Antidepressants

Question 1

SSRI
*MOA?
*SE?
*Examples?

Answer 1

*inhibit presynaptic reuptake of serotonin

*headaches, GI disturbance, drowsiness, sexual dysfunction, hyponatremia, weight gain, rebound anxiety

*Fluoxetine, Paroxetine, Citalopram, Escitalopram, Sertraline

Question 2

SNRI
*MOA?
*SE?
*Examples?

Answer 2

*Inhibit presynaptic reuptake of serotonin and NE

*Hypertension

*Venlafaxine, Duloxetine

Question 3

TCAs
*Overthose?
*SE?
*imp test to do first and why?

Answer 3

*overdose leads to arrhythmias
*sedation, weight gain, orthostatic hypotension, anticholinergic SE
*ECG to rule out long QT

Question 4

MAOIs
*Used for which specific kind of MDD?
*Risk of two things which are?
*most common SE?

Answer 4

*refractory depression (rarely used)
*hypertensive crisis when taken with sympathomimetics or tyramine rich foods (old cheese, liver, alcohol, smoked meats)

*risk of serotonin syndrome when taken with SSRI/SNRI

*orthostatic hypotension

Question 5

Novel agents
*MOA?
*Examples?

Answer 5

*serotonin agonists
*vilazodone, vortioxetine

Question 6

1st line for MDD with psychotic features?

Answer 6

Atypical antipsychotics combined with antidepressants AS WELL AS refractory MDD without psychotic features

Question 7

Serotonin syndrome
*when occurs?
*symptoms?
*tx?

Answer 7

*SSRI/SNRI overdose or when combined with TCAs or MAOIs

*autonomic instability (hypertension, hyperthermia), seizures, hyperthermia with clonus

*treated with Cyproheptadine