Antidepressants Flashcards
Which class of drug is first line for depression and give examples
SSRI Citalopram Sertraline Ecitalopram Paroxetine Fluoxetine (licensed for children and young people)
What is the MOA of SSRIs?
Increases extracellular serotonin by decreasing its reabsorption therefore serotonin stays in the synpatic cleft longer
What are some ADRs of SSRIs?
Sexual dysfunction - decreased libido Nausea Dry mouth Withdrawal - discontinuation syndrome Insomnia Hyponatraemia citalopram - prolonged QT interval
What is important to make patients aware of when prescribing SSRIs?
Increases risk of suicide in first 2 weeks
Also safe in OD
What are some examples of SNRIs?
Duloxetine
Venlafaxine
What is the MOA of SNRIs?
Inhibit the reuptake of both serotonin and noradrenaline by increasing extracellular conc in synaptic gap
therefore the post synapse fires more
What are the ADRs of SNRIs?
decreased libido may elevate BP loss of appetite weight loss sleep disturbance Similar ADRs to SSRIs
What are SNRIs normally used to treat?
major depressive disorder
What are some examples of TCAs?
Amitriptyline
Imipramine
What is the MOA of TCAs?
Block serotonin and noradrenaline transporters therefore increase concentration in synaptic gap
What are the ADRs of TCAs?
Mainly anti-muscarinic effects
- dry mouth
- dry nose
- blurry vision
- constipation
- urinary retention
- memory impairment
- increase body temp
- hyponatraemia
- sexual dysfunction
which antidepressants are dangerous in OD?
Tricyclic Antidepressants
cardiovascular and neurological toxicity
Which drug is a NaSSA?
Mirtazapine
What is the MOA in NaSSAs
Antagonist of alpha 2 receptors and certain serotonin receptors
Enhance adrenergic and seroternergic neurotransmission
What are the ADRs of NaSSAs
Constipation dry mouth Weight gain Increase in appetite Sleepiness
