Anti-depressants Flashcards
primary treatment for depression
antidepressants
5 classes of medication that treat depression
Selective serotonin reuptake inhibitors (SSRI’s)
Serotonin/norepinephrine reuptake inhibitors (SNRI’s)
Tricyclic antidepressants (TCA’s)
Monoamine oxidase inhibitors (MAOI’s)
Atypical antidepressants
how long does it take to see benefits of pharmacotherapy for depression
1-3 weeks, can take up to 12 weeks for a response
how long will pt. remain on med once in remission
4-9 months
best practice for prescribing antidepressants
start low and go slow
when discontinuing anti-depressant be sure to
taper or else pt. will get very sick
all antidepressants come with a black box warning, t or f
true - suicide risk
age related risks for suicide
18-24 increased risk for suicide
25-30 neutral effect
>30 decreased risk
most commonly prescribed anti-depressant
SSRI
prototype SSRI
Prozac
Prozac is commonly prescribed for these disorders
OCD, Bulimia, Premenstrual Dysphoric Disorder
SSRI adverse effects are considered low but include
weight gain and sexual dysfunction
prototype SNRI
Effexor
first line treatment for depression is an
SSRI
which drug class has fewer adverse effects SSRI or SNRI
SSRI
Effexor is commonly prescribed for these disorders
GAD - generalized anxiety disorder
major depression
social anxiety disorder
how does Effexor work
blocks uptake of norepinephrine and serotonin
s/e of Effexor
diastolic HTN - if known hx of HTN do not prescribe
a serious reaction can occur with Effexor and MAOI’s, t or f
true - must wait 2 weeks in between the 2 meds
tricyclic antidepressants are cardio toxic, t or f
true
s/e of tricyclic antidepressants
dizziness (get up slowly),drowsiness, photophobia, blurred vision, dry eye, constipation, increased risk for seizures, hypomania, yawngasm, cardiotoxic
tricyclic antidepressants are a good drug choice for these disorders
bipolar disorder and neuropathic pain
composition of tricyclic antidepressants is similar to
phenothiazine’s
how do tricyclic antidepressants work
blocks receptors for histamine and acetylcholine as well as serotonin and NE
how often/when do you give tricyclic antidepressants
once a day at bedtime
overdose with tricyclic antidepressants can be life threatening, t or f
true
s/s of tricyclic antidepressant overdose
tachycardia and palpitations
trt for tricyclic antidepressant overdose
charcoal with gastric lavage
propranolol
*monoamine oxidase inhibitors and tyramine foods could cause this
hypertensive crisis
how do monoamine oxidase inhibitors work
inactivates NE, serotonin and dopamine, increases neurotransmitters so pt. isn’t depressed
what type of foods have tyramine in them
processed foods aged cheese Swiss, bleu, pepperoni, salami
drug of choice for atypical depression
monoamine oxidase inhibitors
s/e of MOAI
HTN, headache, tachy, n/v, confusion, sweating
atypical antidepressant
Wellbutrin
moa of Wellbutrin
stimulates appetite w/o weight gain; increases sex drive/pleasure
what type of disorder is contraindicated w/Wellbutrin
eating disorders - likely to develop a seizure
non-conventional drugs found to treat depression
ketamine - bolus IV
St. johns wort - interacts w/SSRI’s
SAMe
MOA of SSRI (Prozac)
selective inhibition of serotonin uptake
CNS excitation
