Antidepressants Flashcards
3 neurotransmitters implicated in depression
Serotonin
Dopamine
Noradrenaline/ Norepinephrine
S&S of Depression
Persistent low mood
loss of pleasure in usual activities
fatigue
changes in sleep habits
difficulty in concentration
Aetiology (cause) of depression
stressful events
physical illness
genetics
social isolation
trauma
what antidepressants do
bring neurotransmitters (serotonin, dopamine and noradrenaline) normal level in the body
how long antidepressants benefits can be observed and what are noticeable changes
up to 8 weeks
improvement in sleep, appetite and motivation
neurotransmitter found in the brain made by amino acid trytophan. Contributes to feeling of wellbeing and happiness
This is also 90% found in the GI tract, increases gastric and colonic motility, nausea, vasoconstriction and platelet aggregation
Serotonin
5- hydroxytryptamine (5-HT) is a monoamine neurotransmitter also called as
Serotonin
Monoamine oxidase (MAO) enzyme catalyses or breakdown which neurotransmitters?
Serotonin (5-HT)
Dopamine
Noradrenaline
4 classes of Antidepressant drugs
SSRI/ Selective Serotonin Reuptake Inhibitors
SNRI/ Serotonin and Noradrenaline Reuptake Inhibitors
Tricyclic Antidepressants (TCA)
Monoamine oxidase inhibitor (MAOI)
Pharmacodynamics of SSRI and SNRI
Inhibit reuptake pumps for serotonin and noradrenaline
Temporary or transitory adverse effects of SSRIs and SNRIs
Dizziness, confusion, disorientation, increased anxiety
Nausea
Sleepiness
Suicidal thoughts (young people)
Long term adverse effects of SSRIs and SNRIs
Tremor
Sexual dysfunction
Sweating
Hyponatraemia
Weight loss or gain
HTN and Tachy (SNRI)
Pharmacodynamics of TCA (Tricyclic Antidepressants)
Serotonin and noradrenaline reuptake inhibitors
Histamine (inflammatory mediator for allergic reactions) and acetycholine (parasympathetic neurotransmitter) antigonist
Na and Ca channels inhibitors
First line drug of depression and anxiety
SSRI (Selective Serotonin reuptake inhibitors)
Major side effect of SSRI overdose
Serotonin Syndrome
SSRI meds
Citalopram
Escitalopram
Setraline
Fluoxetine
Vilazodone
Inhibits serotonin reuptake = increasing serotonin levels
SSRI
Inhibits serotonin and noradrenaline or dopamine and noradrenaline reuptake
SNRI/ DNRI
do not mix ________ with MAOIs or TCAs
SNRI and DNRI
SNRI/ DNRI meds
Bupropion (used for smoking cessation)
Duloxetine
Venlafaxine
Milnacipran
Nefazodone
Adverse effects of TCAs
Tremors
Cardio: Arrythmias, postural hypotension
Anticholinergics: dry mouth, dysphagia, constipation, urinary retention, palpitations
Sedation and seizures
TCA meds
Amitriptyline
Nortriptyline
Doxepine
Clomipramine
Blocks monoamine oxidase causing an increase in adrenaline, noradrenaline, dopamine and serotonin or increase in CNS stimulation
MAOI (Monoamine oxidase inhibitor)
Adverse effects of MAOIs
Orthostatic hypotension (encourage pt to rise slowly)
Dizziness
Blurred vission
Constipation
Dry mouth
N&V
HTN crisis
Foods to avoid while taking MAOIs
aged cheese
fermented meats
chocolate
caffeinated beverages
sour and cream yoghurt
MAOI meds
Phenelzine
Tranylcypromine
Isocarboxazid
Excess noradrenaline causes
anxiety
aggression
HTN
deficient noradrenaline causes
depression
lack of focus
excess serotonin causes
headache
confusion
tachycardia
HTN
deficient serotonin causes
depression
anxiety
fatigue
Nursing considerations for pts taking MAOIs
Up to 4 weeks therapeutic benefits
Educate pt S&S of HTN crisis
Avoid foods with Tyramine (aged cheese, fermented meats, chocolate, caffeinated beverages, sour cream and yoghurt)
Nursing considerations for pts taking TCAs
up to 2- 3 weeks to see therapeutic benefits
Wait for 2 weeks before starting TCAs after being off from MAOIs
Nursing considerations for pts taking SSRI
up to 4-6 weeks efficacy
Take meds during morning
First line drug for depression and anxiety
Pt (younger people) can be suicidal as they have the energy to plan
Nursing considerations for SNRI
up to 4-6 weeks efficacy
DO NOT MIX WITH TCAs and MAOIs
DO NOT use it with Zyban (meds for smoking cessation) cause overdose
