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Psychiatry > Antidepressants > Flashcards

Antidepressants Flashcards

1
Q

What drugs are first line for depression?

A

SSRIs

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2
Q

What is the mechanism of action of SSRIs?

A

selectively inhibits reuptake of 5HT from postsynaptic cleft

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3
Q

What does SSRI stand for?

A

selective serotonin reuptake inhibitors

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4
Q

What are some examples of SSRIs?

A

sertraline
citalopram
fluoxetine

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5
Q

What SSRI is licensed in children?

A

fluoxetine

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6
Q

What SSRIs are safe in pregnancy?

A

sertraline and fluoxetine

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7
Q

What SSRI is good for use in patients with epilepsy?

A

citalopram

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8
Q

What SSRI can prolong the QTc interval?

A

citalopram

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9
Q

What SSRI is good for use in patients with cardiac problems?

A

sertraline

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10
Q

What are some discontinuation side effects of SSRIs? How can these be avoided?

A

diarrhoea
sweating
postural hypotension

gradually decrease dose over 4 weeks instead of coming off all at once

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11
Q

What are the side effects of SSRIs?

A 
sexual dysfunction 
vivid dreams 
headache 
nausea 
sweating
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12
Q

SSRIs are safe in overdose - true or false.

A

True

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13
Q

When should you take SSRIs?

A

in the morning

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14
Q

How long should an antidepressant be trialled before trying something else?

A

4-6 weeks

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15
Q

Which antidepressant can cause an increase in suicidal idealisation in under 25s?

A

SSRIs

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16
Q

What antidepressant class should you try if SSRIs aren’t working?

A

SNRIs

17
Q

What does SNRI stand for?

A

serotonin and noradrenaline reuptake inhibitors

18
Q

What is the mechanism of action of SNRIs?

A

block reuptake of NA and 5HT into presynaptic cleft

19
Q

What are some examples of SNRIs?

A

duloxetine

venlafloxine

20
Q

When should you take SNRIs?

A

IN the morning

21
Q

What are some examples of tricyclic antidepressants?

A

amitryptilline
lifepramine
imipramine

22
Q

Are tricyclics toxic in overdose?

A

Yes - cardiotoxic

don’t give to people with a history of suicide attempt by overdose

23
Q

What is the mechanism of action of tricyclic antidepressants?

A

block reuptake of NA and 5HT

24
Q

When do you take tricyclic antidepressants? Why?

A

At night - sedation

25
Q

What are the side effects of tricyclic antidepressants?

A

weight gain
anticholinergic effects - dry mouth, constipation, urinary retention
arrhythmias
postural hypotension

26
Q

What is the mechanism of action of monoamine oxidase inhibitors?

A

inhibit MAO A and B enzymes

27
Q

What are some examples of MAO inhibitors?

A

phenylzine

mobeclomide

28
Q

When are MAO inhibitors used? Why?

A

IN resistant depression - due to side effects and diet restriction

29
Q

Why is diet restricted with MAO inhibitors?

A

Can cause hypertensive crisis
Build up of tyramine (usually broken down by MAO enzymes) - in certain foods e.g. cheese, chocolate
Potent releasor of NA –> hypertension

30
Q

What are some symptoms of hypertensive crisis?

A

nose bleeds
anxiety
SOB
headache

31
Q

How is a hypertensive crisis treated?

A

phentolamine infusion

32
Q

What are some side effects of MAO inhibitors?

A 
insomnia 
postural hypotension 
jaundice 
oedema 
rare - liver damage
33
Q

What does NaSSA stand for?

A

noradrenergic and specific serotonergic antidepressant

34
Q

What is an example of NaSSA?

A

mirtazapine

35
Q

When is mirtazapine used?

A

If SSRI/SNRIs haven’t worked

36
Q

What is the mechanism of action of mirtazapine?

A

blocks alpha 2 and 5-HT 2 and 3

37
Q

What can you give with mirtazapine to stop the seratonergic side effects?

A

SSRI

38
Q

What are side effects of mirtazapine?

A

weight gain

sedation - good in insomnia

39
Q

What happens if you take mirtazapine with alcohol?

A

GI upset

Psychiatry (12 decks)

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