Depression and Anxiety (pharm) Flashcards
Diagnosis of Major Depressive Disorder MDD
-Sadness (depressed mood_
-Sleep disturbances
-Interest reduced
-Guilt and self blame
-Energy loss and fatigue
-Concentration problems
-Apetite changes
-Psychomotor changes
-Suicidal thoughts
-Patient’s Health Questionnaire PHQ-9 (0-27 severe)
Selective Serotonin Reuptake Inhibitor SSRI
-1st line agents
-Sertraline, Paroxetine, Fluoxetine, Paroxetine, Escitalopram, Citalopram
-flat dosage response rate therefore most patients will respond to lowest effective dose
-S/E: headache, dizziness, diarrhea, nausea, constipation, erection problems, libido changes
-Paroxetine= discontinuation syndrome and anticholinergic
-Escitalopram and citalopram at high doses =Prolonged QT
-Citalopram= least drug interaction, least sexual side effects
-Sertaline: few drug interactions, most diarrhea, male sexual dysfunction, increase TG
Serotonin-Norepinephrine Reuptake Inhibitor SNRI
-Duloxetine, Venlafaxine*
Norepinephrine-Dopamine Reuptake Inhibitor NDRI
-Bupropion
Noradrenergic and Specific Serotonergic Antidepressant NaSSA
-Mirtazepine*
Tricyclic Antidepressants TCAs
-Tertiary amines (amitriptyline)
-Secondary amines (nortriptyline)
Monoamine Oxidase Inhibitors MAOI
-Tranylcypromine, Selegiline, Phenelzine
Serotonin Modulators
-Vortioxetine, Valizadone, Trazadone
Panic Disorder DSM-V
-An abrupt surge of intense fear or intense discomfort that reaches a peak within minutes and 4 of: palpitation, sweating, trembling, sensations of SOB, feelings of choking, chest pain, nausea, feeling dizzy, chills, numbness, fear f losing control, fear of drying
Panic disorder medication management
-First line: citalopram, escitalopram, fluoxetine, fluvoxamine, paroxetine, sertraline, venlafaxine
-Second line: mirtzapine, clonazepam, lorazepam
-Third line: Bupropion, Duloxetine, gabapentin, quetiapine, risperidone
