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EPPP B3: Physio & Psychopharm > 08_Antidepressants > Flashcards

08_Antidepressants Flashcards

1
Q

Three Main Classes of Antidepressants

A

Tricyclics

SSRIs

MAOIs

*Also recent development of NDRIs and SNRIs

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2
Q

Tricyclic Antidepressants (TCAs):

Most common Examples

A

Imipramine (Tofranil)

Clomipramine (Anafranil)

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3
Q

Tricyclic Antidepressants (TCAs):

Most Effective Use

A

Depression that involves:

Decreased appetite and weight loss

Sleep disturbances

Psychomotor retardation

Anhedonia

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4
Q

Tricyclic Antidepressants (TCAs):

Particularly effective for this symptom presentation…

A

Vegetative, somatic symptoms of depression

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5
Q

Tricyclic Antidepressants (TCAs):

Common uses

A

Clomipramine: OCD (serotonin)

Imipramine: Eneurisis in children and adolescents

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6
Q

Tricyclic Antidepressants (TCAs):

Mechanism of Action

A

Increase levels of norepinephrine, serotonin and dopamine

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7
Q

Catecholamine Hypothesis

A

Depression is caused by deficiency of norepinephrine

Supported by TCA’s effect on increasing NE

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8
Q

Most Serious Problem with TCA’s

A

They are Cardiotoxic:

Tachycardia

Palpitations

Hypertension

Severe hypotension

Arrhythmia

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9
Q

Tricyclic Antidepressants (TCAs):

Prescribing Considerations

A

Used with caution with those with heart disease

Adverse effects more common in older patients

Side effects can be alleviated by lowering dosage

Lethal in overdose

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10
Q

Tricyclic Antidepressants (TCAs):

Suicidality Consideration

A

TCA’s are lethal in overdose

Prescribed in small doses for patients at high risk

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11
Q

SSRI’s:

Three Most Common SSRI’s

A

Fluoxetine (Prozac)

Paroxetine (Paxil)

Sertraline (Zoloft)

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12
Q

SSRI’s:

Uses

A

Depression
*particularly effective for melancholic depression

OCD

Bulimia

Panic disorder

PTSD

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13
Q

SSRI’s:

Advantages of SSRIs over tricyclics

A

Less cardiotoxic

Safer in overdose

Less likely to produce cognitive impairment

Fairly rapid onset of therapeutic effects (2 to 4 weeks)

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14
Q

True or False?

Prozac is linked with increased suicidality

A

False.

No greater than other antidepressants

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15
Q

Serotonin Syndrome:

Etiology

A

Combination of SSRI with MAOI or other serotonergic agent

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16
Q

Serotonin Syndrome:

Neurological Symptoms

A

Headache

Tremor

Dizziness

17
Q

MAOI’s:

Three most commonly prescribed MAOIs

A

Isocarboxazid (Marplan)

Phenelzine (Nardil)

Tranylcypromine (Parnate)

18
Q

MAOI’s:

Most Effective Uses

A

Non-endogenous and atypical DEPRESSIONs with:

Anxiety

Reverse vegetative symptoms (hypersomnia, hyperphagia)

Interpersonal Sensitivities

19
Q

MAOI’s:

Most dangerous Side Effect

A

Hypertensive Crisis

*seek emergency treatment immediately

20
Q

MAOI’s:

Foods that contain Tyramine

A

Aged cheeses and meets

Beer

Red wine

Chicken liver

Avocados

Bananas

Fava beans

Soy sauce

21
Q

MAOI’s:

Hypertensive Crisis Symptoms

A

Severe headache

Stiff neck

Rapid heart rate

Nausea

Vomiting

Sweating

Photosensitivity

22
Q

NDRIs:

Main example

A

Buproprion (Wellbutrin)

MDD

Major Depressive episode of Bipolar Disorder

23
Q

Buproprion (Wellbutrin):

Brand name when used for smoking cessation

A

Zyban

24
Q

Buproprion (Wellbutrin):

Pros

A

Fewer anticholinergic side effects and less cardiotoxic than TCAs

Does not cause sexual dysfunction

Effective for individuals who’ve not responded to other antidepressants

25
Q

Buproprion (Wellbutrin):

Con

A

May aggravate pre-existing psychosis and seizures

26
Q

SNRIs:

Two main examples

A

Venlafaxine (Effexor)

Duloxetive (Cymbalta)

27
Q

Venlafaxine (Effexor):

Uses

A

MDD

GAD

SAD

OCD

Pain syndromes (e.g. fibromyalgia, back pain)

28
Q

Venlafaxine (Effexor):

Pros

A

Less dangerous in overdose than TCAs

Faster onset of therapeutic effects

29
Q

Venlafaxine (Effexor):

Caution

A

Increases blood pressure

Requires frequent monitoring

30
Q

SNRIs: Duloxetine (Cymbalta)

Overview

A

Similar to Effexor

Prescribed for MDD and GAD

31
Q

Hypertensive Crisis:

Causes

A

Combination of MAOIs and:

Barbiturates, amphetamines, antihistamines

Foods containing Tyramine

32
Q

Serotonin Syndrome:

Changes in Mental State

A

Irritability

Confusion

Delirium

33
Q

Serotonin Syndrome:

Physiological Symptoms

A

Cardiac arrhythmia

*Can progress to coma and death

EPPP B3: Physio & Psychopharm (21 decks)

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