Antidepressants

Question 1

MoA of TCAs

Which receptors do TCAs bind to?

Answer 1

Blocks reuptake of 5-HT and NA

M1
H1
Alpha1

Question 2

Side effects of blocking M1 receptor

Answer 2

1. Dry mouth, blurred vision

2. Urinary retention, constipation

Question 3

Side effects of blocking H1 receptor

Answer 3

1. Sedation

2. Weight gain

Question 4

Side effects of blocking Alpha1 receptor

Answer 4

Arrrhythmias

Question 5

Which antidepressants are absolutely contraindicated in pregnancy

Answer 5

1. Buproprion (dopamine reuptake inhibitor)

2. Old and new MAOi

Question 6

Which antidepressants are contraindicated in pts with heart arrythmias/ other defects

Answer 6

1. TCAs

2. SNRIs

Question 7

Order of drugs to give for depression

Answer 7

1. Fluoxetine (SSRI)
2. Citalopram (SSRI)
3. Mirtazapine (atypical)
4. Venlafaxin (SNRI)
5. Li or ECT if severe depression + bipolar

Question 8

How long to wait if switching from MAOI to SSRI or vice versa

Answer 8

Changing drugs:
MAOI to SSRI: 2 weeks break

SSRI to MAOI: 5 weeks break

Question 9

SSRI side effects

Answer 9

• Precipitates anxiety in first 2-3 weeks
• Sexual dysfunction
• Nausea, constipation
• Weight gain
• Drowsiness, blurred vision, headache
• Dry mouth

Question 10

SNRI side effects

Answer 10

COMMON

• Nausea, constipation
• Headache

UNCOMMON

• Agitation
• Postural hypotension
• Uncontrolled hypertension

Note: contraindicated with arrythmia

Question 11

Which antidepressant can cause bone marrow suppression

Answer 11

Mirtazipine