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Pharm - Psych > Antidepressants > Flashcards

Antidepressants Flashcards

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1
Q

5 indications for antidepressants

A

Depression
Anxiety
OCD
PTSD
Eating disorders (some)

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2
Q

Antidepressant classes (11)

A

SSRI
SNRI
NDRI
SPARI
Alpha-2 antagonist/NaSSa/SNDI
NRI
SARI
TCA
MAO
NMDA receptor antagonist
Multimodal

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3
Q

5 Common SSRIs

A

Citalopram (Celexa)
Escitalopram (Lexapro)
Fluoxetine (Prozac)
Paroxetine (Paxil)
Sertraline (Zoloft)

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4
Q

3 Common SNRIs

A

Duloxetine (Cymbalta)
Venlafaxine XR (Effexor XR)
Desvenlafaxine (Pristiq)

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5
Q

Common NDRI

A

Buproprion (Wellbutrin)

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6
Q

Multimodal Agent

A

Vortioxetine (Trintellix)

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7
Q

Common SPARI

A

Vilazodone (Viibryd)

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8
Q

SSRI metabolized by

A

CYP450 (1A2, 2D6, 3A4)

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9
Q

SSRIs for FDA-approved for PTSD

A

Paroxetine (Paxil)
Sertraline (Zoloft)

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10
Q

What can SSRIs interfere with?

A

Clotting Cascade

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11
Q

How do you dose SSRIs?

A

Start low, go slow, usually increase dose in 2-4 week increments

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12
Q

SSRI Common SE

A

GI upset
Akathisia
Sexual SE
HA
Dry mouth

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13
Q

SSRI Serious SE

A

Serotonin syndrome
Increased suicidal thoughts < 25 years old

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14
Q

Indication for Citalopram (Celexa)

A

FDA Approved for MDD in adults only (favorable in elderly)

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15
Q

Concern w/ Citalopram (Celexa)

A

Can cause QT prolongation > 40mg/day PO

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16
Q

What can Citalopram (Celexa) cause?

A

paradoxical yawning

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17
Q

When to give Citalopram (Celexa)?

A

Give at night (it’s a weak antihistamine)

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18
Q

Citalopram (Celexa) Common SE

A

Nausea
HA
Lightheaded
Anxiety
Sexual dysfunction
Excess sweating
(More than lexapro but not bad)

19
Q

What to monitor for Citalopram (Celexa)?

A

EKG esp w/ other meds that prolong QT or deplete Mg or K

20
Q

Quintessential SSRI

A

Escitalopram (Lexapro)

21
Q

Escitalopram (Lexapro) Indication

A

FDA Approved for MDD, GAD
MDD for children 12+

22
Q

What is Escitalopram (Lexapro) also effective for?

A

OCD, Panic disorder, PTSD, social anxiety, PMDD, PTSD

23
Q

Pros of Escitalopram (Lexapro)

A

Fewer SE, lower doses, more predictable (10mg vs 40mg Celexa)
Most well tolerated SSRI
Very effective in treating Anxiety

24
Q

Prozac (Fluoxetine) indication

A

MDD, OCD, panic disorder, PMDD, bulimia nervosa, bipolar disorder (w/ Zyprexa - Symbyax)

25
Q

Age and Diagnosis indications for Prozac (Fluoxetine)

A

8-17: OCD
7-17: MDD

26
Q

Pros of Prozac (Fluoxetine)

A

Energizing effect (good for anxiety), focus/concentration issues
Longest 1/2 life (if compliance is an issue)
Most studied agent for children (lowest SI risk)

27
Q

Indication for Luvox (Fluvoxamine)

A

OCD and social anxiety disorder

28
Q

Off label use for Luvox (Fluvoxamine)

A

Panic disorder and PTSD
-better for anxiety, may benefit psychosis

29
Q

Age and diagnosis indication for Luvox (Fluvoxamine)

A

8-17: OCD

30
Q

Concern with Luvox (Fluvoxamine)

A

-can interact with other meds
-caffeine increases potency up to 5 times

31
Q

Benefit of Luvox (Fluvoxamine)

A

Most effective agent for social anxiety disorder and OCD

32
Q

Indication for Sertraline (Zoloft)

A

MDD, OCD, panic disorder, PTSD, PMDD, and social anxiety disorder
-may be helpful in psychotic depression

33
Q

Off-label indication for Sertraline (Zoloft)

A

MDD

34
Q

Age and indication Sertraline (Zoloft)

A

6-17: OCD

35
Q

Sertraline (Zoloft) side effects

A

Nausea
HA
Lightheaded
Anxiety
Sexual dysfunction
Less potential for weight gain

36
Q

Concern with Sertraline (Zoloft)

A

Some drug interactions, esp. higher dose range

37
Q

Indication for Paroxetine (Paxil)

A

OCD, panic disorder, social anxiety disorder, GAD, PMDD, PTSD
-anticholinergic, sedating calming

38
Q

Most effective medication for PTSD

A

Paroxetine (Paxil) w/ most side effects

39
Q

What is Paroxetine (Paxil) very effective for

A

sexually disinhibited patients
potentially w/ excessive gambling

40
Q

What is Paroxetine (Paxil) associated with?

A

Withdrawal syndrome (shortest 1/2 life)
-Anticholinergic rebound (akathisia, restlessness, GI upset, dizziness, tingling)

41
Q

Common SE of Paroxetine (Paxil)

A

Nausea
HA
Lightheaded
Anxiety
Sexual Dysfunction

42
Q

What medication is the worst offender for inducing mania in bipolar patients?

A

Paroxetine (Paxil)

43
Q

What is SPARI? What’s an example?

A

Serotonin Partial agonist re-uptake inhibitor
Vilazodone (Viibryd)

Pharm - Psych (7 decks)

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