Antidepressants Flashcards
Antidepressant associated with higher risk of withdrawal symptoms
Venlafaxine
First line antidepressant class
SSRIs
Only licensed reversible MAOI
Meclobemide
Interactions of MAOIs
- tyramine (cheese, pickled herring, broad bean pods, marmite, yeast)
- indirect acting sympathomimetics (in some cough/decongestants)
How long after MAOI can cheese reaction occur?
2 weeks
What are the symptoms of the MAOI interaction
throbbing headache due to dangerously high rise in BP
Can you give MAOIs with other antidepressants
this is considered very dangerous except in experienced hands
2 weeks between SSRI and starting MAOI (5 weeks for fluoxetine)
Can you drink with MAOIs
pt should be advised not to drink or to drink de-alcoholised drinks
Can the cheese reaction still occur if the MAOI is reversible
Yes - avoid large amounts. Risk is less than traditional.
Antidepressant action can begin …. weeks after begining
2 weeks
Before symptoms of depression improve what symptoms might be experienced
aggitation
anxiety
suicide risk
Why is the first line class for depression first line?
less dangerous in overdose and better tolerated
TCAs have what side effect profile compared to SSRIs?
more antimuscurinic, more sedating and less cardiotoxic
following remission how long should antidepressant treatment be continued for?
6 months
12 months in the elderly
12 months with anxiety disorder as relapse risk is higher
All types of antidepressant are associated with what electrolyte change?
Hypernatraemia (most common with SSRIs)