Antidepressants Flashcards
SSRIs
Fluoxetine
Sertraline
Paroxetine
Citralopram
3-4 weeks to start working
SE:
Sexual dysfunction – decreased libido, aorgasma
Serotonin sn
Serotonin Sn sx
Hyperthermia Hyperreflexia Myoclonus Autonomic instability – HTN, tachy -> CV collapse Flushing D Mental status change
Tx: stop med
Cool pt
Benzodiazepines
Cyproheptadine
Medications taken with SSRI that cause serotonin syndrome
SSRI SNRIs MAOIs Triptans St. John’s wort Kava Kava Tryptophans Amphetamines
SNRIs
Venlafaxine
Desvenlafaxine
Duloxetine
Milnacipram – (not depression tx, fibromyalgia)
Tx:
Depression
Generalized anxiety disorder
Chronic pain (duloxetine)
SE:
Elevated BP
Anxiety
N
Sedation
TCA drug names
Amitriptyline Nortriptyline Clomipramine Desipramine Imipramine Amoxapine Doxepin
TCA uses and adverse effects
Block NE and 5HT
Rarely used in depression
Enuresis – imipramine
OCD – clomipramine
Fibromyalgia and neuropathic pain – amitriptyline
SE: Sedation Hypotenion – block alpha Dizziness Anticholinergics
High dose -> QT elongation and arrhythmias
Narrow TI
OD: Tri-C’s
Cardiotoxicity
CNS toxicity
antiCholinergic sx
Tx: OD: bicarb -> more drug bound to protein
Monoamine oxidase inhibitors
Tranylcypromine
Phenelzine
MAO-B specific – tx parkinsons
Selegiline
Rasagiline
Increase 5HT and NE
SE: Serotonin Sn Hypertensive crisis w/ ingestion of tyramine – stimulates NE release -brown bananas -wine -aged cheese -Soy sauce -aged beef
Buproprion
NE/D reuptake inhibitor
Depression
Smoking cessation
Stimulant effect
Decreased seizure threshold
No sexual dysfunction
Mirtazapine
Alpha 2 antag -> NE release
5ht 2, 3 antagonists
SE:
Antihistamine effects
-sedation
-dry mouth
increased appetite -> wt gain
Serotonin modulators
Trazodone
Nefazadone
Inhibit 5HT reuptake
Use: depression – high dose
Insomnia
SE:
Sedation
PRIAPISM!
Electroconvulsive therapy
Controlled, painless seizure
Tx refractory depression
Catatonic schizophrenia
Pregnancy/postpartum depression
SE: disorientated, amnesia
