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Neuro_week7 > antidepressants and mood stabilizers > Flashcards

antidepressants and mood stabilizers Flashcards

1
Q

5 classes of antidepressants

A

1) SSRI = block 5HT presynap reuptake
2) SNRI = block 5-HT and NE reuptake
3) TCAD = block reuptake of 5-HT, NE , DA, and block muscarinic, H1, cholinergic, alpha1 receptor
4) MAOI = irreversible inhib MAO-A and MAO-B, incr 5-HT and NE
5) other

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2
Q

mechanism of SSRI

pluses

A

block 5HT presynap reuptake

plus = safe, effective, used in ED, GAD, PTSD, anxiety, panic, OCD, PMDD

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3
Q

minuses of SSRI

drug interaction

A

acute = diarrhea, nausea, jittery/anxiety, insomnia

long term = sexual decr, cog blurring, weight gain

interaction with P450 inhib

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4
Q

sertraline

what class

A

SSRI

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5
Q

fluoxetine what class

A

ssri

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6
Q

citalopram what class

A

ssri

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7
Q

paroxetine what class

A

ssri

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8
Q

mechanism of SNRI

pluses

A

block 5-HT and NE reuptake

more effective, better tolerate than TCAD
safe

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9
Q

SNRI minuses

A

sexual side effects
sweating
incr diastolic pressure
withdrawal symptom = electric shock + flu

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10
Q

venlafaxine what class

A

SNRI

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11
Q

TCAD mechanism

pluses

A

block 5-HT, NE, DA reuptake
block muscarinic, alpha1, H1, cholinergic receptors

time tested
effective esp severe depression
can check blood level

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12
Q

TCAD

minuses

A 
hypotension, 
orthostasis
weight gain
sexual side effect
10 day can lethal
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13
Q

MAOI mechanism

pluses

A

irrev inhib MAO-A and MAO-B incr 5-HT and NE

effective in nonresp patient esp atypical depression

time tested

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14
Q

MOAI minuses

A 
hypotension
orthostasis
dry mouth, constip, urinary retention
sexual side effect
weight gain

TYRAMINE = HYPERTENSIVE CRISS

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15
Q

Others
mirtazapine mech

pluses

A

blocks 5-HT2A, 5-HT2C, 5-HT3, alpha2 adrenergic

insomnia, anxiety, low sex side effect

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16
Q

mirtazapine minuses

A

daytime somnolence, weight gain

17
Q

Bupropion mechanism

pluses

A

incr whole body NE, weakly block reuptake of DA

no sex side effect,
weight neutral
equal to SSRI

18
Q

bupropion

minuses
don’t use when

A

incr anxiety,
ineffective in panic
inosmnia
incr seizure risk

DON’T USE IN EATING DIOSRDER OR SEIZURE

19
Q

first line antidepressant

if side effect too much use…

A

first line = SSRI

if too much side effect = bupropion but don’t use with anxiety

20
Q

All antidepressants have ___ response rates

A

ALL COMPARABLE

21
Q

general timeline of response to antidepressants

A

8-14 weeks before determine whether works

because need long term change like neurotrophic factors + altered gene expression

22
Q

what is only antidepressant therapy with more rapid side effects

A

ECT

23
Q

issues when treating bipolar

A

more complex than unipolar depression because TREATMENT OF DIFFERENT PHASES must be considered

ideal = anti-manic, antidepressive and prevent futrue episodes

24
Q

which is easier to treat bipolar mania vs bipolar depression

ex of drugs to treat mania and depression

A

bipolar mania

only 2 drugs for bipolar depression = quetipaine, lamotrigine, olanzapine + fluoxetine, lithium

antimaniac = lithium, atypical antipsych, divalproex, carbamazepine

25
Q

for maintenance of bipolar mania

for relapse of bipolar mania

A

lamotrigine
aripiprazole

lithium
olanzapine

26
Q

lithium
pluses

minuses

A

pluses = anti-maniac + some anti-depressant
anti-suicidal
neuro-regenerative
CHEAP

minuses = tremor, n, d, metal taste, thirst,
narrow window
toxic/lethal in O/D
DECR URINE CONCENTRATION, DIABETES INSIPIDUS
HYPOTHYROID

27
Q

DIVALPROEX SODIUM
PLUSES

MINUSES

A

plus = rapid loading, safe, effective

minus = not proven, weight gain, sedation

28
Q

atypical antipsych
positive

negative

A

positive= anti-maniac, safe, effective, rapid dose titration

negative = weight gain, diabetes, incr cholesterol/lipids, $$$

29
Q

episode prevention of bipolar mania

order best to worst

A

1) lithium
2) lithium + divalproex
3) ariprazole, olanzapine, lamotrigine

Neuro_week7 (17 decks)

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