Depression & Anxiety Flashcards
MAO inhibitors
phenelizine, tranylcypromine, isocarboxazid
limited to those unresponsive to other treatments
do not use with SSRIs, SNRIs
avoid foods rich in tyramine
2 week washout period
s/e: hypertensive crisis, serotonin syndrome
serotonin syndrome
can occur w/ multiple serotonergic drugs or MAOi + serotonergic drug
s/sx: dilated pupils, tachycardia, HTN, loss of muscle coordination, aggitation, confusion, sweating, diarrhea
SSRIs
do not use w/ MAOi
fluoxetine (Prozac), paroxetine (Paxil), sertraline (Zoloft), citalopram (Celexa), escitalopram (Lexapro)
SSRI + 5HT1
vilazodone (Viibryd)
vortioxtine (Trintellix)
SNRIs
do not use w/ MAOi
venlafaxine (Effexor), duloxetine (Cymbalta), desvenlafaxine (Pristiq, Khedezla)
TCAs
approved for depression, not approved for anxiety
do not use w/ MAOi
amitrypiline (Elavil)
doxepin
nortripyline
s/e: orthostasis, cardiotoxicity, QT prolongation
dopamine + norepinephrine reuptake inhibitor
bupropion (wellbutrin)
c/i with seizure disorders
s/e: weight loss, seizures
take in the morning - activating
Miscellaneous Antidepressants
mirtazapine (Remeron) - s/e weight gain
trazodone - s/e sedation, priapism
special notes for antidepressants
bupropion for weight loss
sertraline preferred w/ cardiac issues (post-MI, HF, bradycardia)
duloxetine if both depression and pain
treatment-resistant depression
use 2nd generation antipsychotics
aripiprazole (Abilify)
olanzapine/fluoxetine (Symbyax)
quetiapine (seroquel)
Anxiety Treatment
SSRIs 1st line, buspirone 2nd line
anxiety + pain: pregabalin (Lyrica)
stage fright: propranoll (Inderal)
benzos
Benzodiazepines for anxiety
lorazepam (Ativan), alprazolam (Xanax), chlordiazepoxide, clonazepam (Klonopin), diazepam (Valium)
s/e: somnolence, dizziness, ataxia
dependence/tolerance w/ chronic use
