Antidepressants and depression Flashcards
1
Q
What are 5 symptoms of depression?
A
- Significant weight loss
- Depressed mood
- Diminished interest or pleasure
- Insomnia or hypersomnie
- Psychomotor agitation or retardation
- Fatigue or loss of energy
- Feelings of worthlessness or excessive or inappropriate guilt
- Diminished concentration and indecisiveness.
2
Q
What is the rationale for drug use in major depression?
A
Relieve psychological and physical symptoms.
o Improve functional capacity.
o Reduce the likelihood of self-harm or suicide.
3
Q
What is the MOA of SSRIs?
A
- electively inhibit the presynaptic reuptake of serotonin
4
Q
What is the MOA of TCAs?
A
- inhibit reuptake of noradrenaline and serotonin into presynaptic terminals
4
Q
What is the MOA of SNRIs?
A
- Inhibit serotonin and noradrenaline reuptake.
5
Q
What is the MOA of MAOIS?
A
- irreversibly inhibit monoamine oxidases A and Bincreasing the synaptic concentrations of adrenaline, noradrenaline, dopamine and serotonin
6
Q
What are three AEs of TCAs?
A
- increased heart rate, postural hypotension and arrhythmia
7
Q
What are three AEs of SSRIs?
A
- nausea, diarrhoea, anxiety, agitation, insomnia, headache and drowsiness.
8
Q
What are three AEs of SNRIs?
A
- nausea, dry mouth, constipation, sweating and dizziness
9
Q
What are there AEs of MAOIs?
A
- othostatic hypotension, sleep disturbances, headache, dowsiness and fatigue.
10
Q
What are two things you should tell a patient going on SSRIs?
A
- Monitor pts frequently for SI and behaviours at start of treatment and when stopping, taper over several weeks to avoid withdrawal effects, reduce daily dose by ½ no faster than weekly.
11
Q
What are two things you should tell a patient going on TCAs?
A
- Monitor pts frequently for SI and behaviours at start of treatment, withdraw slowly to avoid withdrawal and adverse effects may appear early but the therapeutic response is delayed by 2 weeks
12
Q
What are two things you should tell a patient going on SNRIs?
A
- Monitor pts frequently for SI and behaviours at start of treatment, taper dose over 4 weeks to minimise withdrawal effects
13
Q
What are two things you should tell a patient going on MAOIs?
A
- Avoid foods containing tyramine during and 2 weeks after stopping treatment. Eat fresh or fresh frozen foods, avoid matured or out of date cheeses, yeast, soybean and protein extracts
14
Q
What is serotonin toxicity?
A
- Too much serotonin in brain synapses
