Antidepressants Flashcards
What is key with antidepressants?
safety safety safety
bc of increased risk of suicide within the first week of taking it
What are the different SSRIs
- Citalopram
- Escitalopram
- Fluoxetine
- Paroxetine
- Sertraline
What are SSRIs useful in tx for?
- Depression w anxiety
- Panic disorder
- PTSD
- OCD
- bulimia
Side effects of SSRIs
- Sleep disturbance
- Sexual dysfunction
- Reduced appetite
- Rash/SJS
- Tension headaches
- Hyponatremia
How long does it take SSRIs to take full effect?
2-3 weeks for full effect
Symptoms of serotonin syndrome
SHIVERS
Shivering
Hyperreflexia
Increased temp
VS instability
Encephalopathy
Restlessness
Sweating
Do SSRIs increase bleeding tendencies?
YES
What are the different SNRIs?
- Venlafaxine
- Desvenlafaxine
- Duloxetine
- Levomilnacipran
Do SSRIs and SNRIs have the same symptoms?
yes
What are SNRIs useful in tx for?
- MDD
- anxiety disorder
What are the adverse effects of SNRIs?
Serotonin syndrome
Hyponatremia
What is trazodone used for?
mainly used for sleep but its an antidepressant
What should be known about trazodone?
- extremely sedating
- CAN be given in adjunct with SSRIs
What is an adverse effect of Trazodone?
Priapism
aka painful erect penisssss
What are the different TCAs?
- Amitriptyline
- Doxepin
- Imipramine
- Nortriptyline
What stimulating effects do TCAs target?
Target fatigue and lethargy
What sedating effects do TCAs target?
target agitation or restlessness
What are the anticholinergic side effects of TCAs?
- Dry Mouth
- Blurred vision
- Tachycardia
- Constipation
- Urinary retention
- Esophageal reflux
- Photophobia
- Sexual dysfunction
What two anticholinergic effects of TCAs are considered a medical emergency?
constipation and urinary retention
How long odes it take for TCAs to reach full effect?
4-8 weeks
What are the adverse effects of TCAs?
- orthostatic hypotension
- Dysrythmias
- MI
- Heart block
Which medication class is very cardio toxic?
TCAs
What are the contraindications of TCAs?
- Recent MI
- Narrow angle glaucoma
- Benign prostatic
- Hypertrophy
- seizures
- preggo
What are the different MAOIs?
- Phenelzine
- Tranylcypromine
- Isocarboxazid
- Selegiline
What can MAOIs cause?
HTN crisis
What are the symptoms of a HTN crisis?
- Severe HA or blurry vision
- chest pian
- tachycardia
- SOB
- Diaphoresis
- Anxiety
- Mental status change
- confusion
N/V
If switching from SSRI to MAOI how long is the wash out period?
5 week cleanse
if switching from MAOI to SSRI how long is the cleanse?
14 days
What foods do you avoid when taking MAOIs?
tyramine foods need to be avoided
Will cause HTN if eaten
What are the contraindications of MAOIs?
- CVD
- HTN
- CHF
- liver disease
- recurrent ot severe HA
- Recent surgery
Which antidepressant is mainly used for smoking cessation and prevention of seasonal depression?
Buproprion
What are the adverse effects of bupropion?
- Appetite suppression
- seizures
What medication targets suicide ideation?
Ketamine
How can Ketamine be administered?
IV and nasal
What are the side effects of ketamine?
increased BP, HR
Disassociation
alternative treatments for depression
light therapy
st johns wort
