Antidepressants

Question 1

How long can it take to see antidepressant work? How long before you can see a maximal response?

Answer 1

1-3 weeks, maximal response=3 months

Question 2

If an antidepressant isnt effective what are the steps to take?

Answer 2

increase dosage

switch to another drug in same class

Switch to another drug in a different class

add a second drug (lithium or atypical antidepressant)

Question 3

Can you DC an antidepressant immediately?

Answer 3

no, must taper

Question 4

SSRI examples

Answer 4

celexa, lexapro, prozac, paxil, zoloft

Question 5

celexa, lexapro, prozac, paxil, zoloft

Answer 5

SSRI

Question 6

SNRI examples

Answer 6

Cymbalta, Effexor

Question 7

Cymbalta, Effexor

Answer 7

SNRI

Question 8

Nardil, Marplan

Answer 8

MAOI

Question 9

MAOI examples

Answer 9

Nardil, Marplan

Question 10

what is wellbutrin?

Answer 10

an atypical antidepressant

Question 11

what adverse effects are not seen with SSRIs

Answer 11

hypotension, sedation, cardiac toxicity

Question 12

Half life of Prozac is long so what do we have to remember about this SSRI?

Answer 12

patient may think they are ok if they stop taking it but will have withdrawal symptoms later

Question 13

Adverse effects of SSRI

Answer 13

sexual dysfunction, nausea, headache, insomnia, nervousness, weight gain, anxiety, Bruxism (teeth grinding)

Question 14

SSRI mechanism of action

Answer 14

Causes serotonin to accumulate in the synaptic space by blocking the reuptake pump

Question 15

When does serotonin syndrome begin?

Answer 15

2-72 hours after treatment

Question 16

serotonin syndrome s/s

Answer 16

altered mental status, tremor, fever, hyperflexia, excessive sweating

Question 17

what do you do if serotonin syndrome develops?

Answer 17

DC drug, will resolve spontaneously

Question 18

SSRI drug interactions

Answer 18

MAOI (increases risk for serotonin syndrome), Antiplatelet drugs, Warfarin (start warfarin at a low dose)

Question 19

How do SSRIs effect warfarin

Answer 19

it increases it so start warfarin at a low dose

Question 20

SNRI (effexor) mechanism of action

Answer 20

blocks NE and serotonin uptake

Question 21

adverse effects of SNRIs

Answer 21

weight loss/gain, liver function toxicity, insomnia, headache, sleepiness

Question 22

Tricyclic antidepressants adverse effects

Answer 22

sedation, orthostatic hypotension, cardiac toxicity, Seizures

Question 23

Tricyclic antidepressants are best used for which disorder?

Answer 23

major depression

Question 24

What foods must you avoid when taking an MAOI and why

Answer 24

Tyramine because it can trigger hypertensive crisis

aged cheese, red wine, chicken liver, sauerkraut

Question 25

MAOI mechanism of action

Answer 25

converts monoamine neurotransmitters (NE, serotonin and dopamine) into inactive products

Question 26

Sodium nitroprusside, phentolamine are used for what?

Answer 26

hypertensive crisis from too much tyramine while takin an MAOI