Medications for depressive disorders

Question 1

Selective serotonin reuptake inhibitors (SSRIs) are the first line treatment for…

Answer 1

depression

Question 2

Medications for depressive disorders

Answer 2

Selective serotonin reuptake inhibitors (SSRIs)

Tricyclic antidepressants (TCAs)

Monoamine oxidase inhibitors (MAOIs)

Atypical antidepressants - Bupropion

Other atypical antidepressants - venlafaxine, duloxetine, desvenlafaxine, levomilnacipran

Question 3

SSRIs medications (-tine; -pram; [-aline; -odone])

Answer 3

prototype: fluoxetine
other:
citalopram
escitalopram
paroxetine
sertraline
vilazodone

Question 4

SSRIs (-tine; -pram) therapeutic uses

Answer 4

major depression
obsessive compulsive disorder
bulimia nervosa
premenstrual dysphoric disorders
panic disorders
posttraumatic stress disorder (PTSD)
bipolar disorder

Question 5

SSRIs (-tine; -pram) S/E

Answer 5

sexual dysfunction

CNS stimulation: insomnia, agitation, anxiety

weight changes

serotonin syndrome

withdrawal syndrome

hyponatremia

rash

sleepiness, faintness, lightheadedness

gastrointestinal bleeding

bruxism

Question 6

SSRIs (-tine; -pram) S/E sexual dysfunction

Answer 6

anorgasmia, impotence, decreased libido

Question 7

SSRIs (-tine; -pram) S/E CNS stimulation

Answer 7

insomnia, agitation, anxiety

Question 8

SSRIs (-tine; -pram) S/E weight changes

Answer 8

weight loss early in therapy

weight gain with long-term Tx

Question 9

SSRIs (-tine; -pram) S/E serotonin syndrome

Answer 9

mental confusion, difficulty concentrating
abdominal pain
diarrhea
agitation
fever
anxiety
hallucinations
hyperflexia, incoordination
diaphoresis
tremors

Question 10

SSRIs (-tine; -pram) S/E withdrawal syndrome

Answer 10

headache, nausea, visual disturbances, anxiety, dizziness, tremors

Question 11

SSRIs (-tine; -pram) S/E hyponatremia

Answer 11

hyponatremia

Question 12

SSRIs (-tine; -pram) S/E rash

Answer 12

rash

treatable w/antihistamine or discontinuation of med

Question 13

SSRIs (-tine; -pram) sleepiness, faintness, lightheadedness

Answer 13

sleepiness, faintness, lightheadedness

avoid driving

Question 14

SSRIs (-tine; -pram) S/E GI bleeding

Answer 14

GI bleeding

Question 15

SSRIs (-tine; -pram) S/E bruxism

Answer 15

bruxism

Question 16

SSRIs (-tine; -pram) contraindications

Answer 16

taking MAOIs or TCAs

use cautiously in clients who have liver and/or renal dysfunction, cardiac disease, seizure disorders, diabetes, ulcers, and a history of GI bleeding

Question 17

SSRIs (-tine; -pram) interactions

Answer 17

concurrent use with MAOIs, TCAs, St. John’s Wort increases risk of serotonin syndrome

concurrent use with warfarin –> increased warfarin levels

concurrent use with tricyclic antidepressants and lithium –> increased levels of the meds

concurrent use with NSAIDs and anticoagulants –> further suppress platelet aggregation –> increase risk of bleeding

Question 18

MOAIs medications (-zine; -oxzid; -promine; -giline)?

Answer 18

prototype: phenelzine

other:
isocarboxazid
tranylcypromine
selegiline (transdermal patch)