depression

Question 1

antidepressant discontinuation syndrome

Answer 1

Flu-like symptoms
Insomnia
Nausea
Imbalance
Sensory disturbance -> tingling, electric shock
Hyperarousal -> anxiety, irritability, aggression

Question 2

fluvoxamine dose

Answer 2

50mg ON max 300mg/d

anxiety: 50mg OD max 300mg OD

Question 3

SSRI side effects

Answer 3

GI, sexual dysfunction
tremors, hypoNa, QTC
drowsiness, anticholiergic, OH

Question 4

setraline dose

Answer 4

25-50mg OD max 200mg/d

same for anxiety

Question 5

escitalopram

Answer 5

5-10mg OD max 20mg/d
anxiety same

renal hepatic impairment 10mg/d

Question 6

fluoxetine dose

Answer 6

20-80mg OM max 80mg/d

anxiety same

depression in bipolar 20mg ON max 50mg/d

Question 7

serotonin syndrome

Answer 7

altered mental status - confused, agitated, seizures

dysautonomia - HTN, fever, tachycardia

neuromuscular - tremor, rigidity, ataxia, myoclonus

Question 8

venlafaxine dose

Answer 8

75mg OD mac 375mg/d

crcl 30-89: decr 25%
crcl <30: decrease 50%

Question 9

amitriptyline dose

Answer 9

50-100mg ON max 300mg/d

Question 10

notriptyline dose

Answer 10

25mg TDS max 200mg
BPSD 10mg ON

Question 11

mirtazapine dose

Answer 11

15mg OD 15-45mg OD

BPSD 7.5mg ON

DDI MAOi

SE: drowsiness, weight gain, dyscrasia

Question 12

bupropion dose

Answer 12

150mg OM max 450mg/d

BPSD 37.5mg OM max 150mg BD

SE: nausea, dry mouth, insomnia, seizure

Question 13

Trazodone -> blocks reuptake of 5HT1, antagonises 5HT2A, h1, 5alpha adrenoceptor

Answer 13

75mg-150mg OD max 600mg/d

DDI MAOi
SE same as SSRI + caution priapism

Question 14

meclobemide

Answer 14

150mg BD max 600mg/d

SE: hypotension, tachycardia, insomnia, agitation, tremors, GI