const pptxgen = require("pptxgenjs");

const pres = new pptxgen();
pres.layout = "LAYOUT_WIDE"; // 13.3" x 7.5"
pres.title = "Antidepressant and Antianxiety Drugs";
pres.author = "MBBS Pharmacology";

// ── MASTER COLOUR PALETTE ──
const C = {
  navyDark:  "0A2240",
  navyMid:   "0D3B6E",
  teal:      "0B7A8C",
  tealLight: "13A5BB",
  white:     "FFFFFF",
  offWhite:  "F0F6FC",
  gold:      "F5A623",
  red:       "C0392B",
  green:     "1A7A4A",
  purp:      "6C3483",
  sky:       "D0EEF8",
  mint:      "D4EFDF",
  peach:     "FDEBD0",
  lightGray: "E8EFF5",
  darkText:  "1A2030",
  amber:     "E67E22",
  pink:      "CB4335",
};

// ── HELPERS ──
function slideHeader(slide, title, subtitle) {
  // Dark top bar
  slide.addShape(pres.ShapeType.rect, {
    x: 0, y: 0, w: 13.3, h: 0.9,
    fill: { color: C.navyDark }
  });
  slide.addText(title, {
    x: 0.35, y: 0, w: 11.5, h: 0.9, margin: 0,
    fontSize: 22, bold: true, color: C.white, valign: "middle"
  });
  if (subtitle) {
    slide.addText(subtitle, {
      x: 0.35, y: 0.62, w: 11.5, h: 0.32, margin: 0,
      fontSize: 11, color: C.tealLight, italic: true
    });
  }
  // Accent bar
  slide.addShape(pres.ShapeType.rect, {
    x: 0, y: 0.9, w: 13.3, h: 0.06,
    fill: { color: C.teal }
  });
  // Footer
  slide.addShape(pres.ShapeType.rect, {
    x: 0, y: 7.3, w: 13.3, h: 0.2,
    fill: { color: C.navyMid }
  });
  slide.addText("KD Tripathi – Essentials of Medical Pharmacology | Chapter 33 | MBBS Pharmacology", {
    x: 0, y: 7.3, w: 13.3, h: 0.2, margin: 2,
    fontSize: 7, color: C.tealLight, align: "center"
  });
}

function highlightBox(slide, x, y, w, h, text, bgColor, textColor, fontSize) {
  slide.addShape(pres.ShapeType.roundRect, {
    x, y, w, h,
    fill: { color: bgColor },
    line: { color: bgColor, width: 0 },
    rectRadius: 0.08
  });
  slide.addText(text, {
    x, y, w, h, margin: 6,
    fontSize: fontSize || 11, color: textColor || C.white,
    bold: true, valign: "middle", align: "center", wrap: true
  });
}

function sectionBox(slide, x, y, w, h, heading, bullets, headColor, bgColor, bulletColor) {
  slide.addShape(pres.ShapeType.rect, {
    x, y, w, h,
    fill: { color: bgColor || C.offWhite },
    line: { color: headColor || C.teal, width: 1.5 }
  });
  // Heading strip
  slide.addShape(pres.ShapeType.rect, {
    x, y, w, h: 0.34,
    fill: { color: headColor || C.teal }
  });
  slide.addText(heading, {
    x, y, w, h: 0.34, margin: 6,
    fontSize: 12, bold: true, color: C.white, valign: "middle"
  });
  // Bullets
  const items = bullets.map((b, i) => ({
    text: b,
    options: { bullet: true, breakLine: i < bullets.length - 1, fontSize: 10.5, color: bulletColor || C.darkText }
  }));
  slide.addText(items, { x: x + 0.05, y: y + 0.37, w: w - 0.1, h: h - 0.42, margin: 4, valign: "top" });
}

function pearl(slide, x, y, w, h, emoji, text) {
  slide.addShape(pres.ShapeType.roundRect, {
    x, y, w, h,
    fill: { color: "FFF9E6" },
    line: { color: C.gold, width: 1.5 },
    rectRadius: 0.1
  });
  slide.addText(emoji + "  " + text, {
    x: x + 0.08, y, w: w - 0.16, h, margin: 5,
    fontSize: 10.5, color: C.navyDark, bold: false, valign: "middle", wrap: true
  });
}

// ══════════════════════════════════════════════════
// SLIDE 1 – TITLE SLIDE
// ══════════════════════════════════════════════════
{
  const sl = pres.addSlide();
  sl.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 13.3, h: 7.5, fill: { color: C.navyDark } });
  // Decorative arcs
  sl.addShape(pres.ShapeType.ellipse, { x: -1.5, y: -1.5, w: 6, h: 6, fill: { color: C.navyMid }, line: { color: C.navyMid } });
  sl.addShape(pres.ShapeType.ellipse, { x: 9.5, y: 3.5, w: 5, h: 5, fill: { color: C.teal }, line: { color: C.teal } });
  // Teal accent bar
  sl.addShape(pres.ShapeType.rect, { x: 1.5, y: 2.1, w: 0.12, h: 3.5, fill: { color: C.tealLight } });
  // Main title
  sl.addText("ANTIDEPRESSANT &", {
    x: 1.9, y: 1.6, w: 10, h: 0.9, fontSize: 40, bold: true, color: C.white, fontFace: "Calibri"
  });
  sl.addText("ANTIANXIETY DRUGS", {
    x: 1.9, y: 2.4, w: 10, h: 0.9, fontSize: 40, bold: true, color: C.tealLight, fontFace: "Calibri"
  });
  sl.addText("Chapter 33 | Drugs Used in Mental Illness", {
    x: 1.9, y: 3.35, w: 9, h: 0.5, fontSize: 16, color: C.gold, italic: true
  });
  sl.addShape(pres.ShapeType.rect, { x: 1.9, y: 4.0, w: 8.5, h: 0.04, fill: { color: C.tealLight } });
  sl.addText("MBBS Pharmacology  |  Section 7: CNS Drugs", {
    x: 1.9, y: 4.1, w: 8.5, h: 0.4, fontSize: 13, color: C.offWhite
  });
  sl.addText("Reference: KD Tripathi – Essentials of Medical Pharmacology (8th Ed.)", {
    x: 1.9, y: 4.6, w: 8.5, h: 0.35, fontSize: 11, color: C.tealLight, italic: true
  });
  // Tag boxes at bottom
  const tags = ["Depression", "Anxiety", "SSRIs", "TCAs", "SNRIs", "MAOIs", "Atypical"];
  tags.forEach((t, i) => {
    sl.addShape(pres.ShapeType.roundRect, {
      x: 1.9 + i * 1.6, y: 5.6, w: 1.5, h: 0.38,
      fill: { color: C.teal }, rectRadius: 0.07
    });
    sl.addText(t, { x: 1.9 + i * 1.6, y: 5.6, w: 1.5, h: 0.38, fontSize: 9.5, color: C.white, align: "center", valign: "middle" });
  });
}

// ══════════════════════════════════════════════════
// SLIDE 2 – LEARNING OBJECTIVES
// ══════════════════════════════════════════════════
{
  const sl = pres.addSlide();
  sl.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 13.3, h: 7.5, fill: { color: C.offWhite } });
  slideHeader(sl, "Learning Objectives", "By the end of this session, you will be able to:");

  const objs = [
    ["01", "Define depression & anxiety; describe the monoaminergic hypothesis of depression"],
    ["02", "Classify antidepressants and antianxiety drugs with examples (KD Tripathi)"],
    ["03", "Explain mechanism of action of TCAs, SSRIs, SNRIs, MAOIs and atypical agents"],
    ["04", "Describe pharmacokinetics (ADME) of major antidepressant classes"],
    ["05", "List therapeutic uses, adverse effects & contraindications"],
    ["06", "Identify important drug interactions and manage adverse effects"],
    ["07", "Apply clinical pearls for MBBS viva, university & NEET PG examinations"],
  ];

  objs.forEach(([num, text], i) => {
    const col = i % 2 === 0 ? C.teal : C.navyMid;
    const x = i < 4 ? 0.4 : 6.8;
    const baseY = i < 4 ? 1.1 + i * 1.3 : 1.1 + (i - 4) * 1.3;
    // For 7 items we do 4 on left, 3 on right
    const yL = [1.1, 2.4, 3.7, 5.0];
    const yR = [1.1, 2.4, 3.7];
    const yPos = i < 4 ? yL[i] : yR[i - 4];
    const xPos = i < 4 ? 0.4 : 6.8;
    sl.addShape(pres.ShapeType.rect, { x: xPos, y: yPos, w: 0.52, h: 0.52, fill: { color: col } });
    sl.addText(num, { x: xPos, y: yPos, w: 0.52, h: 0.52, fontSize: 16, bold: true, color: C.white, align: "center", valign: "middle" });
    sl.addShape(pres.ShapeType.rect, {
      x: xPos + 0.55, y: yPos, w: 5.7, h: 0.52,
      fill: { color: C.white }, line: { color: col, width: 1 }
    });
    sl.addText(text, {
      x: xPos + 0.6, y: yPos, w: 5.6, h: 0.52, margin: 4,
      fontSize: 10.5, color: C.darkText, valign: "middle"
    });
  });
}

// ══════════════════════════════════════════════════
// SLIDE 3 – INTRODUCTION
// ══════════════════════════════════════════════════
{
  const sl = pres.addSlide();
  sl.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 13.3, h: 7.5, fill: { color: C.offWhite } });
  slideHeader(sl, "Introduction – Affective Disorders & Depression");

  // Left column – intro text
  sectionBox(sl, 0.3, 1.1, 5.8, 2.7, "What is Major Depression?", [
    "Pathological change in mood state (affective disorder)",
    "Sad mood, loss of interest/pleasure, low energy",
    "Worthlessness, guilt, psychomotor retardation or agitation",
    "Change in appetite, sleep, suicidal thoughts",
    "May be UNIPOLAR or BIPOLAR cyclic disorder",
  ], C.navyMid, C.white + "10");

  sectionBox(sl, 6.4, 1.1, 6.6, 2.7, "What is Pathological Anxiety?", [
    "Excessive, persistent, uncontrollable worry or fear",
    "GAD, Panic Disorder, Social Phobia, OCD, PTSD",
    "Anxiety and depression are the leading psychiatric disorders",
    "May co-exist: anxiety can lead to depression and vice versa",
  ], C.teal, C.sky + "40");

  // Monoaminergic hypothesis box
  sl.addShape(pres.ShapeType.rect, { x: 0.3, y: 3.95, w: 12.7, h: 0.36, fill: { color: C.navyMid } });
  sl.addText("⭐ MONOAMINERGIC HYPOTHESIS OF DEPRESSION (High-Yield)", {
    x: 0.3, y: 3.95, w: 12.7, h: 0.36, margin: 5,
    fontSize: 12, bold: true, color: C.gold, align: "center", valign: "middle"
  });
  sl.addShape(pres.ShapeType.rect, { x: 0.3, y: 4.31, w: 12.7, h: 1.55, fill: { color: C.white }, line: { color: C.navyMid, width: 1 } });

  const hyp = [
    { text: "Monoaminergic: ", options: { bold: true, color: C.teal, fontSize: 11, breakLine: false } },
    { text: "Depression caused by ↓ noradrenergic (NA) and/or serotonergic (5-HT) transmission in cortical & limbic areas. Supported by reserpine-induced depression.   ", options: { color: C.darkText, fontSize: 11, breakLine: true } },
    { text: "Neurotrophic: ", options: { bold: true, color: C.purp, fontSize: 11, breakLine: false } },
    { text: "Depression associated with ↓ BDNF. Antidepressants promote NGF elaboration → axonal/dendritic growth → improved synaptic plasticity.   ", options: { color: C.darkText, fontSize: 11, breakLine: true } },
    { text: "Key insight: ", options: { bold: true, color: C.amber, fontSize: 11, breakLine: false } },
    { text: "Uptake blockade is rapid BUT antidepressant effect takes 2–3 weeks → desensitisation of presynaptic α₂ & 5-HT₁A autoreceptors is the actual trigger.", options: { color: C.darkText, fontSize: 11 } },
  ];
  sl.addText(hyp, { x: 0.5, y: 4.38, w: 12.3, h: 1.44, margin: 5, valign: "top" });

  // Exam pearl
  pearl(sl, 0.3, 5.95, 12.7, 0.65,
    "⭐",
    "VIVA PEARL: Why does antidepressant effect lag behind uptake blockade? → Because time is needed for desensitisation of presynaptic autoreceptors (α₂ and 5-HT₁A), allowing increased NA/5-HT firing. This takes 2–3 weeks.");
}

// ══════════════════════════════════════════════════
// SLIDE 4 – DEFINITION
// ══════════════════════════════════════════════════
{
  const sl = pres.addSlide();
  sl.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 13.3, h: 7.5, fill: { color: C.offWhite } });
  slideHeader(sl, "Definition & Overview");

  // Definition cards
  const defs = [
    { title: "Antidepressants", color: C.navyMid, text: "Drugs that can elevate mood in depressive illness. Practically all affect monoaminergic transmission in the brain – either by inhibiting reuptake of NA and/or 5-HT, or inhibiting their enzymatic degradation (MAO)." },
    { title: "Antianxiety Drugs (Anxiolytics)", color: C.teal, text: "Drugs that relieve anxiety without causing significant sedation or sleep. Include benzodiazepines (BZDs), buspirone, SSRIs, SNRIs and beta-blockers for situational anxiety." },
    { title: "Affective Disorder", color: C.purp, text: "Pathological change in mood state. Includes: (a) Unipolar depression (recurrent low mood), (b) Bipolar disorder (cycles of mania and depression), (c) Dysthymia (chronic mild depression)." },
  ];

  defs.forEach((d, i) => {
    const x = 0.4 + i * 4.25;
    sl.addShape(pres.ShapeType.rect, { x, y: 1.15, w: 4.0, h: 0.5, fill: { color: d.color } });
    sl.addText(d.title, { x, y: 1.15, w: 4.0, h: 0.5, fontSize: 13, bold: true, color: C.white, align: "center", valign: "middle" });
    sl.addShape(pres.ShapeType.rect, { x, y: 1.65, w: 4.0, h: 2.1, fill: { color: C.white }, line: { color: d.color, width: 1.5 } });
    sl.addText(d.text, { x: x + 0.08, y: 1.7, w: 3.84, h: 2.0, fontSize: 10.5, color: C.darkText, valign: "top", wrap: true, margin: 4 });
  });

  // Key facts row
  sl.addShape(pres.ShapeType.rect, { x: 0.4, y: 3.95, w: 12.5, h: 0.36, fill: { color: C.teal } });
  sl.addText("KEY FACTS – EPIDEMIOLOGY & DRUG CLASS OVERVIEW", {
    x: 0.4, y: 3.95, w: 12.5, h: 0.36, fontSize: 12, bold: true, color: C.white, align: "center", valign: "middle", margin: 4
  });

  const facts = [
    ["~300 million", "People affected by depression worldwide"],
    ["2–3 weeks", "Lag period for antidepressant action"],
    ["1st line", "SSRIs are now 1st line antidepressants"],
    ["5 classes", "TCAs, SSRIs, SNRIs, MAOIs, Atypical"],
    ["1958", "Imipramine (1st TCA) discovered"],
    ["1987", "Fluoxetine (1st SSRI) introduced"],
  ];
  facts.forEach(([val, label], i) => {
    const x = 0.4 + i * 2.1;
    sl.addShape(pres.ShapeType.rect, { x, y: 4.31, w: 2.0, h: 0.6, fill: { color: C.navyDark } });
    sl.addText(val, { x, y: 4.31, w: 2.0, h: 0.6, fontSize: 14, bold: true, color: C.gold, align: "center", valign: "middle" });
    sl.addShape(pres.ShapeType.rect, { x, y: 4.91, w: 2.0, h: 0.5, fill: { color: C.lightGray } });
    sl.addText(label, { x, y: 4.91, w: 2.0, h: 0.5, fontSize: 9, color: C.darkText, align: "center", valign: "middle", wrap: true });
  });

  pearl(sl, 0.4, 5.55, 12.5, 0.65,
    "⭐",
    "MNEMONICS: Types of depression = 'UAB' – Unipolar, Atypical, Bipolar. Antidepressants do NOT cause euphoria in normal individuals – they only elevate depressed mood (not stimulants).");
}

// ══════════════════════════════════════════════════
// SLIDE 5 – CLASSIFICATION (Drug Tree)
// ══════════════════════════════════════════════════
{
  const sl = pres.addSlide();
  sl.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 13.3, h: 7.5, fill: { color: "EBF5FB" } });
  slideHeader(sl, "Classification of Antidepressants", "KD Tripathi Chapter 33 – Complete Drug Tree");

  // Root box
  highlightBox(sl, 5.3, 1.05, 2.7, 0.48, "ANTIDEPRESSANTS", C.navyDark, C.white, 12);

  // Draw lines and class boxes
  // Class 1 – RIMAs (far left)
  sl.addShape(pres.ShapeType.line, { x: 5.3, y: 1.29, w: -3.2, h: 0, line: { color: C.navyMid, width: 1.2 } });
  sl.addShape(pres.ShapeType.line, { x: 2.1, y: 1.29, w: 0, h: 0.5, line: { color: C.navyMid, width: 1.2 } });
  highlightBox(sl, 0.4, 1.79, 3.4, 0.48, "Reversible MAO-A Inhibitors (RIMAs)", C.navyMid, C.white, 10);
  sl.addShape(pres.ShapeType.rect, { x: 0.4, y: 2.27, w: 3.4, h: 0.9, fill: { color: C.white }, line: { color: C.navyMid, width: 1 } });
  sl.addText([
    { text: "Moclobemide", options: { bold: true, color: C.teal, breakLine: true, fontSize: 10 } },
    { text: "Clorgyline", options: { color: C.darkText, fontSize: 10 } }
  ], { x: 0.5, y: 2.3, w: 3.2, h: 0.8, margin: 3 });

  // Class 2 – TCAs
  sl.addShape(pres.ShapeType.line, { x: 5.3, y: 1.29, w: -1.2, h: 0, line: { color: C.teal, width: 1.2 } });
  sl.addShape(pres.ShapeType.line, { x: 4.1, y: 1.29, w: 0, h: 0.5, line: { color: C.teal, width: 1.2 } });
  highlightBox(sl, 2.8, 1.79, 2.6, 0.48, "Tricyclic Antidepressants (TCAs)", C.teal, C.white, 10);
  sl.addShape(pres.ShapeType.rect, { x: 2.8, y: 2.27, w: 2.6, h: 2.4, fill: { color: C.white }, line: { color: C.teal, width: 1 } });
  sl.addText([
    { text: "NA+5-HT reuptake inhibitors:", options: { bold: true, color: C.teal, breakLine: true, fontSize: 9.5 } },
    { text: "Imipramine, Amitriptyline,\nTrimipramine, Doxepin,\nDothiepin, Clomipramine", options: { color: C.darkText, fontSize: 9.5, breakLine: true } },
    { text: "\nPredominantly NA inhibitors:", options: { bold: true, color: C.navyMid, breakLine: true, fontSize: 9.5 } },
    { text: "Desipramine, Nortriptyline,\nReboxetine", options: { color: C.darkText, fontSize: 9.5 } },
  ], { x: 2.9, y: 2.3, w: 2.4, h: 2.3, margin: 3 });

  // Class 3 – SSRIs (centre-right)
  sl.addShape(pres.ShapeType.line, { x: 8.0, y: 1.29, w: 0.55, h: 0, line: { color: C.green, width: 1.2 } });
  sl.addShape(pres.ShapeType.line, { x: 8.55, y: 1.29, w: 0, h: 0.5, line: { color: C.green, width: 1.2 } });
  highlightBox(sl, 7.3, 1.79, 2.6, 0.48, "SSRIs (2nd Gen)", C.green, C.white, 10);
  sl.addShape(pres.ShapeType.rect, { x: 7.3, y: 2.27, w: 2.6, h: 2.2, fill: { color: C.white }, line: { color: C.green, width: 1 } });
  sl.addText([
    { text: "Fluoxetine\n", options: { bold: true, color: C.green, fontSize: 9.5, breakLine: false } },
    { text: "Fluvoxamine\n", options: { color: C.darkText, fontSize: 9.5, breakLine: false } },
    { text: "Paroxetine\n", options: { color: C.darkText, fontSize: 9.5, breakLine: false } },
    { text: "Sertraline\n", options: { color: C.darkText, fontSize: 9.5, breakLine: false } },
    { text: "Citalopram\n", options: { color: C.darkText, fontSize: 9.5, breakLine: false } },
    { text: "Escitalopram\n", options: { color: C.darkText, fontSize: 9.5, breakLine: false } },
    { text: "Dapoxetine", options: { color: C.darkText, fontSize: 9.5 } },
  ], { x: 7.4, y: 2.3, w: 2.4, h: 2.1, margin: 3 });

  // Class 4 – SNRIs
  sl.addShape(pres.ShapeType.line, { x: 8.0, y: 1.29, w: 2.2, h: 0, line: { color: C.amber, width: 1.2 } });
  sl.addShape(pres.ShapeType.line, { x: 10.2, y: 1.29, w: 0, h: 0.5, line: { color: C.amber, width: 1.2 } });
  highlightBox(sl, 9.6, 1.79, 2.6, 0.48, "SNRIs (2nd Gen)", C.amber, C.white, 10);
  sl.addShape(pres.ShapeType.rect, { x: 9.6, y: 2.27, w: 2.6, h: 1.1, fill: { color: C.white }, line: { color: C.amber, width: 1 } });
  sl.addText("Venlafaxine\nDesvenlafaxine\nDuloxetine", {
    x: 9.7, y: 2.3, w: 2.4, h: 1.0, margin: 3, fontSize: 9.5, color: C.darkText
  });

  // Class 5 – Atypical
  sl.addShape(pres.ShapeType.line, { x: 8.0, y: 1.29, w: 3.7, h: 0, line: { color: C.purp, width: 1.2 } });
  sl.addShape(pres.ShapeType.line, { x: 11.7, y: 1.29, w: 0, h: 0.5, line: { color: C.purp, width: 1.2 } });
  highlightBox(sl, 10.8, 1.79, 2.15, 0.48, "Atypical Agents", C.purp, C.white, 10);
  sl.addShape(pres.ShapeType.rect, { x: 10.8, y: 2.27, w: 2.15, h: 2.2, fill: { color: C.white }, line: { color: C.purp, width: 1 } });
  sl.addText("Trazodone\nMianserin\nMirtazapine\nBupropion\nAmoxapine\nTianeptine\nAmineptine", {
    x: 10.9, y: 2.3, w: 1.95, h: 2.1, margin: 3, fontSize: 9.5, color: C.darkText
  });

  // Mnemonic
  sl.addShape(pres.ShapeType.roundRect, {
    x: 0.4, y: 5.05, w: 12.5, h: 0.65,
    fill: { color: "FFFDE7" }, line: { color: C.gold, width: 1.5 }, rectRadius: 0.08
  });
  sl.addText([
    { text: "⭐ MNEMONIC – SSRIs: ", options: { bold: true, color: C.navyDark, fontSize: 11 } },
    { text: '"', options: { color: C.navyDark, fontSize: 11 } },
    { text: "F", options: { bold: true, color: C.red, fontSize: 11 } },
    { text: "luoxetine, ", options: { color: C.darkText, fontSize: 11 } },
    { text: "F", options: { bold: true, color: C.teal, fontSize: 11 } },
    { text: "luvoxamine, ", options: { color: C.darkText, fontSize: 11 } },
    { text: "P", options: { bold: true, color: C.navyMid, fontSize: 11 } },
    { text: "aroxetine, ", options: { color: C.darkText, fontSize: 11 } },
    { text: "S", options: { bold: true, color: C.green, fontSize: 11 } },
    { text: "ertraline, ", options: { color: C.darkText, fontSize: 11 } },
    { text: "C", options: { bold: true, color: C.amber, fontSize: 11 } },
    { text: "italopram, ", options: { color: C.darkText, fontSize: 11 } },
    { text: "E", options: { bold: true, color: C.purp, fontSize: 11 } },
    { text: "scitalopram, ", options: { color: C.darkText, fontSize: 11 } },
    { text: "D", options: { bold: true, color: C.pink, fontSize: 11 } },
    { text: 'apoxetine"  →  ', options: { color: C.darkText, fontSize: 11 } },
    { text: " 'Five Pretty Sexy CEDs' ", options: { bold: true, italic: true, color: C.teal, fontSize: 11 } },
  ], { x: 0.55, y: 5.05, w: 12.2, h: 0.65, margin: 5, valign: "middle" });

  // Bottom note on antianxiety
  sl.addShape(pres.ShapeType.rect, { x: 0.4, y: 5.8, w: 12.5, h: 0.06, fill: { color: C.teal } });
  sl.addShape(pres.ShapeType.rect, { x: 0.4, y: 5.86, w: 12.5, h: 0.8, fill: { color: C.sky } });
  sl.addText([
    { text: "ANTIANXIETY DRUGS: ", options: { bold: true, color: C.navyDark, fontSize: 11 } },
    { text: "BZDs (Alprazolam, Diazepam, Lorazepam) | Buspirone (5-HT₁A partial agonist) | SSRIs/SNRIs (1st line for GAD/panic) | Beta-blockers (situational anxiety) | Hydroxyzine | Pregabalin", options: { color: C.darkText, fontSize: 11 } },
  ], { x: 0.55, y: 5.9, w: 12.2, h: 0.7, margin: 4, valign: "middle" });
}

// ══════════════════════════════════════════════════
// SLIDE 6 – MECHANISM OF ACTION
// ══════════════════════════════════════════════════
{
  const sl = pres.addSlide();
  sl.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 13.3, h: 7.5, fill: { color: C.offWhite } });
  slideHeader(sl, "Mechanism of Action", "Serotonergic Synapse & Sites of Action");

  // Left: Mechanism diagram (text-art style boxes)
  sl.addShape(pres.ShapeType.rect, { x: 0.3, y: 1.1, w: 5.5, h: 5.8, fill: { color: C.white }, line: { color: C.teal, width: 1.5 } });
  sl.addShape(pres.ShapeType.rect, { x: 0.3, y: 1.1, w: 5.5, h: 0.38, fill: { color: C.teal } });
  sl.addText("SEROTONERGIC SYNAPSE – SITES OF DRUG ACTION", {
    x: 0.3, y: 1.1, w: 5.5, h: 0.38, fontSize: 10, bold: true, color: C.white, align: "center", valign: "middle", margin: 3
  });

  // Pre-synaptic neuron
  sl.addShape(pres.ShapeType.ellipse, { x: 1.2, y: 1.65, w: 3.7, h: 2.1, fill: { color: "FEF9E7" }, line: { color: C.amber, width: 1.5 } });
  sl.addText("PRE-SYNAPTIC NEURON\n(Serotonergic)", { x: 1.2, y: 1.65, w: 3.7, h: 0.5, fontSize: 9, bold: true, color: C.amber, align: "center", valign: "top" });
  // Tryptophan → 5-HTP → 5-HT
  sl.addText("TP → 5-HTP → 5-HT\n(Hydroxylase → Decarboxylase)", {
    x: 1.3, y: 2.1, w: 3.5, h: 0.6, fontSize: 8.5, color: C.navyDark, align: "center", italic: true
  });
  // VMAT-2 vesicles
  sl.addShape(pres.ShapeType.ellipse, { x: 1.8, y: 2.65, w: 0.35, h: 0.35, fill: { color: C.teal } });
  sl.addShape(pres.ShapeType.ellipse, { x: 2.2, y: 2.65, w: 0.35, h: 0.35, fill: { color: C.teal } });
  sl.addShape(pres.ShapeType.ellipse, { x: 2.6, y: 2.65, w: 0.35, h: 0.35, fill: { color: C.teal } });
  sl.addText("5-HT vesicles (VMAT-2)", { x: 1.6, y: 3.02, w: 2.9, h: 0.3, fontSize: 8, color: C.teal, align: "center" });
  // MAO label inside
  highlightBox(sl, 1.7, 3.35, 0.85, 0.28, "MAO", C.red, C.white, 8);
  sl.addText("Degradation\nsite", { x: 1.58, y: 3.63, w: 1.1, h: 0.35, fontSize: 7.5, color: C.red, align: "center" });

  // MAOI label
  highlightBox(sl, 3.0, 3.35, 0.85, 0.28, "MAOI ⊖", C.navyMid, C.white, 8);

  // Synaptic cleft
  sl.addShape(pres.ShapeType.rect, { x: 1.0, y: 3.75, w: 4.2, h: 0.3, fill: { color: "D5F5E3" }, line: { color: C.green, width: 1 } });
  sl.addText("SYNAPTIC CLEFT – 5-HT", { x: 1.0, y: 3.75, w: 4.2, h: 0.3, fontSize: 8.5, color: C.green, align: "center", valign: "middle", bold: true });
  // SERT transporter
  sl.addShape(pres.ShapeType.rect, { x: 1.5, y: 3.55, w: 0.6, h: 0.55, fill: { color: C.navyDark }, line: { color: C.white, width: 1 } });
  sl.addText("SERT", { x: 1.5, y: 3.55, w: 0.6, h: 0.55, fontSize: 7.5, color: C.white, align: "center", valign: "middle", bold: true });
  // SSRI/TCA/SNRI label on SERT
  sl.addShape(pres.ShapeType.roundRect, { x: 0.35, y: 3.48, w: 1.1, h: 0.38, fill: { color: C.sky }, line: { color: C.teal, width: 1 }, rectRadius: 0.05 });
  sl.addText("SSRI/TCA/SNRI ⊖ SERT", { x: 0.35, y: 3.48, w: 1.1, h: 0.38, fontSize: 7, color: C.navyDark, bold: true, align: "center", valign: "middle" });

  // Post-synaptic neuron
  sl.addShape(pres.ShapeType.roundRect, { x: 1.0, y: 4.05, w: 4.2, h: 0.7, fill: { color: C.lightGray }, rectRadius: 0.1 });
  sl.addText("POST-SYNAPTIC NEURON  |  5-HT₁R, 5-HT₂R", {
    x: 1.0, y: 4.05, w: 4.2, h: 0.7, fontSize: 9, bold: true, color: C.navyDark, align: "center", valign: "middle"
  });

  // Pre-synaptic autoreceptor
  sl.addShape(pres.ShapeType.ellipse, { x: 3.7, y: 3.5, w: 0.5, h: 0.4, fill: { color: C.amber }, line: { color: C.amber } });
  sl.addText("α₂/5-HT₁A\nauto-R", { x: 3.5, y: 3.3, w: 1.0, h: 0.55, fontSize: 7, color: C.amber, align: "center" });

  // Right: 4 class mechanism boxes
  const mechs = [
    { class: "TCAs", color: C.teal, moa: "Block NET (norepinephrine transporter) + SERT → ↑ NA & 5-HT in synapse. Also block muscarinic, α₁, H₁ receptors (side effects)." },
    { class: "SSRIs", color: C.green, moa: "Selectively block SERT → ↑ 5-HT in synapse. No action on cholinergic, adrenergic, histaminergic receptors (fewer side effects)." },
    { class: "SNRIs", color: C.amber, moa: "Block both SERT and NET → ↑ 5-HT + NA. No direct action on adrenergic/cholinergic receptors unlike TCAs." },
    { class: "MAOIs / RIMAs", color: C.navyMid, moa: "Inhibit MAO enzyme (degrades NA, 5-HT, DA) → ↑ monoamine levels. RIMAs (Moclobemide) reversibly inhibit MAO-A only." },
    { class: "Mirtazapine (NaSSA)", color: C.purp, moa: "Blocks α₂ auto- and heteroreceptors → ↑ NA and 5-HT release. Also blocks 5-HT₂ and 5-HT₃ receptors (less nausea, no sexual dysfunction)." },
    { class: "Bupropion", color: C.red, moa: "Inhibits DA + NA reuptake (DAT + NET). Has excitant rather than sedative property. Used in smoking cessation." },
  ];

  mechs.forEach((m, i) => {
    const col = i % 2 === 0 ? 6.2 : 9.7;
    const row = Math.floor(i / 2);
    const y = 1.1 + row * 1.85;
    sl.addShape(pres.ShapeType.rect, { x: col, y, w: 3.2, h: 0.38, fill: { color: m.color } });
    sl.addText(m.class, { x: col, y, w: 3.2, h: 0.38, fontSize: 11, bold: true, color: C.white, align: "center", valign: "middle", margin: 3 });
    sl.addShape(pres.ShapeType.rect, { x: col, y: y + 0.38, w: 3.2, h: 1.38, fill: { color: C.white }, line: { color: m.color, width: 1 } });
    sl.addText(m.moa, { x: col + 0.06, y: y + 0.43, w: 3.08, h: 1.28, fontSize: 9.5, color: C.darkText, valign: "top", wrap: true, margin: 4 });
  });

  pearl(sl, 0.3, 6.95, 12.7, 0.3,
    "⭐",
    "EXAM PEARL: SSRIs/TCAs/SNRIs block SERT → rapid NA/5-HT ↑ in cleft. But antidepressant effect delayed 2–3 wks due to time needed for autoreceptor desensitisation (α₂, 5-HT₁A). [KD Tripathi, p.484]");
}

// ══════════════════════════════════════════════════
// SLIDE 7 – PHARMACOLOGICAL ACTIONS
// ══════════════════════════════════════════════════
{
  const sl = pres.addSlide();
  sl.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 13.3, h: 7.5, fill: { color: C.offWhite } });
  slideHeader(sl, "Pharmacological Actions of TCAs", "Imipramine as Prototype");

  const systems = [
    { sys: "1. CNS", col: C.navyMid, bullets: [
      "Normal individuals: tiredness, light-headedness, unsteady gait, anxiety – NOT euphoria",
      "Depressed patients: little acute effect; after 2–3 weeks → gradual mood elevation",
      "Suppresses REM sleep → fewer awakenings",
      "Lowers seizure threshold (except Desipramine); Clomipramine/Bupropion = highest risk"
    ]},
    { sys: "2. ANS", col: C.teal, bullets: [
      "Potent anticholinergic: dry mouth, blurred vision, constipation, urinary retention",
      "Potentiate exogenous & endogenous NA (block NA reuptake)",
      "Weak α₁ adrenergic blocking action",
      "Amitriptyline, Doxepin, Trimipramine: also have antihistamine (H₁) action"
    ]},
    { sys: "3. CVS", col: C.red, bullets: [
      "Tachycardia: anticholinergic + NA potentiation",
      "Postural hypotension: α₁ blockade + impaired CV reflexes",
      "ECG changes: T-wave inversion/suppression",
      "Arrhythmias in overdose (QRS widening) → ventricular arrhythmias → DANGER"
    ]},
    { sys: "Tolerance & Dependence", col: C.amber, bullets: [
      "Anticholinergic & hypotensive effects: tolerance develops gradually",
      "Antidepressant action: SUSTAINED (no tolerance)",
      "Physical dependence rare; addiction does not occur",
      "Gradual withdrawal recommended to avoid discontinuation syndrome"
    ]},
  ];

  systems.forEach((s, i) => {
    const x = i < 2 ? 0.3 : 6.8;
    const y = i % 2 === 0 ? 1.1 : 3.9;
    const w = 6.1;
    sectionBox(sl, x, y, w, 2.65, s.sys, s.bullets, s.col, C.white + "05");
  });

  pearl(sl, 0.3, 6.95, 12.7, 0.3,
    "⭐",
    "VIVA: TCAs are NOT euphorics – they only elevate depressed mood. Amitriptyline = most sedating TCA. Imipramine = most cardiotoxic. Clomipramine = 1st choice for OCD among TCAs.");
}

// ══════════════════════════════════════════════════
// SLIDE 8 – PHARMACOKINETICS
// ══════════════════════════════════════════════════
{
  const sl = pres.addSlide();
  sl.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 13.3, h: 7.5, fill: { color: C.offWhite } });
  slideHeader(sl, "Pharmacokinetics of Antidepressants", "ADME – Absorption, Distribution, Metabolism, Excretion");

  // ADME boxes
  const adme = [
    { letter: "A", title: "Absorption", color: C.teal, text: "Oral absorption of TCAs is good but often slow. SSRIs: well absorbed orally. MAOIs: well absorbed. First-pass effect significant for TCAs." },
    { letter: "D", title: "Distribution", color: C.navyMid, text: "TCAs: highly protein-bound (plasma + tissue), large Vd (~20 L/kg). SSRIs: also widely distributed. Fluoxetine: highest Vd." },
    { letter: "M", title: "Metabolism", color: C.amber, text: "TCAs: extensively metabolised in liver (CYP2D6, CYP3A4, CYP1A2). Imipramine → Desipramine; Amitriptyline → Nortriptyline (active). SSRIs inhibit CYP2D6 and CYP3A4." },
    { letter: "E", title: "Excretion", color: C.green, text: "Metabolites excreted in urine over 1–2 weeks. Plasma t½: Imipramine/Amitriptyline/Doxepin = 16–24 h. Fluoxetine = 2 days (active metabolite t½ = 7–10 days). Sertraline = 26 h." },
  ];

  adme.forEach((a, i) => {
    const x = 0.3 + i * 3.15;
    sl.addShape(pres.ShapeType.rect, { x, y: 1.1, w: 3.0, h: 0.65, fill: { color: a.color } });
    sl.addText(a.letter, { x, y: 1.1, w: 0.65, h: 0.65, fontSize: 26, bold: true, color: C.white, align: "center", valign: "middle" });
    sl.addText(a.title, { x: x + 0.65, y: 1.1, w: 2.35, h: 0.65, fontSize: 14, bold: true, color: C.white, align: "center", valign: "middle" });
    sl.addShape(pres.ShapeType.rect, { x, y: 1.75, w: 3.0, h: 1.5, fill: { color: C.white }, line: { color: a.color, width: 1.5 } });
    sl.addText(a.text, { x: x + 0.05, y: 1.8, w: 2.9, h: 1.4, fontSize: 9.5, color: C.darkText, valign: "top", wrap: true, margin: 4 });
  });

  // Half-life table
  sl.addShape(pres.ShapeType.rect, { x: 0.3, y: 3.4, w: 12.7, h: 0.38, fill: { color: C.navyMid } });
  sl.addText("PLASMA HALF-LIFE COMPARISON TABLE (High-Yield for Exams)", {
    x: 0.3, y: 3.4, w: 12.7, h: 0.38, fontSize: 11, bold: true, color: C.white, align: "center", valign: "middle", margin: 4
  });

  const rows = [
    ["Drug", "Class", "t½ (hours)", "Active Metabolite", "Daily Dose (mg)"],
    ["Imipramine", "TCA", "16–24", "Desipramine", "50–200"],
    ["Amitriptyline", "TCA", "16–24", "Nortriptyline", "50–200"],
    ["Fluoxetine", "SSRI", "48 (2 days)", "Nor-fluoxetine (7–10 days)", "20–40"],
    ["Sertraline", "SSRI", "26", "Active metabolite", "50–150"],
    ["Escitalopram", "SSRI", "27–32", "None active", "10–20"],
    ["Venlafaxine", "SNRI", "5–11", "Desvenlafaxine", "75–150"],
    ["Duloxetine", "SNRI", "12", "None", "30–80"],
    ["Mirtazapine", "Atypical", "20–40", "None", "15–45"],
  ];

  const colW = [2.5, 1.7, 2.0, 3.7, 2.3];
  const colX = [0.3, 2.8, 4.5, 6.5, 10.2];
  rows.forEach((row, ri) => {
    const y = 3.78 + ri * 0.38;
    const bg = ri === 0 ? C.teal : (ri % 2 === 0 ? C.lightGray : C.white);
    const fc = ri === 0 ? C.white : C.darkText;
    row.forEach((cell, ci) => {
      sl.addShape(pres.ShapeType.rect, { x: colX[ci], y, w: colW[ci], h: 0.38, fill: { color: bg }, line: { color: "CCCCCC", width: 0.5 } });
      sl.addText(cell, { x: colX[ci] + 0.05, y, w: colW[ci] - 0.1, h: 0.38, fontSize: ri === 0 ? 10 : 9, bold: ri === 0, color: fc, valign: "middle", margin: 3 });
    });
  });

  pearl(sl, 0.3, 7.05, 12.7, 0.22,
    "⭐",
    "Therapeutic Window: TCAs (Imipramine, Amitriptyline, Nortriptyline) show optimal effect at 50–200 ng/ml plasma concentration. Below or above → inadequate or toxic effect.");
}

// ══════════════════════════════════════════════════
// SLIDE 9 – THERAPEUTIC USES
// ══════════════════════════════════════════════════
{
  const sl = pres.addSlide();
  sl.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 13.3, h: 7.5, fill: { color: C.offWhite } });
  slideHeader(sl, "Therapeutic Uses of Antidepressants", "Class-wise Clinical Indications");

  const uses = [
    { class: "TCAs", color: C.teal, items: [
      "Major depression (moderate-severe)",
      "Panic disorder (Imipramine)",
      "OCD – Clomipramine (1st choice TCA)",
      "Nocturnal enuresis – Imipramine",
      "Neuropathic pain, fibromyalgia",
      "Attention deficit disorder",
      "Migraine prophylaxis (Amitriptyline)"
    ]},
    { class: "SSRIs", color: C.green, items: [
      "Depression – 1st LINE (all types)",
      "OCD – 1st LINE (Fluvoxamine)",
      "Panic disorder, Social phobia",
      "GAD, PTSD – Sertraline, Paroxetine",
      "Eating disorders (Fluoxetine)",
      "PMDD – Citalopram, Fluoxetine",
      "Premature ejaculation – Dapoxetine"
    ]},
    { class: "SNRIs", color: C.amber, items: [
      "Major depression (1st/2nd line)",
      "GAD, Social anxiety – Venlafaxine",
      "Neuropathic pain, Fibromyalgia – Duloxetine",
      "Diabetic peripheral neuropathy – Duloxetine",
      "Stress urinary incontinence – Duloxetine",
      "Menopausal hot flashes – Venlafaxine",
      "Panic disorder – Venlafaxine"
    ]},
    { class: "Atypical / MAOIs", color: C.purp, items: [
      "Smoking cessation – Bupropion",
      "ADHD (off-label) – Bupropion",
      "Atypical depression – MAOIs",
      "Social phobia – Moclobemide (RIMA)",
      "Insomnia + depression – Mirtazapine, Trazodone",
      "Elderly/cardiac patients – Moclobemide"
    ]},
  ];

  uses.forEach((u, i) => {
    const x = 0.3 + (i % 2) * 6.5;
    const y = i < 2 ? 1.1 : 4.15;
    sl.addShape(pres.ShapeType.rect, { x, y, w: 6.1, h: 0.38, fill: { color: u.color } });
    sl.addText(u.class, { x, y, w: 6.1, h: 0.38, fontSize: 12, bold: true, color: C.white, align: "center", valign: "middle", margin: 3 });
    sl.addShape(pres.ShapeType.rect, { x, y: y + 0.38, w: 6.1, h: 2.5, fill: { color: C.white }, line: { color: u.color, width: 1 } });
    const items = u.items.map((item, ii) => ({
      text: item,
      options: { bullet: { type: "bullet" }, breakLine: ii < u.items.length - 1, fontSize: 10, color: C.darkText }
    }));
    sl.addText(items, { x: x + 0.1, y: y + 0.42, w: 5.9, h: 2.4, margin: 4, valign: "top" });
  });

  pearl(sl, 0.3, 7.05, 12.7, 0.3,
    "⭐",
    "HIGH-YIELD: Clomipramine = BEST TCA for OCD | Fluoxetine = only antidepressant approved in children for OCD | Duloxetine = diabetic neuropathy + stress urinary incontinence | Bupropion = smoking cessation");
}

// ══════════════════════════════════════════════════
// SLIDE 10 – ADVERSE EFFECTS
// ══════════════════════════════════════════════════
{
  const sl = pres.addSlide();
  sl.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 13.3, h: 7.5, fill: { color: C.offWhite } });
  slideHeader(sl, "Adverse Effects", "Side Effect Profile Comparison");

  // Shared adverse effects
  sl.addShape(pres.ShapeType.rect, { x: 0.3, y: 1.1, w: 12.7, h: 0.36, fill: { color: C.navyMid } });
  sl.addText("COMMON / SHARED ADVERSE EFFECTS", { x: 0.3, y: 1.1, w: 12.7, h: 0.36, fontSize: 11, bold: true, color: C.white, align: "center", valign: "middle", margin: 4 });

  const common = [
    { label: "GI", text: "Nausea, vomiting, loose motions (especially SSRIs)", color: C.red },
    { label: "Sexual", text: "Delayed ejaculation, anorgasmia, decreased libido", color: C.purp },
    { label: "Weight", text: "↑ weight with TCAs, Mirtazapine, Trazodone; ↓ with Bupropion", color: C.amber },
    { label: "Switch", text: "Mania 'switch-over' in bipolar patients on any antidepressant", color: C.teal },
  ];
  common.forEach((c, i) => {
    const x = 0.3 + i * 3.2;
    sl.addShape(pres.ShapeType.rect, { x, y: 1.46, w: 3.1, h: 0.32, fill: { color: c.color } });
    sl.addText(c.label, { x, y: 1.46, w: 3.1, h: 0.32, fontSize: 10, bold: true, color: C.white, align: "center", valign: "middle" });
    sl.addShape(pres.ShapeType.rect, { x, y: 1.78, w: 3.1, h: 0.6, fill: { color: C.white }, line: { color: c.color, width: 1 } });
    sl.addText(c.text, { x: x + 0.05, y: 1.82, w: 3.0, h: 0.53, fontSize: 9, color: C.darkText, valign: "middle", wrap: true, margin: 3 });
  });

  // Class-specific table
  sl.addShape(pres.ShapeType.rect, { x: 0.3, y: 2.52, w: 12.7, h: 0.35, fill: { color: C.teal } });
  sl.addText("CLASS-SPECIFIC ADVERSE EFFECTS", { x: 0.3, y: 2.52, w: 12.7, h: 0.35, fontSize: 11, bold: true, color: C.white, align: "center", valign: "middle", margin: 4 });

  const aeRows = [
    ["Class", "Anticholinergic", "Sedation", "Cardiotoxic", "Seizure Risk", "Hypotension", "Special"],
    ["TCAs", "+++", "+++", "+++", "++", "++", "Arrhythmia in OD"],
    ["SSRIs", "−", "±", "−", "±", "−", "Serotonin syndrome"],
    ["SNRIs", "−/+", "+", "±", "−", "−", "↑ BP (Venlafaxine)"],
    ["MAOIs", "−", "±", "−", "−", "+", "Cheese reaction"],
    ["Mirtazapine", "±", "+++", "−", "−", "+", "Weight gain +++"],
    ["Bupropion", "−", "−", "−", "+++", "−", "No sexual SE"],
  ];
  const aeColW = [2.2, 1.7, 1.5, 1.6, 1.5, 1.6, 2.3];
  const aeColX = [0.3, 2.5, 4.2, 5.7, 7.3, 8.8, 10.4];
  aeRows.forEach((row, ri) => {
    const y = 2.87 + ri * 0.46;
    const isHeader = ri === 0;
    row.forEach((cell, ci) => {
      const bg = isHeader ? C.navyDark : (ri % 2 === 0 ? C.white : C.lightGray);
      const fc = isHeader ? C.white : (cell === "+++" ? C.red : cell === "−" ? C.green : C.darkText);
      sl.addShape(pres.ShapeType.rect, { x: aeColX[ci], y, w: aeColW[ci], h: 0.46, fill: { color: bg }, line: { color: "CCCCCC", width: 0.5 } });
      sl.addText(cell, { x: aeColX[ci] + 0.04, y, w: aeColW[ci] - 0.08, h: 0.46, fontSize: isHeader ? 9.5 : 9, bold: isHeader || cell === "+++" || cell === "−", color: fc, valign: "middle", align: ci === 0 ? "left" : "center", margin: 3 });
    });
  });

  // Serotonin syndrome + TCA OD boxes
  sl.addShape(pres.ShapeType.rect, { x: 0.3, y: 6.1, w: 6.1, h: 0.46, fill: { color: C.red } });
  sl.addText("⚠ SEROTONIN SYNDROME", { x: 0.3, y: 6.1, w: 6.1, h: 0.46, fontSize: 11, bold: true, color: C.white, align: "center", valign: "middle", margin: 4 });
  sl.addShape(pres.ShapeType.rect, { x: 0.3, y: 6.56, w: 6.1, h: 0.65, fill: { color: "FDEDEC" }, line: { color: C.red, width: 1 } });
  sl.addText("Agitation, restlessness, rigidity, hyperthermia, twitching → convulsions. Triggered when serotonergic drug (MAOIs, tramadol, pethidine) given to SSRI patient.", {
    x: 0.4, y: 6.6, w: 5.9, h: 0.58, fontSize: 9.5, color: C.darkText, wrap: true, margin: 3
  });

  sl.addShape(pres.ShapeType.rect, { x: 6.7, y: 6.1, w: 6.3, h: 0.46, fill: { color: C.amber } });
  sl.addText("⚠ TCA ACUTE POISONING (NEET PG High-Yield)", { x: 6.7, y: 6.1, w: 6.3, h: 0.46, fontSize: 11, bold: true, color: C.white, align: "center", valign: "middle", margin: 4 });
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  sl.addText("Excitement + delirium (atropine-like) → muscle spasms → convulsions → coma → respiratory depression. ECG: QRS widening. Rx: Gastric lavage, IV diazepam (convulsions), IV bicarbonate (arrhythmias). Avoid class IA/IC antiarrhythmics.", {
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  });
}

// ══════════════════════════════════════════════════
// SLIDE 11 – CONTRAINDICATIONS
// ══════════════════════════════════════════════════
{
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  sl.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 13.3, h: 7.5, fill: { color: C.offWhite } });
  slideHeader(sl, "Contraindications", "When NOT to Use – Class-Wise Guide");

  const cis = [
    { class: "TCAs", color: C.teal, items: [
      "Ischaemic heart disease, recent MI, arrhythmias",
      "Angle-closure glaucoma (anticholinergic effect)",
      "Benign prostatic hyperplasia (urinary retention)",
      "Bipolar disorder (risk of mania switch)",
      "Epilepsy (lowers seizure threshold)",
      "MAO inhibitors concurrently (hypertensive crisis)",
      "Pregnancy (safety not established)"
    ]},
    { class: "SSRIs", color: C.green, items: [
      "MAO inhibitors – risk of serotonin syndrome",
      "Children < 7 years (except Fluoxetine for OCD)",
      "Citalopram: avoid in QT prolongation",
      "Caution: Paroxetine in pregnancy (cardiac defects)",
      "Active suicidality in young adults (monitor closely)",
      "Platelet dysfunction / GI bleeding risk with NSAIDs",
    ]},
    { class: "MAOIs", color: C.navyMid, items: [
      "Tyramine-rich foods (cheese reaction risk)",
      "Sympathomimetic amines (ephedrine, phenylephrine)",
      "Pethidine – hyperthermia, convulsions, coma",
      "SSRIs, TCAs – serotonin syndrome risk",
      "Levodopa – hypertensive crisis",
      "Diabetes mellitus (unpredictable BG effects)"
    ]},
    { class: "Bupropion", color: C.amber, items: [
      "Epilepsy / seizure disorder (ABSOLUTE CI)",
      "Eating disorders (anorexia/bulimia) – seizure risk",
      "Bipolar disorder (risk of mania)",
      "Abrupt alcohol/BZD withdrawal (seizure risk)",
      "Concurrent MAOI use",
    ]},
  ];

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    "EXAM PEARL: MAOIs + Pethidine = MOST DANGEROUS combination → hyperthermia, convulsions, death. Bupropion CI in epilepsy and eating disorders. Paroxetine = most discontinuation symptoms among SSRIs.");
}

// ══════════════════════════════════════════════════
// SLIDE 12 – DRUG INTERACTIONS
// ══════════════════════════════════════════════════
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  slideHeader(sl, "Drug Interactions", "Clinically Important Interactions – High-Yield");

  const interactions = [
    { drug: "TCAs + Sympathomimetics\n(Ephedrine, local anaesthetics with adrenaline)", result: "↑ NA release → severe hypertension, arrhythmias", severity: "SEVERE", scolor: C.red },
    { drug: "TCAs + MAOIs", result: "Hyperpyrexia, convulsions, hypertensive crisis", severity: "SEVERE", scolor: C.red },
    { drug: "TCAs + CNS Depressants\n(Alcohol, antihistamines)", result: "Potentiation of sedation → respiratory depression", severity: "MODERATE", scolor: C.amber },
    { drug: "TCAs + Phenytoin/Carbamazepine", result: "Enzyme induction → ↓ TCA levels; also displaces from protein binding → transient toxicity", severity: "MODERATE", scolor: C.amber },
    { drug: "TCAs + Phenobarbitone", result: "Competitive inhibition of CYP → ↑ imipramine levels (phenobarbitone) OR enzyme induction → ↓ TCA levels", severity: "MODERATE", scolor: C.amber },
    { drug: "SSRIs + MAOIs", result: "SEROTONIN SYNDROME (agitation, rigidity, hyperthermia, convulsions) – potentially fatal", severity: "FATAL", scolor: C.red },
    { drug: "SSRIs + TCAs / Haloperidol / Clozapine", result: "SSRIs inhibit CYP2D6/3A4 → ↑ plasma levels of co-administered drug → toxicity", severity: "SEVERE", scolor: C.red },
    { drug: "SSRIs + NSAIDs / Warfarin", result: "↑ bleeding risk (platelet 5-HT depletion). GI bleed risk significantly ↑ with NSAIDs + SSRIs", severity: "MODERATE", scolor: C.amber },
    { drug: "MAOIs + Tyramine-rich foods\n(Cheese, yeast, pickled fish, red wine)", result: "CHEESE REACTION: severe hypertension, cerebrovascular accident", severity: "FATAL", scolor: C.red },
    { drug: "MAOIs + Pethidine / Tramadol", result: "Fever, excitation, delirium, convulsions, coma, respiratory failure", severity: "FATAL", scolor: C.red },
  ];

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  sl.addText("Clinical Effect", { x: 6.8, y: hY, w: 4.8, h: 0.38, fontSize: 10.5, bold: true, color: C.white, valign: "middle", margin: 5 });
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  sl.addText("Severity", { x: 11.6, y: hY, w: 1.4, h: 0.38, fontSize: 10.5, bold: true, color: C.white, align: "center", valign: "middle", margin: 5 });

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  });
}

// ══════════════════════════════════════════════════
// SLIDE 13 – IMPORTANT DRUGS WITH EXAMPLES
// ══════════════════════════════════════════════════
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  sl.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 13.3, h: 7.5, fill: { color: C.offWhite } });
  slideHeader(sl, "Important Drugs – Key Features & Examples", "NEET PG & MBBS Viva High-Yield Drug Profiles");

  const drugs = [
    { name: "Imipramine", class: "TCA", color: C.teal, features: ["Prototype TCA | inhibits NA+5-HT reuptake", "Used: Major depression, Panic disorder, Nocturnal enuresis", "Most cardiotoxic TCA | Therapeutic window: 50–200 ng/ml", "Rx: DEPSONIL 25–75 mg SR"] },
    { name: "Amitriptyline", class: "TCA", color: C.navyMid, features: ["Most SEDATING TCA (H₁ blockade)", "Used: Depression with insomnia, Migraine prophylaxis, Neuropathic pain", "Highest anticholinergic among TCAs", "Rx: AMLINE, TRYPTOMER 10–75 mg"] },
    { name: "Clomipramine", class: "TCA", color: C.teal, features: ["BEST TCA for OCD", "Highest seizure-precipitating potential", "Also used: Panic disorder, Phobias", "Rx: CLOFRANIL, CLONIL 10–150 mg"] },
    { name: "Fluoxetine", class: "SSRI", color: C.green, features: ["1st SSRI introduced | Longest acting (t½ 2 days; metabolite 7–10 days)", "APPROVED in children (≥7 yr) for OCD", "Used: Depression, OCD, Bulimia, Panic, PMDD", "Rx: FLUDAC, FLUPAR 20–40 mg"] },
    { name: "Sertraline", class: "SSRI", color: C.green, features: ["1st choice in PTSD, GAD, Juvenile depression", "Fewest CYP interactions among SSRIs", "Active metabolite; t½ 26 h", "Rx: SERLIN, SERTIL 50–100 mg"] },
    { name: "Duloxetine", class: "SNRI", color: C.amber, features: ["SNRI – mildly sedating, anticholinergic effects", "Used: Depression, Diabetic neuropathy, Fibromyalgia, Stress UI", "Raises BP at high doses", "Rx: CYMBALTA, DULANE 20–60 mg"] },
    { name: "Mirtazapine", class: "NaSSA", color: C.purp, features: ["Blocks α₂ auto+heteroreceptors → ↑ NA+5-HT", "NO sexual dysfunction, NO nausea (5-HT₃ blockade)", "Weight gain + sedation (H₁ blockade)", "Rx: MIRT, MIRTAZ 15–45 mg"] },
    { name: "Bupropion", class: "NDRI", color: C.red, features: ["DA + NA reuptake inhibitor (excitant, not sedating)", "Used: Depression, SMOKING CESSATION", "No sexual SE; CI in epilepsy, eating disorders", "Rx: SMOQUIT 150 mg"] },
  ];

  drugs.forEach((d, i) => {
    const x = 0.3 + (i % 4) * 3.2;
    const y = i < 4 ? 1.1 : 4.15;
    sl.addShape(pres.ShapeType.rect, { x, y, w: 3.0, h: 0.44, fill: { color: d.color } });
    sl.addText(d.name + "  |  " + d.class, { x, y, w: 3.0, h: 0.44, fontSize: 10.5, bold: true, color: C.white, align: "center", valign: "middle", margin: 3 });
    sl.addShape(pres.ShapeType.rect, { x, y: y + 0.44, w: 3.0, h: 2.5, fill: { color: C.white }, line: { color: d.color, width: 1 } });
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    }));
    sl.addText(items, { x: x + 0.06, y: y + 0.48, w: 2.88, h: 2.4, margin: 4, valign: "top" });
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    "⭐",
    "NEET PG ONE-LINERS: 1st SSRI = Fluoxetine | 1st TCA = Imipramine | OCD drug of choice = Fluvoxamine (SSRI) or Clomipramine (TCA) | Smoking cessation = Bupropion | No sexual SE = Mirtazapine, Bupropion");
}

// ══════════════════════════════════════════════════
// SLIDE 14 – CLINICAL PEARLS / MNEMONICS / MIND MAP
// ══════════════════════════════════════════════════
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  const sl = pres.addSlide();
  sl.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 13.3, h: 7.5, fill: { color: C.offWhite } });
  slideHeader(sl, "Clinical Pearls, Mnemonics & High-Yield Facts", "⭐ MBBS Viva | University Exams | NEET PG");

  // Mind map centre
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  sl.addText("ANTIDEPRESSANTS\nMIND MAP", { x: 5.0, y: 2.9, w: 3.2, h: 1.2, fontSize: 12, bold: true, color: C.white, align: "center", valign: "middle" });

  // Lines from centre
  const branches = [
    { x: 2.3, y: 1.4, w: 2.7, h: 0.6, label: "MECHANISM", color: C.teal, note: "Block SERT/NET\n(SSRIs/TCAs/SNRIs)" },
    { x: 8.0, y: 1.4, w: 2.7, h: 0.6, label: "USES", color: C.green, note: "Depression, OCD,\nAnxiety, Pain" },
    { x: 0.3, y: 3.2, w: 2.5, h: 0.6, label: "SIDE EFFECTS", color: C.red, note: "Anticholinergic,\nSerotonin syn." },
    { x: 10.2, y: 3.2, w: 2.8, h: 0.6, label: "1st LINE", color: C.amber, note: "SSRIs for most\nconditions" },
    { x: 2.0, y: 4.8, w: 2.7, h: 0.6, label: "INTERACTIONS", color: C.purp, note: "MAOIs: fatal\ncombinations" },
    { x: 8.3, y: 4.8, w: 2.7, h: 0.6, label: "SPECIAL USES", color: C.navyMid, note: "OCD, Neuropathy,\nSmoking cess." },
  ];

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  });

  // Mnemonics panel at bottom
  const mnems = [
    { title: "SSRIs (Serially)", text: "'Flee From Paris, See Colourful Escapes Daily'\nFluoxetine, Fluvoxamine, Paroxetine, Sertraline, Citalopram, Escitalopram, Dapoxetine", color: C.green },
    { title: "TCA SE: ACHD", text: "A – Anticholinergic\nC – Cardiotoxic\nH – Hypotension (postural)\nD – Decreased seizure threshold", color: C.teal },
    { title: "MAOIs remember: 'PIPE'", text: "P – Pethidine (fatal with MAOIs)\nI – Isocarboxazid\nP – Phenelzine\nE – Extra tyramine = Cheese reaction", color: C.navyMid },
    { title: "2–3 Week Lag Rule", text: "All antidepressants share 2–3 week lag for mood effect due to autoreceptor desensitisation (α₂ + 5-HT₁A). Rapid uptake ≠ Rapid effect!", color: C.amber },
  ];

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  });
}

// ══════════════════════════════════════════════════
// SLIDE 15 – SUMMARY
// ══════════════════════════════════════════════════
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  slideHeader(sl, "Summary – One-Liner Revision Notes", "Last-Minute High-Yield Points for MBBS & NEET PG");

  const points = [
    ["01", C.red, "Antidepressants do NOT cause euphoria in normal individuals – they only elevate depressed mood"],
    ["02", C.teal, "SSRIs are the 1st LINE for depression, anxiety, OCD, PTSD, and most psychiatric conditions today"],
    ["03", C.navyMid, "2–3 WEEK LAG: Uptake blockade is rapid; mood elevation is delayed due to autoreceptor desensitisation"],
    ["04", C.amber, "TCA prototype = Imipramine | Most sedating = Amitriptyline | OCD TCA = Clomipramine | Neuropathy = Desipramine/Nortriptyline"],
    ["05", C.green, "SSRI mnemonic: Fluoxetine (longest t½, approved in children), Fluvoxamine (OCD/GAD), Paroxetine (most anticholinergic)"],
    ["06", C.purp, "SNRIs: Venlafaxine (depression, anxiety, hot flashes) | Duloxetine (neuropathy, fibromyalgia, stress UI)"],
    ["07", C.red, "SEROTONIN SYNDROME: MAOIs + SSRIs/pethidine/tramadol → agitation, hyperthermia, rigidity, convulsions"],
    ["08", C.teal, "CHEESE REACTION: MAOIs + tyramine-rich foods → severe hypertension → CVA"],
    ["09", C.amber, "Bupropion: DA+NA reuptake inhibitor → excitant, NO sexual SE, used in smoking cessation; CI: epilepsy"],
    ["10", C.navyMid, "Mirtazapine (NaSSA): blocks α₂ receptors, NO nausea, NO sexual dysfunction; causes weight gain + sedation"],
    ["11", C.green, "TCA overdose: atropine-like symptoms → convulsions → arrhythmias. Rx: IV diazepam + IV bicarbonate"],
    ["12", C.purp, "Fluoxetine = only SSRI approved in children (≥7 yr) for OCD. Dapoxetine = SSRI for premature ejaculation"],
  ];

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// ══════════════════════════════════════════════════
// SLIDE 16 – REFERENCES
// ══════════════════════════════════════════════════
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    x: 0.5, y: 0.5, w: 10, h: 0.9, fontSize: 32, bold: true, color: C.white, fontFace: "Calibri"
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    ["[1]", "KD Tripathi", "Essentials of Medical Pharmacology", "8th Edition, 2019. Jaypee Brothers Medical Publishers. Chapter 33: Antidepressant and Antianxiety Drugs, pp. 482–510."],
    ["[2]", "Goodman & Gilman", "The Pharmacological Basis of Therapeutics", "13th Edition (2018). Drug Therapy of Depression and Anxiety Disorders, Chapter 16."],
    ["[3]", "Rang, Dale, Ritter, Flower, Henderson", "Rang and Dale's Pharmacology", "9th Edition (2019). Antidepressant Drugs, Chapter 47."],
    ["[4]", "Stahl SM", "Stahl's Essential Psychopharmacology", "4th Edition (2013). Antidepressants, Chapter 7. Cambridge University Press."],
    ["[5]", "WHO", "Mental Health Action Plan 2013–2030", "World Health Organization. Treatment of Depression. https://www.who.int/mental_health"],
  ];

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}

// ── Write output ──
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  .then(() => console.log("✅ PPTX saved successfully!"))
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