Antidepressants: SSRIs Flashcards
What does SSRI stand for?
Selective serotonin reuptake inhibitors
What is the mechanism of action for SSRIs?
Selectively block/inhibit the reuptake of serotonin
What are some examples of SSRIs?
Fluoxetine
Sertaline
Paroxetine
Fluvoxamine
Can you take an SSRI with an MAOI (monamine oxidase inhibitor)? Why or why not?
No; SSRIs can interact adversely with MAOIs and other serotonergic drugs; these combinations must be avoided
What is the most common complaint with SSRIs?
Sexual side-effects
For SSRIs, who is at higher risk for suicidal ideation: Younger ages or older ages?
Younger ages;
When are people most likely to commit suicide?
After discharge
What is the chemical name for serotonin?
5-hydroxytryptamine (5-HT)
SSRIs selectively block the reuptake of serotonin, what kind of neurotransmitter is serotonin?
Monamine
Since the reuptake of serotonin is blocked, the concentration of serotonin (5-HT) in the synapse ______, causing increased activation of post-synaptic 5-HT receptors.
Increases
SSRIs block 5-HT receptors within hours of dosing, but relief of depression takes several weeks to fully develop. What is this suggesting?
Therapeutic effects are the result of adaptive cellular changes that take place in response to prolonged reuptake blockade
Do SSRIs block reuptake of dopamine or norepinephrine?
No
SSRI: Fluoxetine
Does fluoxetine block cholinergic, histaminergic, or alpha1-adrenergic receptors?
No
SSRI: Fluoxetine
Does fluoxetine produce CNS excitation or sedation?
Excitation
SSRI: Fluoxetine
Has death from overdose with fluoxetine been reported?
No
SSRI: Fluoxetine- Adverse effects
What are the most common side effects for fluoxetine?
Sexual dysfunction Nausea Headache Manifestations of CNS stimulation (nervousness, insomnia, and anxiety) Weight gain
Can SSRIs cause serotonin syndrome?
Yes; Begins 2-72 hours after treatment onset
If you are taking a SSRI drug, what would increase your risk of serotonin syndrome?
Concurrent use of MAOIs and other drugs
Of the SSRIs, which one (fluoxetine, sertraline, paroxetine, or fluvoxamine) is the least likely to cause a withdrawal reaction?
Fluoxetine
SSRIs: Use of fluoxetine and other SSRIs LATE in pregnancy poses a small risk for what 2 effects in the newborn?
- Neonatal abstinence syndrome (NAS)
- Persistent pulmonary hypertension of the newborn (PPHN)
Do fluoxetine and other SSRIs cause birth defects?
Probably not; and if they do, the risk is very low
What two SSRIs may cause septal heart defects in a newborn? Is this risk high or low?
Paroxetine and fluoxetine
Very low
SSRI: Sertraline
Sertraline blocks the reuptake of _____.
Sertaline relieves ______.
Sertaline causes CNS stimulation or sedation?
Sertraline blocks the reuptake of serotonin.
Sertraline relives symptoms of major depression.
Sertaline causes CNS stumulation
SSRI: Can sertraline be combined with MAOIs?
No
If you are on sertraline, and you need to start taking an MAOI, how long must the prescriber wait to start the MAOI after finishing the sertraline?
14 days
If you are taking an MAOI, and you need to start taking a sertraline, how long must the prescribe wait to start sertraline after finishing the MAOI?
14 days
SSRI: Paroxetine
What is this drugs mechanism of action?
Blocking the reuptake of seratonin
SSRI: Paroxetine
What pregnancy risk category is this drug and why?
D
Because of the small risk that the baby will of cardiovascular birth defects (primary ventricular septal defects)
SSRI: Fluvoxamine
Does this SSRI cause CNS stimulation or sedation?
Moderate sedative effects
All the SSRI drugs poses risks for what 4 things
HYPOnatremia
GI bleeding
NAS (neonatal abstinence syndrome)
PPHN (persistent pulmonary hypertension of the newborn)
ALL the SSRI drugs CANNOT be taken with what other antidepressant?
MAOIs
Which 3 of the 4 SSRIs cause CNS stimulation?
Fluoxetine
Sertraline
Paroxetine
Which of the SSRIs causes moderate CNS sedative effects?
Fluvoxamine
