Mental Health

Question 1

What are SSRIs used for? (3)

(selective serotonin reupdate inhibitors)

Answer 1

1. depression
2. Panic disorders
3. Obsessive compulsive disorders

Question 2

What are the common side effects of SSRIs? (4)

Answer 2

1. GI - nausea, changes in appetite
2. sleep disturbance
3. Possibility of hypersensitivity - skin rash
4. Lowers sodium - especially in the elderly which could be a cause of confusion
5. Increase risk of bleeding

Question 3

What are very important considerations with SSRI prescribing? (50

Answer 3

1. Risk of hyponatraemia, especially with the elderly.
2. Risk of bleeding, especially with the elderly
3. Increase in suicidal thoughts/ behaviour at the beginning
4. Overdose - Serotonin Syndrome
5. Caution with epilepsy - prolongs QT interval.

Question 4

How does serotonin syndrome present?

Question 5

If increased risk of bleeding due to other medications (e.g. NSAIDs, aspirin, anticoagulants) then…

Answer 5

prescribe a PPI

Question 6

What must you advise a patient before starting on a SSRI?

Answer 6

1. Expect an improvement after a few weeks
2. Treatment is long-term (min. 6 months)
3. Don’t stop medication suddenly otherwise will get withdrawal symptoms (sleeping problems, nausea)