MOOD MEDS Flashcards
What are the SSRIs?
Escitalopram
Citalopram
Fluoxetine
Paroxetine
Sertraline
What are the side effects for SSRIs?
Decreased libido, delayed ejaculation, serotonin syndrome, GI, insomnia
What are the signs of serotonin syndrome
Serotonin syndrome is a potentially life-threatening condition caused by serotonergic overactivity due to the use of serotonergic drugs. It can be caused by a therapeutic dose or overdose of a serotonergic drug, concomitant use of multiple serotonergic drugs, or interactions with CYP450 inhibitors. Onset is typically rapid, occurring within 24 hours of drug administration. Classic features include autonomic dysfunction, neuromuscular excitability (e.g., rigidity, hyperreflexia), and altered mental status. Increased neuromuscular activity can also lead to hyperthermia.
what are the signs of lithium toxicity
Acute lithium poisoning
Early: gastrointestinal symptoms
Hours after ingestion: neurological symptoms
Acute-on-chronic lithium poisoning: Gastrointestinal and neurological symptoms may occur simultaneously.
Chronic lithium poisoning: Neurological symptoms predominate.
Gastrointestinal: nausea, vomiting, and diarrhea
Neurological
Altered mental status, confusion
Somnolence, coma
Delirium, encephalopathy, psychomotor impairment
Coarse tremors, seizures, fasciculations, myoclonus
Ataxia, slurred speech, nystagmus
Hyperreflexia
Extrapyramidal syndrome
What labs/imaging must you start before starting an antipsychotic?
ECG!
And some require CBC, LFTs, or RFTs
SNRIs
Venlafaxine
Desvenlafaxine
Duloxetine
Atypical antidepressents
Buproprion
Serotonin modulators
Mirtazapine and trazodone
What is mirtazapine?
Appetite stim
What are the TCAs?
Things that end in ‘tryptilline’
Imipramine
Desipramine
Doxepin
What major side effects can you have with TCAs?
Enuresis, convulison/coma/cardiac, anti-ach including dry mouth, sedation, urinary retention, constipation
What studies must you order before starting TCAs?
ECG because it can widen the QRS leading to arrythmias
What are anticholinergi side effects and what meds are they associated with?
Anticholnergic include dry mouth/dry eyes, dialated pupils, urine retention, constipation
Whats in a B52?
haloperidol, lorazepam, and diphenhydramine
What is first line treatment for GAD, OCD, and PTSD?
~therapy~
Firstline drug of choice for bipolar 1
Lithium
Drug next in line for bipolar if lithium is contraindicated
Valproate
Major side effects for lithium
Its a teratogen, neprhotoxic kidney injury 1.5 cr and obove, can cause nephrogenic diabetes, has a narrow therapeutic index, can lead to hypothyroidism
Side effects of valproate
teratogen (spina bidifa), thrombocytopenia, agranulocytosis, pancreatitis
Second line medication for bipolar and can be used in all phases of treatment (in mania AND maintence)
quetiapine
Quetiapine major side effects
weight gain and QTC prolongation
Lamotrigine
mood stab, second line tx for bipolar, side effects include blurred vision and steven johnson
Carbamazepine
thirdline mood stab for bipolar, can be used to help tx trigeminal neuralgia and absence seizures. Its a teratogen (cleft palate), rash, sjs, av block
What do you use to tx bipolar in the acute phase/manic phase?
Li + antipsychotic
What do you use to treat depressed mood in bipolar?
quetiapine
major sign of nephrogenic diabetes insipidus
hypernatremia
If a patient on lithium develops renal toxicity, what do you do?
Switch them to valproate
If a patient has refractory Bipolar, what meds would you recommend?
Li or valproate plus an antipsychotic like quetiapine
Major side effects of quetiapine
sedation and QTc prolongation weight gain
Treatment of specific phobias consists of CBT or medications that target…
gamma aminobutyric acid type A receptors (GABA). Benzos modulate gaba.
Benzodiazepines target what
GABA
Phobias are treated with
BENZOS!
Buspirone targets what
serotonin agonist
