Antidepressants- SSRI's Flashcards
What does SSRI stand for?
Selective serotonin reuptake inhibitors
What is the main use for SSRI’s?
Depression
What is the mechanism of SSRI’s?
Block the presynaptic serotonin reuptake
What are the 2 most commonly used SSRI’s?
Sertraline
Fluoxetine
What is the more useful SSRI post MI?
Sertraline
What tends to be the drug of choice when an antidepressant is indicated?
Fluoxetine
What is the most common side effect of SSRI’s?
Gastrointestinal symptoms- Increased risk of GI bleeding
What should be give if a patient is taking an SSRI and NSAID?
Proton Pump Inhibitor
How might a patient feel after starting on an SSRI?
Increasing anxious and agitated
What is the main adverse effect of citalopram?
Can cause a prolonged QT interval
In which patients should citalopram not be used?
Patients with:
• Congenital long QT syndrome
• Known pre-existing QT interval prolongation
• In combination with other medicines that prolong the QT interval
Which drugs to SSRI’s interact with?
NSAID's Warfrain/heparin Triptans Aspirin Monoamine Oxidase Inhibitors (MAOIs)
What do triptans increase the risk of when given with an SSRI?
Serotonin syndrome
What do Monoamine Oxidase Inhibitors increase the risk of when given with an SSRI?
Serotonin syndrome
When should a patient be reviewed after starting an Antidepressant?
After 2 weeks
When should patients under 30 or at increased risk of suicide be reviewed after starting an Antidepressant?
After 1 week
How long should a patient be kept on an antidepressant to prevent risk of relapse?
At least 6 months
When stopping an SSRI, over how long of a period should the dose be reduced?
Over a 4 week period
not with fluoxetine
What are the symptoms of discontinuation syndrome?
- increased mood change
- restlessness
- difficulty sleeping
- unsteadiness
- sweating
- gastrointestinal symptoms: pain, cramping, diarrhoea, vomiting
- paraesthesia
What does the use of SSRI’s in the first trimester of pregnancy increase the risk of?
Congenital Heart Defects
What does the use of SSRI’s in the third trimester of pregnancy increase the risk of?
Persistent pulmonary hypertension of the baby
What are the 2 main issues with Paroxetine?
Higher incidence of discontinuation symptoms.
Increased risk of congenital malformations, especially in first trimester
What are the characteristic features of sertraline?
Short half- life
needs to be taken with food- GI upset
What are the characteristic features of Fluoxetine?
Long half-life
Initially will increase anxiety and insomnia
What are the 2 main side effects of SSRI’s?
GI upset
Sexual dysfunction
What is the problem with taking an SSRI and NSAID?
Increase the risk of GI bleeding
