Antidepressants

Question 1

What is the action of SSRI antidepressants?

Answer 1

Prolongs serotonin

Question 2

When are SSRI antidepressants used?

Answer 2

Depression, anxiety, eating disorder

Question 3

What is the action of SSNRI antidepressants?

Answer 3

Inhibits reuptake of serotonin and norepinephrine

Question 4

When are SSNRI antidepressants used?

Answer 4

Depression, anxiety, neuropathic pain

Question 5

What are the side effects of SSRI & SSNRI antidepressants?

Answer 5

Neuroleptic malignant syndrome, suicidal thoughts, dizziness, insomnia, dry mouth, sexual dysfunction, decreased libido, anorgasmia

Question 6

What are specific severe side effects that can occur with SSNRI antidepressants?

Answer 6

Hepatotoxicity & Steven-Johnson Syndrome

Question 7

What is a severe side effect that can occur with SSRI & SSNRI antidepressants?

Answer 7

Serotonin syndrome

Question 8

What are the side effects of Serotonin Syndrome?

Answer 8

Involuntary muscle twitches, muscle spasms, hyperthermia, tachycardia, agitation, delirium, coma, seizures

Question 9

What cause Serotonin Syndrome?

Answer 9

Overdose of serotonin

Question 10

What are considerations with SSRI & SSNRI’s?

Answer 10

Mental status or suicidal thoughts
Serotonin syndrome
Rash
BP
Sexual dysfunction
Pain

Question 11

When should a patient take SSRI & SSNRI’s?

Answer 11

Morning with or without meals

Question 12

What is the action of tricyclic antidepressants?

Answer 12

Block uptake of serotonin and norepinephrine

Question 13

When is a tricyclic antidepressant used?

Answer 13

Depression, enuresis (bedwetting), neurogenic pain

Question 14

What are the side effects of tricyclic antidepressants?

Answer 14

Suicidal thoughts, drowsiness, fatigue, sedation, arrhythmias, urinary retention, constipation

Question 15

What can happen to a patients symptoms when taking an antidepressant?

Answer 15

Worsen before getting better

Question 16

What are some considerations when taking tricyclic antidepressants?

Answer 16

Suicidal thoughts
Restrict amount to patients
BP and pulse
Sexual dysfunction
Pain
CBC, glucose, LFT

Question 17

When should tricyclic antidepressants be taken?

Answer 17

Bedtime with food to minimize GI upset

Question 18

What is common with tricyclic antidepressants?

Answer 18

Overdose and toxicity - 80% result in death

Question 19

What do you do with a patient overdoses on a tricyclic antidepressant?

Answer 19

Treat symptoms- arrhythmias, seizures, hallucinations, fever

Question 20

What is the action of MAO antidepressants?

Answer 20

Inhibit MAO enzyme system in the CNS

Question 21

When are MAO antidepressants used?

Answer 21

Depression

Question 22

What are the side effects of MAO antidepressants?

Answer 22

Seizures, akathisia, ataxia, hypertensive crisis, headache, photosensitivity, blurred vision

Question 23

What should patients avoid when taking MAO antidepressants?

Answer 23

Food and beverages that contain a high tyramine content

Question 24

What are some foods that have a high tyramine content?

Answer 24

Alcohol, red wines

Bananas, smoked or pickled meats, aged cheese, sauerkraut, gravy

Question 25

How should you discontinue the use of MAO antidepressants?

Answer 25

Washout period of 2 weeks when switching from MAO's to another antidepressant

Question 26

What are some considerations when a patient is taking an MAO antidepressant?

Answer 26

``` Mental status Hypertensive crisis Restrict amount of drug available BP and pulse Sexual dysfunction Peripheral edema or urinary retention LFT, glucose labs ```

Question 27

What is the patient teaching associated with antidepressants?

Answer 27

Look for signs or symptoms of suicidality Do not stop abruptly Drug effects won't be noticed for 2-4 weeks Avoid alcohol or other CNS depressants Avoid herbal supplements Photosensitivity Women should change forms of oral contraception