Antidepressants Flashcards
mCPP is active metabolite for what?
trazodone
Which antidepressant can be effective sublinguillay
fluoxetine
Which antidepessant can be given bucally/transdermally
selegeline
Post MI recommended SSRI
sertraline
Which antidepressants should be avoided in those with risk of arrythmia
Bupropion, citalopram, escitalopram, moclobemide, lofepramine and venlafaxine
Which TCA is less cardiotoxic
Lofepramine
Is the arrhythmogenic potential of TCAs and other antidepressants dose dependent?
yes
Which should be avoided in diabetes
TCAs and MAOIs
What may the following symptoms suggest:
Flu-like symptoms
Dizziness
Insomnia
Vivid dreams
Irritability
Crying spells
Sensory symptoms (e.g. sensations resembling electric shocks in the arms, legs, or head)
SSRI discontinuation syndrome
What type of drug is venlafaxine
SNRI
Discontinuation symptoms seem least likely with which SSRI
fluoxetine
Which antidepressants are most associated with discontinuation symptoms
Paroxetine (SSRI)
Venlafaxine (SNRI)
TCAs particularly associated with discontinuation symptoms include which?
Amitriptyline
Imipramine
The following are discontinuation symptoms of which antidepressant type?
Agitation/ irritability
Ataxia
Movement disorders
Insomnia
Vivid dreams
MAOI
Risk factors for discontinuation symptoms?
those on antidepressants with shorter half lives
those who have been taking antidepressants for 8 weeks or longer (longer duration of treatment)
those using higher doses
those who developed anxiety symptoms at the start of antidepressant therapy
those receiving other centrally active medications (e.g. antihypertensives, antihistamines, antipsychotics)
younger people
those who have experienced discontinuation symptoms before
TCA discontinuation symptoms?
Flu-like symptoms
Insomnia
Excessive dreaming
When do discontinuation symptoms usually occur
usually within 5 days of stopping but varies depending on half life
How quickly do discontinuation symptoms resolve if medication recommenced?
usually resolve fully within 24 h if the original antidepressant is recommenced
Which antidepressants may be used for Nocturnal enuresis in children
Amitriptyline, Imipramine, Nortriptyline
Which antidepressants may be used for phobic and obsessional states?
clomipramine
Which antidepressant can be used for Adjunctive treatment of cataplexy associated with narcolepsy
clomipramine
Which antidepressants are licensed for agoraphobia and panic disorder?
Citalopram, Escitalopram, Sertraline, Paroxetine, Venlafaxine
Which antidepressants are licensed for agoraphobia and panic disorder?
Citalopram, Escitalopram, Sertraline, Paroxetine, Venlafaxine
Which additional antidepressant is licensed for social anxiety
Moclobemide
Antidepressant licensed for bulimia?
Fluoxetine
Antidepressants licensed for OCD?
Escitalopram, Fluoxetine, Fluvoxamine, Paroxetine, Sertraline
Antidepressants licensed for PTSD?
Paroxetine and Sertraline
How does duloxetine work
Serotonin and noradrenaline reuptake inhibitor (SNRI) also weak inhibitor of dopamine reuptake
How does venlafaxine work
Serotonin and noradrenaline reuptake inhibitor (SNRI)
How does reboxetine work
Noradrenaline reuptake inhibitor (NRI)
How does bupropion work
Noradrenaline and dopamine reuptake inhibitor (NDRI)
How does trazadone work
Weak SRI and 5HT agonist
How does St Johns wort work
Weak MAOI and weak SNRI
How does mirtazepine work?
Noradrenaline and serotonin specific antidepressant (NaSSa).
5HT-1, 5HT-2, 5HT-3, H1 antagonist,
presynaptic alpha 2 antagonist (which stimulates the release of NA and 5HT)
Minimum effective dose of mirtazepine?
30 mg / day
Minimum effective dose of trazadone?
150 mg / day
Which TCAs are most dangerous in overdose?
amitriptyline and dosulepin (dothiepin)
Which SSRI most likely to cause weight gain
Paroxetine
Which medications are less likely than SSRIs to cause weight gain
bupropion and nefazodone
Which antidepressant types most likely to cause weight gain?
tricyclic antidepressants (TCAs) and perhaps monoamine oxidase inhibitors (MAOIs)
