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Psych Shelf > Antidepressants > Flashcards

Antidepressants Flashcards

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1
Q

Major categories of antidepressants

A

Selective Serotonin Reuptake Inhibitors (SSRIs)
Heterocyclic antidepressants (TCAs and tetracyclic antidepressants)
Monoamine Oxidase Inhibitors (MOAIs)

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2
Q

Most antidepressants require a trial of how long for noticeable effects

A

3-4 weeks

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3
Q

antidepressant withdrawal phenomenon sx?

A

dizziness, headaches, nausea, insomnia, and malaise

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4
Q

why are SSRIs the most commonly prescribed antidepressants?

A

low incidence of side effects and most resolve with time, no food restrictions, and much safer in overdose

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5
Q

6 examples of SSRIs

A

Fluoxetine, Sertraline, paroxetine, fluvoxamine, citalopram, escitalopram

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6
Q

SSRI with highest rick of GI disturbances

A

Sertraline (zoloft)

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7
Q

SSRI safe in pregnancy and used in children

A

Fluoxetine (prozac)

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8
Q

SSRI with anticholinergic like side effects of sedation, constipation, weight gain

A

Paroxetine (paxil)

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9
Q

SSRI with short half life leading to the withdrawal phenomena more often

A

Paroxetine

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10
Q

SSRI with fewest drug-drug interactions and fewer sexual side effects

A

Citalopram

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11
Q

what should you worry about in somebody who is taking a high dose SSRI and cough medicine

A

serotonin syndrome- over the counter cold remedies have drugs that increase serotonin

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12
Q

sexual side effects of SSRIs can be treated how?

A

augmenting the regimen with buproprion, changing to a non-SSRI antidepressant or by adding a medication like sildenafil for men

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13
Q

what is the FDA’s black box warning against all SSRIs for

A

“increased suicidal thinking and behavior”

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14
Q

side effects of SSRIs

A

sexual dysfunction, GI disturbances, insomnia, headache, anorexia, weight loss, restlessness, seizures and of course serotonin syndrome

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15
Q

what drugs taken with SSRIs increases risk for serotonin syndrome

A

MAOIs, triptans, over the counter cough remedies

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16
Q

SSRIs can increase levels of which drug which requires increased monitoring when starting and stopping these medications

A

warfarin

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17
Q

Venlafaxine, and duloxetine are what class of drug?

A

serotonin-norepi reuptake inhibitors (SNRIs)

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18
Q

Venlafaxine is often used for what?

A

generalized anxiety disorder

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19
Q

Venlafaxine should not be used in what kind of patients

A

patients with untreated or labile blood pressure (can increase blood pressure)

20
Q

Duloxetine is often used for ?

A

depression and neuropathic pain or in fibromyalgia

21
Q

Duloxetine may show more side effects in which kind of patients

A

liver disease or heavy alcohol use patients may have increased liver side effects

22
Q

antidepressant with relative lack of sexual side effects

A

Bupropion (wellbutrin)

23
Q

antidepressant that can lower seizure threshold

A

Bupropion

24
Q

Bupropion should be used with caution in which patients?

A

patients with epilepsy and eating disorders (lowers seizure threshold)

25
Q

Serotonin Receptor Antagonists and agonists

A

Trazodone and Nefazodone

26
Q

Positives of Trazodone and Nefazodone

A

do not have sexual side effects and do not affect rapid eye movement sleep

27
Q

Indications for Trazodone and Nefazodone

A

refractory major depression, major depression with anxiety and insomnia

28
Q

Nefazodone carries a black box warning for?

A

rare but serous liver failure

29
Q

alpha2-adrenergic receptor antagonist used as antidepressant

A

Mirtazapine (remeron)

30
Q

used for depression in elderly because it helps with sleep and appetite

A

mirtazapine

31
Q

Mirtazapine side effects?

A

sedation, WEIGHT GAIN (useful in pts who need to gain weight), dizziness, somnolence, tremor, dry mouth, constipation and rare agranulocytosis

32
Q

mainstay for TCA overdose

A

IV sodium bicarbonate

33
Q

TCA useful in enuresis and panic disorder

A

Imipramine

34
Q

TCA useful in treatment of OCD

A

Clomipramine

35
Q

TCA least likely to cause orthostatic hypotension

A

Nortriptyline

36
Q

TCAs in general are useful in treating?

A

chronic pain

37
Q

major complications of TCA’s

A

cardiotoxicity, convulsions, coma

38
Q

EKG changes due to TCAs

A

widening qrs, qt and pr intervals

39
Q

what must you assess before prescribing TCAs

A

SUICIDE RISK - they are lethal in overdose

40
Q

prevent the inactivation of biogenic amines such as norepi, serotonin, dopamine, and tyramine

A

MAOIs

41
Q

MAOIs are very effective in treating which conditions?

A

refractory depression and refractory panic/anxiety disorders

42
Q

Name 3 MAOIs

A

phenelzine, tranylcypromine, isocarboxazid, selegiline

43
Q

which MAOI used to treat depression does not require following dietary restrictions when used in low doses but decongestants and serotonergic drugs must still be avoided

A

selegiline

44
Q

foods to avoid when taking a MAOI

A

foods with tyramine (red wine, cheese, chicken liver, fava beans, cured meats). will give you a hypertensive crisis

45
Q

most common side effect of MAOIs

A

orthostatic hypotension

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