depression Flashcards
diagnosis
ds5
hamiltondepression
rule out bipolar to avoid inducing mania or rapid cycling
drugs that worsens depression
atomoxetine
indomethacin
efavirenze
betablocker (propranolol)
contraeptives
steroids
benzos alone
interferons
ethanol
varenicline
natural products for depression
st johns wort 9SS)
valerian
5HTp (SS)
Same (SS)
pregnancy and depression
psychotherpay first
SSRIs not paroxetine (cardiac effects)
potential risk of persisten pulmonary hypertension of the new born with SSRIs
SSRis and TCA are okay in breast feeding except doxapin
brexanolone is a controlled drug for post partum
which anti depressent does not require tapering
fluoxetine
boxed warning and med guides
for all anti depressants
SSRIs
citalopram celexa
escitalopram lexapro
fluoxetine prozac
paroxetine paxil
sertraline zoloft
SSRI warnigns
suicide risk
sexual dysfunction
bleeding with anticoags
QT prolongation
do not use with mao, linezolid IV methylene blue
SIADH Syndrome of inappropriate antidiuretic hormone secretio
which SSRI is preffered in CV
sertraline
which SSRI is not preff in pregnancy
paroxetine (sedating )
what natural products have DDI with SSRIs
Ginko
Garalic
Ginger
ginseng
glucosamine
fish oils
what are some combination SSRIs
vilazodone(Viibryd)- SSRI/5HT1A partial agonist
vortioxetine (trintellix)- SSRI/5HT3 receptor antagonist and 5HT1A agonist
SNRIs
venlafaxine (effexor)- pain depression/anxiety
Duloxetine (cymbalta )- pain/depression/anxiety
desvenlafaxine (pristique)
ssnri vs SSRI
SNRI since NE increases so does HR
drumouth constipation sweating
duloxxetine and tamoxifen interaction
TCA
NE and 5HT kinda like SNRI but also blocks ach and histamine receptors
which TCA is more effective but has more AE
tertiary amines
tertiary amines
amitryptiline
doxepin
:pramine”
secondary amines
nortyptiline (pamelor)
AE of amines
QT, SS, suicidal ideation
orthostasis
dry mouth blurred vision urinary retention
weigh gain
vvid dream s
dopa and ne inhibitor
bupropion (wellbutrin)
Zyban for smoking cessation
contrave for weight loss
AE for bupropion
drymouth
seizure
weight loss
do not use with MAO
MAO
HYPERTENSIVE CRISIS
isocarboxazid (marplan)
phenelzine (nardil )
tranylcypromine (parnate )
selegline patch emsam , zelpar for parkinsons
what food are contra indicated with MAO
tyramine rich foods - cheese, pickled herring, yeast
air dried meat
saukernaut
soy
aged, fermented, smoked, pickled
other antidepressants
mirtazapine (rameron) A2 blocker
trazodone 5ht reuptake blocks H and A1
treatment resistant depression
after 3-8 weeks change to a new antidepressant
increast the anti depressant dose
add buspirone or low dose atypical
adjunct therapy with antidepressants
aripiprazole (abilify)
quetiapine (seroquel)
esketamine (spravato
for people with cardaic risk
Sertraline is preffered
smokers can benefit from
bupropion
neuropathy pts
duloxetine
for seizure risk
do not use sertraline
for pregnancy
do not use paroxetine
use SSRI
sedation drugs
paroxetine mirtazapine trazodone take before bedtime
insomnia drugs
bupropion, fluoxetine
take early in the day
sexual dysfunction
high risk in SSRI and SNRI
lower risk with bupropion and mirtazapine
citalopram max ddose
40
20 in >60 years
