/anorexia and weight loss

Milnacipran increases NE energy → stimulates Oddis sphincter α1 receptors → contracts Oddis sphincter → poor bile flow → indigestion/obstructive jaundice, right upper quadrant tenderness/liver damage/dark urine

Methylphenidate increases NE energy → contracts the sphincter of Oddis → bile flows into the pancreas → pancreatic enzyme is activated into pancreatic enzyme → pancreatitis → fever, shock/blood amylase higher than 500U/pancreatic juice stimulates the peritoneum

Milnacipran increases NE energy → stimulates α1 receptors → inhibits intestinal motility → constipation

Venlafaxine increases NE energy → stimulates adipocyte β3 receptors → promotes lipolysis → sweating and hot flashes

Duloxetine increases NE energy → stimulates α1 receptors in the internal bladder sphincter → contracts the bladder sphincter →

Clozapine inhibits α1 receptors → relaxes the internal bladder sphincter → nocturnal enuresis and daytime urinary incontinence

Duloxetine increases NE energy → stimulates the locus coeruleus-supraoptic nucleus NE pathway → promotes ADH release → increases the permeability of the distal convoluted tubule and collecting duct to water → increases water reabsorption but no change in sodium reabsorption → hyponatremia Symptoms, hypernatremia→Cell edema→

Milnacipran increases NE energy → stimulates the α1 receptor of the pupillary muscle → contracts the pupillary muscle → dilates the pupil and narrows the anterior chamber angle → increases intraocular pressure

Use with caution: People with glaucoma or increased intraocular pressure. Contraindications: Untreated angle-closure glaucoma.

Milnacipran increases NE energy→stimulates α1 receptors→contracts arrector pili muscles→piloerection

Bupropion increases NE energy → inhibits incoming pain signals from the dorsal horn of the spinal cord → numbness

hair loss

itching

Raynaud's phenomenon

Vitiligo

Bupropion increases NE energy → activates lymphocytes → produces stress immunosuppressive proteins → increases infection and influenza rates

Antidepressants that block α2 receptors: mirtazapine, trazodone

Atypical antipsychotics block α2A receptors from strong to weak: risperidone (moderate) = aripiprazole = lurasidone > clozapine (weak) > olanzapine > quetiapine