Mental Health

Question 1

Depression first line

Answer 1

SSRI such as Sertraline, citalopram, fluoxetine, paroxetine

Question 2

Citalopram interactions

Answer 2

Drugs that prolong QT interval (such as fluconazole)

Question 3

Antidepressants and seizures

Answer 3

Antiepileptics lower seizure threshold

Question 4

Antidepressant choice: warfarin

Answer 4

Avoid: SSRIs, SNRIs, TCAs. Try Mirtazepine, reboxetine, trazodone, mianserin.

Question 5

Antidepressant choice: Triptans

Answer 5

Avoid SSRIs

Question 6

Antidepressants that cause sexual dysfunction

Answer 6

SSRIs

Question 7

Antidepressants that cause hyponatremia

Answer 7

All, highest risk with SSRIs

Question 8

SSRI CIs

Answer 8

Manic phase bipolar, poor epilepsy control, severe hepatic impairment (sertraline), QT prolongation ( (es)citalopram)

Question 9

SSRI warnings

Answer 9

Bleeding disorder (particularly GI), history of mania, cardiac disease, diabetes, epilepsy, hepatic impairment, renal impairment (sertraline), significant bradycardia ( (es)citalopram).

Question 10

SSRI ADRs - Cardiac

Answer 10

Palpitations, tachycardia, QT Prolongation, Torsade de pointes

Question 11

SSRI ADRs - GI

Answer 11

Diarrhoea, nausea, dr mouth, abdo pain, constipation, vomiting, dyspepsia, microscopic colitis, pancreatitis. Melania, stomatitis, tongue/mouth ulcers, glossitis.

Question 12

SSRI ADRs - Nervous system

Answer 12

Headache, somnolescence, parasthesia, tremor, hypertonia, dysgeusia, convulsions, speach disorders. SEROTONIN SYNDROME

Question 13

SSRI ADRs - Psychiatric

Answer 13

Insomnia, depression, nightmares, agitation, anxiety, suicidal thoughts and behaviour.

Question 14

SSRI ADRs - Bone, soft tissue, skin

Answer 14

Bone fractures (unclear mechanism), rash, hyperhidrosis, oedema, alopecia, dermatitis