A.30.Selective serotonin and/or norepinephrine reuptake inhibitors Flashcards
list the SSRI’s
"Please Call if Feel Suicidal" Paroxetine Citalopram Fluoxetine Sertraline
which SSRI’s are used for children?
Fluoxetine
what are SSRI’s?
selective serotonin reuptake inhibitors
what is the mechanism of action of SSRI’s?
- selective inhibition of 5-HT reuptake
inhibit the transporter, binding at a site other than that of serotonin
2.minimal inhibitory effects on NE transporter, cholinergic and adrenergic receptors
how long for SSRI’s treatment response?
4-6 weeks
what is the T1/2 of SSRI’s?
18-24 hours
once daily
how are SSRI’s and SNRI’s given?
orally
what type of metabolism do SSRI’s have?
hepatic
are SSRI’s and SNRI’s inhibitors of CYP450?
yes
indications for SSRI’s
- major depressive disorders (1st choice usually)
- anxiety disorders (GAD)
- obsessive-compulsive disorder (OCD)
- post-traumatic stress disorder (PTSD)
- premenstrual dysphoric disorder (PMDD)
- panic disorders
- Bulimia
what are the adverse effects of SSRI’s?
anxiety, agitation sleep disorders Bruxism (jaw clenching/teeth grinding) sexual dysfunction--> ↓ libido weight gain or weight loss SIADH
when discontinuing SSRI’S or SNRI’S abruptly, what can occur?
withdrawal syndrome–> flu-like symptoms, dizziness, anxiety, tremor, palpitations
SNRI’s- severe
what agents are given as adjunct therapy in the first few weeks of SSRI treatment, to control anxiety and agitation symptoms
Benzodiazepines (alprazolam)
which agent is the least associated with drug-drug interactions
Citalopram
why does SSRI’s increase levels of TCA’s, benzodiazepines, warfarin
cause they are inhibitors of P450 enzymes
