Antidepressants Flashcards
The symptoms of ____
- Apathy, depressed mood
-Weight changes, sleep disturbances, psychomotor agitation or retardation, fatigue, guilt/worthlessness, executive dysfunction, suicidal ideation
Depression
What 2 neurotransmitters are thought to be deficient causing depression?
Norepinephrine
Serotonin
HOw long do the antidepressants take to begin to cause noticeable change due to downregulation of receptors?
2-4 weeks
What are the 2 most common oral side effects with antidepressants?
Xerostomia and Dysgeusia
- phenelzine (Nardil)
- tranylcypromine
(Parnate) - drug-drug and
drug-food interactions
– hypertensive crisis
– serotonin syndrome
Monoamine Oxidase Inhibitors
(MAO-I)
- Defined by diastolic blood pressure > 120 mmHg
- Potentially fatal reaction characterized by:
– Occipital headache – may radiate frontally
– Palpitation
– Neck stiffness or soreness
– Nausea and/or vomiting
– Sweating
– Dilated pupils, photophobia
– Tachycardia or bradycardia
– Chest pain
MAO-I
Hypertensive crisis
Foods that contain _____ can cause interactions MAO-I
Tyramine
- Addition or increase of
known serotonergic agent to
an established medication
regimen - Other etiologies (infectious,
metabolic, substance abuse
or withdrawal) have ruled
out. - Antipsychotic has not been
started or increased prior to
the onset of sign/symptoms - Three of more of the
following symptoms:
– Agitation
– Diaphoresis
– Diarrhea
– Fever
– Hyperreflexia
– Incoordination
– Mental status changes
(confusion, hypomania)
– Myoclonus
– Shivering
– Tremor
Serotonin syndrome
WHat are TCAs used in now more than for depression?
Neuropathic pain
What are the 2 TCAs that we talked about?
Amitriptyline
Nortriptyline
What type of antidepressant has an additive effect with CNS depressants?
TCAs
– minimal to no effect on
H1, M1 or alpha1
receptors
– side effect profile - GI
upset, headache,
insomnia, restlessness,
anxiety, weight gain,
sexual dysfunction
SSRIs
What is the one class of antidepressant that cause bruxism?
SSRIs
The following are what type of drugs?
* fluoxetine (Prozac)
* paroxetine (Paxil, Paxil CR,
Pexeva)
* sertraline (Zoloft)
* citalopram (Celexa)
* escitalopram (Lexapro)
SSRIs
What drug interaction is important for SSRI?
NSAIDs
