depression

Question 1

SE of SSRI

Answer 1

drowsy, sedating, can sleep well
- takes 1-2 weeks to take effect, give trazadone to help sleep

blurred vision - inflammation of eye nerve

Question 2

what does monoamine oxidase A do?

so what does reversible inhinbitor of MOA do?

what food not to eat with MOA?

Answer 2

breaks down noreadrenoline -

blocks break down of of NEpi- cause htn crisis

cant eat cheese, wine, chickpeas, grapefruit, produces tyrosin - precursor to norepinephorine - too much norepi&raquo_space; htn crisis

Question 3

Bupropion(Wellbutrin) 
Venlafaxine(Effexor) 
Mirtazepine(Remeron)
Moclobemide 
Trazodone(Desyrel)

Answer 3

Bupropion(Wellbutrin) (NDRI)
Venlafaxine(Effexor) (Cymbalta,Pristiq)(SNRI)
Mirtazepine(Remeron)(NaSSA)
Moclobemide (Manerix)(RIMA)
Trazodone(Desyrel) (SARI)

Question 4

Citalopram –

Escitalopram-

Sertraline- zoloft

Fluoxetine-

Paroxetine – paxil

Fluvoxamine –

Answer 4

Citalopram – least drug interactions, least sexual side-effects (delayed ejaculation,anorgasmia,libido changes)

Escitalopram- half dose of citalopram. Max dose 20 mgdaily(due to QTc prolongation with higher doses)

Sertraline-few drug interactions, most diarrhea, male sexual dysfunction, may increase TG

Fluoxetine-Most anorexic, stimulating (am dosing): long half-life(4-6 days) 5 week washout

Paroxetine – use with caution in renal impairment (levels may increase by 150% with GFR<30mL/min); most sedating of the SSRIs so indicated for anxiety, most anticholinergic. Most anxiety indications. Increase wt. and sexual dysfunction, worst D/C syndrome.

Fluvoxamine – most drug interactions due to CYP inhibition and protein binding

Question 5

which drug containdicate for seizures, hx of anorxia?

class?

SE?

Answer 5

wellbutrin - bupropirion -
for smoking and depression

NDRI

Tachycardia

Question 6

SE of most antidepressant

Answer 6

HA
insomnia
erectile dysfn

cuz stimilating

Question 7

which drug good for chronic pain? ie nerve pain

need low tyramine diet? which line of use?

Answer 7

TCA

MAOIs - cuz tyramine is precursor noreadreniline - MAOI no break down&raquo_space; hypertensive crisis

3rd line

Question 8

MAOI two types? wash out period?

both need to with what?

Answer 8

reversibile - eg, moclovemide, only block A not B&raquo_space; lower risk of htn crisis
- short wash out period, 2 days

irreversible - long wash out period, need low tyrasime diet

take with food&raquo_space; nausea