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Psychiatry > Antidepressants > Flashcards

Antidepressants Flashcards

1
Q

SSRI with 1 week half life

A

Fluoxetine (Prozac)

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2
Q

What results in discontinuation syndrome

A

SSRI with short half life that is abruptly stopped

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3
Q

SE when SSRI and MAO-i are used in combination

A

Serotonin Syndrome

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4
Q

SSRI most likely to cause weight gain

A

Paroxetine (Paxil)

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5
Q

Washout period when switching from MAO-i to SSRI

A

2 Weeks

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6
Q

S-Enantiomer of Citalopram (Celexa)

A

Escitalopram (Lexapro)

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7
Q

Which SSRIs should be tapered to be discontinued and why?

A

Paroxetine (Paxil)
Fluvoxamine (Luvox)

Very short half lives

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8
Q

Common SE of SSRI that patients are embarrassed about

A

Sexual Dysfunction

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9
Q

SNRI MOA

A

Serotonin NE Reuptake Inhibitor

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10
Q

SNRI that is a psychoactive metabolite of another

A

Desvenlafaxine (Pristiq)

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11
Q

At what dose does Venlafaxine (Effexor) block reuptake of serotonin

A

All (Low, moderate, high)

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12
Q

What does Venlafaxine (Effexor) block at very high doese?

A

Blocks reuptake of Dopamine at >375mg/dl

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13
Q

Which SNRI is used for pain in depression or diabetic neuropathy pain

A

Duloxetine (Cymbalta)

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14
Q

When do you see poop-out syndrome (relapse)?

A

Like with SSRIs, patients take SNRI for depression -> get initial response -> continue taking medication but then experience this

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15
Q

Depressed patient started on SSRI/SNRI experiences activation and agitation. What is this?

A

Induced Bipolar State

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16
Q

What weird effect for women might venlafaxine (effexor) be useful for?

A

Hot Flashes/Flushes in Perimenopausal women

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17
Q

Common, Dose Dependent Cardiac SE of Venlafaxine (Effexor)

A

Increased BP (HTN)

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18
Q

What type of antidepressant is Buproprion (wellbutrin)

A

NDRI

19
Q

What category of antidepressant is useful for smoking cessation?

A

NDRI

20
Q

What specific SE does NDRI NOT have that SSRIs do?

A

Sexual Dysfunction

21
Q

What risk increase is seen with NDRI?

A

Seizures (increases from 0.4% to 4% at very high doses)

22
Q

What is NDRIs NOT useful for treatig compared to SSRI or SNRIs?

A

Anxiety Disorders

23
Q

What aspect of atypical depression may NDRIs be useful for?

A

Hypersomnia (>10 hr sleep per night)

24
Q

NDRI and weight

A

Decrease

25
Q

Besides depression, what else can NDRIs be considered for?

A

ADHD in children and adults due to stimulating effects

26
Q

How many weeks before onset of action with NDRIs?

A

2-4 weeks

27
Q

What does NaSSA stand for?

A

Noradrenergic and Specific Serotonergic Agent

28
Q

NaSSA MOA

A

Increases NE and Serotonin via:

Presyaptic a2- adrenergic antagonist

29
Q

Which antidepressants is an NaSSA Class

A

Mirtazepine (Remeron)

30
Q

Which SE seen with SSRI and Venlafaxine may be reveresed in NaSSA and via what receptor?

A 
GI SE (N/V/D, cramps)
This is via 5HT3 antagonism
31
Q

Which SE of Mirtazapine (Remeron)is not a problem if it hasn’t occured within the first 6 weeks of treatment?

A

Weight Gainn

32
Q

When do you see Serotonin Syndrome with Mirazapine (Remeron)

A

When it is taken with MAO-i at same time
OR
Within 2 weeks of each other

33
Q

What receptors does MIrtazapine (remeron) block?

A

Presynaptic Receptor
Serotonin Post Synaptic
Histamine Post Synaptic

34
Q

Which problems does MIrtazapine(remeron) have an almost immediate onset of action for?

A

Anxiety and Insomnia

35
Q

Does Mirtazapine(Remeron) affect CYP450 system?

A

No

36
Q

TCA Pairs of tertiary and secondary amines

A

Amitriptyline (Elavil) -> Nortriptyline (Pamelor)

Imipramine(Tofranil) -> Desipramine{(Norpramin)

37
Q

Anticholinergic SE of TCA

A

Blurred Vision
Urinary Hesitancy
Dry Mouth
Constipation

38
Q

Which gender might TCA be more effective than SSRI with regards to treating depression?

A

Males

39
Q

What p450 enzyme is correlated with TCA concentration?

A

Cytochrome P450 2D6; Blocking this may increase TCA concentration

40
Q

TCA SE: Dizziness, Sedation, Hypotension is caused by blockage of what receptor?

A

a1-adrenergic receptor

41
Q

What receptor blockade causes SE of sedation and weight gain with TCA?

A

H1 receptor block

42
Q

TCA MOA

A

Serotonin and NE Reuptake Inhibitor

43
Q

What is a dangerous SE of TCA

A

Cardiac Arrhythmias due to blockage of sodium channels

Seen with TCA overdose

Psychiatry (7 decks)

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