Depression

Question 1

What does SSRI stand for?

Answer 1

Selective Serotonin Re-uptake Inhibitor

Question 2

Name 5 SSRI’s

Answer 2

Fluoxetine 
Paroxetine
Sertraline
Citalopram
Escitalopram

Question 3

Main side effects of SSRI’s

Bonus Q: Name a SE specific to Escitalopram

Answer 3

Dizziness, headaches, N + V, dry mouth, insomnia

Can prolong QT interval = lower dose in elderly

Question 4

SSRI’s: Mechanism of Action

Answer 4

2-4 weeks to effect

Block serotonin from reuptake in the synaptic space = increase levels

Question 5

SSRI’s: Interactions

Answer 5

Avoid Ibuprofen (NSAIDs), TCAs, AEDs, MAOIs, warfarin

Question 6

What does TCA stand for?

Answer 6

Tricyclic Antdepressants

Question 7

Name 4 TCAs

Answer 7

Amitriptyline
Imipramine
Desipramine
Clomipramine

Question 8

Adverse effects: TCAs

Answer 8

Drowsiness (driving), arrhythmias, dizziness, headaches, antimuscarinic (constipation, blurred vision, dry mouth), hyponatraemia in elderly

Question 9

Mechanism of Action: TCAs

Answer 9

2 weeks+ to effect

Inhibit reuptake mechanism of noradrenaline, dopamine, serotonin in central presynaptic terminals

Question 10

Interactions: TCAs

Answer 10

MAOIs, AEDs, alcohol, antihistamines

Fatal in overdose due to cardiac arrhythmias

Question 11

What does SNRI stand for?

Answer 11

Serotonin and Noraddrenaline Re-uptake Inhibitor

Question 12

Name 4 SNRIs

Answer 12

Venlafaxine
Desvenlafaxine
Duloxetine
Milnacripan

Question 13

Adverse Effects: SNRIs

Answer 13

BP increase, weight loss, hepatitis, GI discomfort, dizziness, headaches
Withdrawal symptoms
Sexual dysfunction, sedation, nausea

Question 14

Mechanism of action: SNRIs

Answer 14

Inhibit reuptake of noradrenaline and serotonin

Question 15

Interactions: SNRIs

Answer 15

NSAIDs, Li, other antidepressants

Question 16

Name 1 Noradrenaline Re-uptake Inhibitor

Answer 16

Reboxetine

Question 17

Adverse Effects: Noradrenaline Re-uptake Inhibitor

Answer 17

Similar to TCA
Safe in overdose
Low risk of cardiac dysrythmias

Question 18

Mechanism of Action: Noradrenaline Re-uptake Inhibitor

Answer 18

Inhibits reuptake of noradrenaline so increases level in synapse

Question 19

Interactions: Noradrenaline Re-uptake inhibitor

Answer 19

AEDs - Anti-Epileptic Drugs

Question 20

Name 3 Monoamine receptor antagonists

Answer 20

Mirtazapine
Trazodone
Mianserin

Question 21

Adverse Effects: Monoamine receptor antagonists

Answer 21

Less CV side effects than TCAs, sedation, hypotension, dry mouth, weight gain

Question 22

Mechanism of action: Monoamine receptor antagonists

Answer 22

Enhances Na+

Question 23

Interactions: Monoamine receptor antagonists

Answer 23

AEDs, other antidepressants, antipsychotics

Question 24

Name 3 Monoamine oxidase antagonists

Answer 24

Irreversible: Phenelzine, Tranylcypromine

Reversible MAO-A selective: Moclobemide

Question 25

Adverse effects: Monoamine oxidase antagonists

Answer 25

Orthostatic hypotension, weight gain, sexual dysfunction, dizziness, headaches, migraine aggravation, antimuscarinic effects

Question 26

Interactions:

Answer 26

Sympathomimetics (decongestants), SSRIs, TCAs, Levodopa, opioids, tyramine (cheese, beans)

Don’t start antidepressants until after 2 weeks