Antidepressants

Question 1

Causes

Answer 1

Results from a deficiency of norepinephrine (controls attentiveness, emotions, sleeping, dreaming and learning) and serotonin (regulates mood, sleep, appetite, energy level, cognitive function, psychomotor function).

Question 2

Antidepressants usage

Answer 2

Treatment of depression, migraine, chronic pain, menopausal symptoms and sleep disorders

Question 3

Mechanism of action

Answer 3

Actions are immediate but takes several weeks to affect mood.

Question 4

Types of antidepressants

Answer 4

First Gen- tricyclic antidepressants, monoamine oxidase inhibitors
Second Gen- SSRIs and atypical antidepressants

Question 5

Indications for use

Answer 5

-mdd symptoms persisting at least 2 weeks, tx of anxiety disorders, tcas may be used in children and adolescents in management of enuresis, and commonly used for treatment of neuropathic pain. Maoi considered 3rd line drugs

Question 6

Specific SSRIs

Answer 6

-citalopram (Celexa)
- escitalopram (Lexapro)
- fluoxetine (Prozac)
- paroxetine (Paxil)
- sertraline (Zoloft)
- vortioxitine (trintellix)
- vilazodone (Viibryd)

Question 7

SSRIs

Answer 7

• usually administered once daily in the am, oral, allows serotonin to remain longer in synaptic cleft, safer and less side effects.
  -undergo extensive first-pass metabolism in the liver.

Question 8

Fluoxetine (Prozac)

Answer 8

Adverse effects- gi symptoms, sexual dysfunction, cns stimulation, severe agitation, self harm or harm to others.

Question 9

Serious SSRIs stuff

Answer 9

• they should not be taken concurrently or within 2 weeks of each other.
• avoid herbal remedies
• Ssri discontinuation syndrome