Depression Flashcards
What does SSRI stand for?
Selective Serotonin Re-uptake Inhibitor
Name 5 SSRI’s
Fluoxetine Paroxetine Sertraline Citalopram Escitalopram
Main side effects of SSRI’s
Bonus Q: Name a SE specific to Escitalopram
Dizziness, headaches, N + V, dry mouth, insomnia
Can prolong QT interval = lower dose in elderly
SSRI’s: Mechanism of Action
2-4 weeks to effect
Block serotonin from reuptake in the synaptic space = increase levels
SSRI’s: Interactions
Avoid Ibuprofen (NSAIDs), TCAs, AEDs, MAOIs, warfarin
What does TCA stand for?
Tricyclic Antdepressants
Name 4 TCAs
Amitriptyline
Imipramine
Desipramine
Clomipramine
Adverse effects: TCAs
Drowsiness (driving), arrhythmias, dizziness, headaches, antimuscarinic (constipation, blurred vision, dry mouth), hyponatraemia in elderly
Mechanism of Action: TCAs
2 weeks+ to effect
Inhibit reuptake mechanism of noradrenaline, dopamine, serotonin in central presynaptic terminals
Interactions: TCAs
MAOIs, AEDs, alcohol, antihistamines
Fatal in overdose due to cardiac arrhythmias
What does SNRI stand for?
Serotonin and Noraddrenaline Re-uptake Inhibitor
Name 4 SNRIs
Venlafaxine
Desvenlafaxine
Duloxetine
Milnacripan
Adverse Effects: SNRIs
BP increase, weight loss, hepatitis, GI discomfort, dizziness, headaches
Withdrawal symptoms
Sexual dysfunction, sedation, nausea
Mechanism of action: SNRIs
Inhibit reuptake of noradrenaline and serotonin
Interactions: SNRIs
NSAIDs, Li, other antidepressants
Name 1 Noradrenaline Re-uptake Inhibitor
Reboxetine
Adverse Effects: Noradrenaline Re-uptake Inhibitor
Similar to TCA
Safe in overdose
Low risk of cardiac dysrythmias
Mechanism of Action: Noradrenaline Re-uptake Inhibitor
Inhibits reuptake of noradrenaline so increases level in synapse
Interactions: Noradrenaline Re-uptake inhibitor
AEDs - Anti-Epileptic Drugs
Name 3 Monoamine receptor antagonists
Mirtazapine
Trazodone
Mianserin
Adverse Effects: Monoamine receptor antagonists
Less CV side effects than TCAs, sedation, hypotension, dry mouth, weight gain
Mechanism of action: Monoamine receptor antagonists
Enhances Na+
Interactions: Monoamine receptor antagonists
AEDs, other antidepressants, antipsychotics
Name 3 Monoamine oxidase antagonists
Irreversible: Phenelzine, Tranylcypromine
Reversible MAO-A selective: Moclobemide
Adverse effects: Monoamine oxidase antagonists
Orthostatic hypotension, weight gain, sexual dysfunction, dizziness, headaches, migraine aggravation, antimuscarinic effects
Interactions:
Sympathomimetics (decongestants), SSRIs, TCAs, Levodopa, opioids, tyramine (cheese, beans)
Don’t start antidepressants until after 2 weeks
