Depression Case Flashcards
t/f: antidepressants are habit forming
f!
SSRI’s affect what NT in the brain
serotonin
SNRI’s affect what 2 hormones/NT in the brain
serotonin
NE
2 first line meds for dpn
SSRI
SNRI
name 5 SSRIs
citalopram (celexa)
escitalopram (lexapro)
fluoxetine (prozac)
paroxetine (paxil)
sertraline (zoloft)
name 3 SNRI’s
desvenlafaxine (pristiq)
duloxetine (cymbalta)
venlafaxine (effexor)
TCA’s are useful for what type of depression
melancholic (profoundly sad)
which 2 antidepressants carries a risk of lethal overdose
TCA
MAOI
name 1 TCA
amitriptyline (Elavil)
name 1 tetracyclic antidepressant
buproprion (wellbutrin)
name 2 MAOI’s
isocarbozid (marplan)
penelzine (nardil)
what 2 antidepressants can be helpful for concurrent insomnia/anxiety
mirtazapine (remeron)
penelzine (desyrel)
what 2 antidepressants can be helpful for resistant depression
aripiprazole (abilify)
quetiapine (seroquel)
6 clinical uses of antidepressants
depression
anxiety
chronic pain
premenstrual dysphoric disorder (PMDD)
smoking cessation
eating disorders
which antidepressants are associated with deadly withdrawal
tick question - none!
adverse effects of SSRI’s (6)
serotonic activity ->
nausea
GI upset
diarrhea
diminished sexual fxn
HA
weight gain
2 symptoms of SSRI discontinuation syndrome
dizzy
paresthesias
s.e of SNRIs
serotenergic effects
PLUS
noradrenergic effects:
increased BP and HR
insomnia, anxiety, agitation
s.e of TCAs (5)
anticholinergic ->
dry mouth
constipation
urinary retention
blurred vision
confusion
sx of TCA discontinuation syndrome
cholinergic rebound
flu like sx
what antidepressant has the highest rates of sexual effects
MAOIs
besides sexual effects, 2 other s.e of MAOI’s
orthostatic hypotn
weight gain
very last line antidepressant that should only be used as a refractory option
MAOIs
mc method of suicide attempts
drug overdose
esp TCAs
how to manage GI s.e of antidepressants
take after meals
how do you manage sedation s.e of antidepressants
take at HS
least sedating antidepressant
SSRIs
least sedating SSRI
prozac
3 sedating antidepressants
remeron
celexa
effexor
how to manage agitation s.e of antidepressants
switch to more sedating antidepressant
2 antidepressants with least sexual side effects
wellbutrin
remeron
(also consider PDE-5)
antidepressants that are good for anxiety/panic
paxil
remeron
effexor
TCAs
avoid benzos
2 methods to manage orthostatic hypotn s.e of antidepressants
hydration
education on movement
you should taper antidepressants over __ weeks
4
slower if symptomatic
2 OTC options for depression
st. john’s wort
SAMe
t/f: st john’s wort can be taken with a serotenergic agent
f!
