Anti-depressants Flashcards
Broad mechanism of action of most antidepressants
Increase synaptic availability of neurotransmitter
Precursor amino acid for synthesis of serotonin
Tryptophan
Mechanism of action of citalopram, sertraline,fluoxetine
Selective serotonin re-uptake inhibitors (SSRIs)-increase 5-HT availability in the synaptic cleft
Why do SSRIs generally have fewer side effects than TCAs?
Are serotonin-selective- have no effect on noradrenaline uptake, and cause less blockade of other receptors
Indications for SSRIs (3)
Depression
Anxiety disorders
OCD
Common adverse effects of SSRIs (3)
Gastrointestinal upset
Appetite and weight disturbance
May increase suicide/self harm risk in young people in first few weeks
When should SSRIs be prescribed with caution? (3)
People with epilepsy- can lower the seizure threshold
People with peptic ulcer disease- can increase bleeding
Young people- have poorer efficacy,and risk of self harm
Which classes of drug should SSRIs not be prescribed with? (2)
Drugs which prolong the QT interval
Monoamine oxidase inhibitors
Indications for TCAs (2)
Second line treatment of depression
Neuropathic pain
Mechanism of action of TCAs (2)
SNRI
blockade of various other receptors
Why is clinical utility of TCAs limited?
Blockade of various receptors causes a wide variety of potential adverse effects
Antimuscarinic side effects of TCAs (4)
Dry mouth
Constipation
Urinary retention
Blurred vision
Cardiac side effects of TCAs
Postural hypotension (interferes with orthostatic reflexes- cholinergic and adrenergic blockade)
