Final: antidepressants Flashcards
when must antidepressants be taken before relief of symptoms begin
2-4 weeks
dont stop taking antid’s….
prematurely or once you feel better
antidepressant discontinuation syndrome
stopping antid suddenly s/s:
- flu-like symptoms
- insomnia
- nausea
- dizziness
- hyperactivity
how to stop antid’s
taper off gradually over 6-8 week period
BBW for antid’s
may increase suicidal thoughts in children and adolescents
if a pt seems to have antid discontinuation syndrome what might be happening
pt may have skipped a dose by accident
Fluoxetine (prozac) class
SSRI
selective serotonin reuptake inhibitior
Fluoxetine (prozac) MOA
blocks serotonin reuptake which increases serotonin availability for the body
indications for Fluoxetine (prozac)
- depression
- anxiety
- OCD
Fluoxetine (prozac) SE
- n/v
- anxiety
- insomnia
- diarrhea
Fluoxetine (prozac) contraindications
life threatening interaction wit MAOI
must wait 2 weeks between use
BBW for Fluoxetine (prozac)
suicidal ideation
Venlafxine (effexor) class
SNRI
selective serotonin and norepi reuptake inhibitor
Venlafxine (effexor) action
inhibits serotonin and norepi reuptake making more available for use
Venlafxine (effexor) uses
- depression
- anxiety
- pain
Venlafxine (effexor) SE
more than SSRI but much less than TCA and MAOI
Amitriptyline (Elavil) class
TCA
tricyclic antidepressant
amitriptiline is a tricyclic antidepressant that elevates mood
Amitriptyline (Elavil) use
depression
Amitriptyline (Elavil) SE most common
- sedation
- orthostatic hypotension
- anticholinergic effects
Amitriptyline (Elavil) SE most dangerous
cardiac tox
danger with Amitriptyline (Elavil)
danger of overdose, limit use and never use in suicidal pts
Phenelzine (Nardil) class
MAOI
monoamine oxidase inhibitor
major thing with Phenelzine (Nardil)
high incidnece of drug-drug and drug-food interactions so rarely given unless treatment resistant depression
Phenelzine (Nardil) MOA
block MAO in brain making norepi and serotonin avilable
Phenelzine (Nardil) use
depression and OCD
Phenelzine (Nardil) SE
- orthostatic hypotension
- CNS stimulation
- Hypertensive crisis from dietary tyramine
Phenelzine (Nardil) contraindications
avoid tyramine rich foods (chessses, cured meats, red wine, bananas) and many drug interactions
