Antidepressants and Antipsychotics Flashcards
What are some common effects of adrenergic receptor agonism?
Sweating
Tremor
Headaches
Nausea
Dizziness
What are some common effects of muscarinic receptor agonism?
Dry mouth + thirst (+dysphagia)
Urinary retention/difficulty urinating
Hot and flushed skin
Dry skin
What are some common effects of histamine receptor agonism?
Dry mouth
Drowsiness
Dizziness
N+V
What neurotransmitter system do most anti-depressants act on?
Serotonin
What do most serotonin related anti-depressants aim to do?
Increase serotonin activity at post-synaptic receptors
How long can it take for most anti-depressants to begin working?
2-3 weeks
What is the most commonly used type of anti-depressant?
SSRI’s (Selective serotonin re-uptake inhibitors)
What are some other types of ant-depressant’s?
NSRI’s (noradrenaline and serotonin re-uptake inhibitors)
Mirtazapine
Tricyclics
MAOI’s (Mono-amine oxidase inhibitors)
How doe SSRI’s exert their effects?
By increasing serotonin activity at post-synaptic receptors
How do SSRI’s increase serotonin activity?
Reducing the pre-synaptic re-uptake of serotonin after its release
What does the reduction of the pre-synaptic re-uptake of serotonin result in?
More serotonin sitting in the nerve junction
Other than increased serotonin in the nerve junction, what effect do SSRI’s have on the nerve junction?
Down regulates post-synaptic serotonin receptors
What are some common side-effects of SSRI’s?
Restlessness and agitation on initiation Nausea/GI disturbances Headaches Weight changes Sexual dysfunction
Bleeding and suicidal ideation (less common and usually age related)
What are some examples of SSRI’s?
Sertraline
Citalopram
Escitalopram
Fluoxetine
Paroxetine
What is the dose range for sertraline?
50 - 200mg
In the context of what group of non-psychiatric conditions is sertaline considered the safest?
Cardiac disease
What is the dose range for citalopram?
20 - 40mg
What is the dose range for escitalopram?
10 - 20mg
What must be considered when prescribing citalopram/escitalopram?
QTc prolongation
What is the dose range for fluoxetine?
20 - 60mg
What must be considered when switching from fluoxetine?
Serotonin syndrome
What is the dose range for paroxetine?
20 - 60mg
What must be considered when stopping paroxetine?
Discontinuation syndrome
What does NSRI stand for?
Noradrenaline and serotonin re-uptake inhibitors