Antidepressants Flashcards
What is the most common psychiatric illness?
Depression
What percent of Americans will experience depression at some point in their lives?
30%
What are some non-drug therapies that help treat depression?
Excercise
Nutrition
Spiritual Health
Therapy
Common Monoamine Oxidase Inhibitors (MAOIs)
Isocarboxazid
Phenelzine
Selegiline transdermal
Tranylcypromine
MAOIs are prescribed for what?
major depression
What is the enzyme that breaks down dopamine, norepinephrine, and serotonin?
Monoamine oxidase
MAOIs increase what in the brain’s synapses?
Serotonin
Norepinephrine
Dopamine
What should clients who are taking MAOIs avoid?
Foods that contain tyramine
Rule of thumb for foods containing tyramine
“Old” and “Stinky”
What process produces high levels of tyramine in foods?
Aging Process
Anytime a client takes an MAOI, what happens to the serotonin, norepinephrine, and dopamine levels?
There is going to be a significant increase in the levels.
Clients must avoid what kind of other drugs that increase these MAOI neurotransmitters?
Other antidepressants
Over-the-counter cold medications
Meperidine (pain med)
Triptans (migraine meds)
What will happen is a client uses excessive amounts of tyramine?
Their blood pressure will skyrocket.
High norepinephrine levels will do the same.
What is characterized by an altered mental status, high fever, sweating, and clonus?
Serotonin Syndrome
What is clonus?
An involuntary, rhythmic muscle contraction
Many clients taking MAOIs experience what?
Hypertensive Crisis
Serotonin Syndrome
Orthostatic Hypotension
Common Trycyclic Antidepressants (TCAs)
Amitriptyline
Nortriptyline
TCAs are prescribed for what?
Major Depression
Neuropathic Pain
Anxiety Disorders
TCAs work by blocking what?
Serotonin and norepinephrine reuptake pumps.
Serotonin and norepinephrine levels are increased in synapses.
TCAs are not selective, so they also block muscarinic cholinergic receptors causing what?
Anticholinergic Effects (Can’t See, Can’t Pee, Can’t Spit, Can’t Defocate)
Many clients taking TCAs experience what?
Anticholinergic Effects
Orthostatic Hypotension
Cardiotoxicity
What is the most serious problem with TCAs?
They can cause fatal heart dysrhythmias when overdosed. It can also cause suicidal thoughts.
Common Selective Serotonin Reuptake Inhibitors (SSRIs)
Escitalopram
Fluoxetine
Paroxetine
Sertraline
SSRIs are first-line drugs for what?
Depression
Anxiety
SSRIs are very selective and only block what?
Serotonin reuptake pump increasing levels of serotonin in the brain
What are some side effects associated with SSRIs?
Stomach troubles Slow metabolism Sexual dysfunction Suicidal ideas Sedation (except for Fluoxetine)
Common Serotonin Norepinephrine Reuptake Inhibitors (SNRIs)
Duloxetine
Venlafaxine
SNRIs are prescribed for what?
Major Depression
Neuropathic Pain
Anxiety
SNRIs are very selective and only block what?
Serotonin and norepinephrine reuptake pumps
What are some side effects associated with SNRIs?
Similar to SSRIs (5 S’s) except they can cause hypertension also
Bupropion
Prescribed for Depression, Smoking Cessation, Adult ADHD
Inhibits reuptake of dopamine and norepinephrine
No significant effect on serotonin
INCREASES LIBIDO
Side Effects: Anxiety and Insomnia
Contraindicated in clients with risk of seizures
Trazadone
Prescribed for Depression and Insomnia
Weak inhibitor of serotonin with strong sedative and anticholinergic effects
Can cause priapism(prolonged, painful erection)
Two common themes in clients taking antidepressants
- It takes a few weeks to start working. Don’t give up!
2. Most have a black box warning regarding an increased risk of suicidal thoughts. Most common <18.
