Depression Flashcards
True or false: Antidepressants should be used for mild depression
FALSE - Psychological therapies are first line
How long does it usually take before the effects of an SSRI are noticed ?
3 - 4 weeks
How long should antidepressants be continued after remission to prevent relapse?
6 months
2 years if they are at high risk of relapse or history of recurrent depression
Increased risk of suicide when treatment with an antidepressant is started, particularly in patients aged _______
Under 30 years old
Which SSRI is known to have a long half life
Fluoxetine
How long of a wash out period is needed when switching from a MAOI to another antidepressant?
2 weeks
What are the 3 categories of symptoms associated with serotonin syndrome?
- Neuromuscular hyperactivity e.g. tremor or rigidity
- Autonomic dysfunction e.g. tachycardia and hyperthermia
- Altered mental state e.g. confusion, mania and agitation
Which SSRI is associated with QT prolongation
Citalopram
also Escitalopram - an isomer of citalopram
The only antidepressant licensed for use in children
Fluoxetine
Antidepressant of choice for patient with history of MI/unstable angina
Sertraline
______ is a less sedating TCA
3 options
Lofepramine
Notriptyline
Imipramine
Phenalzine is an example of which class of antidepressant?
MAOI
True or false: MAOI interact with mature cheeses and marmite
TRUE - cheese contains Tyramine. The interaction can lead to a hypertensive crisis
Which antidepressant can (rarely) cause blood disorders?
Mirtazapine (counsel patients on signs of blood disorders)
What is the interaction between fluoxetine and phenelzine?
Increased risk of serotonin syndrome (phenelzine is a MOAI)
Continue antidepressant treatment for at least ______ before switching to a different drug due to lack of efficacy
4 weeks
Continue for 6 weeks in the elderly
How long should antidepressants be continued after remission ?
At least 6 months (at the same dose)
NB: May be ~12 months in the elderly
How long should antidepressants be continued as maintenance in those with a history or recurrent depression?
At least 2 years
Which class of antidepressants are known to cause hyponatraemia
SSRIs
Usually in the elderly. Possible due to inappropriate ADH secretion.
Most sedating TCA
Dosulepin
Wash out period when switching from TCA to MAOI
1-2 weeks
True or false:
Amitriptylline is known to have antimuscarinic effects. This includes dry eyes
FALSE
While it does have antimuscarinic properties, dry eyes is not listed as a side effect (BNF)
It DOES cause constipation, drowsiness and dry mouth
The maximum dose of citalopram is ______ in patients aged _____ and over.
This is because higher doses increase the risk of ________
1) 20mg
2) 65 and over
3) QT prolongation
