Antidepressants Flashcards
(111 cards)
When given at equivalent and target doses, most antidepressants are _______ efficacious in treating major depressive disorder, but patient responses _____.
Equally
Differ
Side effect profiles vary greatly from class to class and individual ______ responses to drug therapy varies from class to class
Patient
A response is considered a reduction in symptoms but not?
Complete remission
Antidepressant therapy is often chosen based on what two things?
Adverse effects and individual response
List the five general properties common to all antidepressants?
Drug distribution Effects on monoamine neurotransmitters: evidence for the monoamine theory of depression Time course of drug action Effects at receptors Discontinuation/withdrawal syndrome
Medication compliance is influenced greatly by ________.
Tolerability
It is important to consider side effects occur much _____ than the positive therapeutic effects, making adherence a common problem
Sooner
_____ ______ is most commonly associated with tricyclics antidepressants, monoamine oxidase inhibitors, and mirtazapine
Weight gain
What is recommended as a first line to managing weight gain?
Diet and exercise
If the patient is non compliant with diet/exercise or they are unsuccessful, the patient should be?
Switched to an alternative agent that is less likely to cause weight gain.
What antidepressant is less likely to cause weight gain?
Bupropion
What two medications were associated with higher incidence of sexual side effects?
Paroxetine and citalopram
What SSRI is associated with less sexual dysfunction?
Fluoxetine
Antidepressants not associated with sexual side effects are what two?
Bupropion and Mirtazapine
So if you have a patient being non compliant with antidepressants due to sexual side effects what would be the best two medications to switch him to?
Bupropion and mirtazapine
Nausea with antidepressant therapy is _______ in nature
Transient
To prevent nausea due to antidepressants it is recommended to start therapy with ____ dose and titrate ____.
Low
Slowly
Taking antidepressant with food will make nausea better or worse
Better
When should you take antidepressants to help prevent nausea?
Before bed
Sleep disturbances with antidepressants involves what sleep disturbances?
Insomnia
Inability to fall asleep
Difficulty staying awake
First action of the provider when a patient complains of sleep disturbances with an antidepressant is to?
Assess the dosing schedule
If the patient is experiencing difficulty staying awake during the day, be sure that the patient is taking the antidepressant when?
At nighttime before bed
If the patient reports insomnia or difficulty sleeping, when should the patient take the antidepressant?
In the morning
What SSRI is commonly associated with insomnia?
Fluoxetine