NERVOUS SYSTEM: ANTIDEPRESSANTS - SSRIs

Question 1

SSRIs: INDICATIONS

Answer 1

• 1st line tx for moderate-severe depression, mild depression if all other therapies failed
• Panic Disorder
• OCD

Question 2

SSRIs: MOA

Answer 2

• Preferentially inhibit neuronal reuptake of Serotonin (5-HT) from the synaptic cleft
• Increases its avaliablity for neuronal transmission

Question 3

SSRIs: ADVERSE EFFECTS

Answer 3

• GI upset
• Appetite + weight disturbance (loss/gain)
• HS Rxns
• Hyponatraemia = elderly, reduced consciousness and confusion
• Suicidal thoughts and behaviour increased
• Lower seizure threshold
• CITALOPRAM = prolong QT interval and can predispose to arrhythmias
• Increase risk of bleeding
• SEROTONIN SYNDROME - triad of autonomic hyperactivity, altered mental state and neuromuscular excitement
• Sudden withdrawl = GI upset, neurological and influenza-like symptoms and sleep disturbance

Question 4

SSRIs: WARNINGS

Answer 4

• Epilepsy
• PUD
• Young People = increased risk of suicidal thoughts and self harm
• Hepatic impairment (metabolised by the liver)

Question 5

SSRIs: INTERACTIONS

Answer 5

• MOA inhibs
• Gastroprotection should be prescribed (aspirin/nsaids)
• Increased bleeding risk when co prescribed with anti coags
• Should not be combined with other drugs that prolong the QT interval

Question 6

SSRIs: EXAMPLES

Answer 6

• Citalopram
• Fluoxetine
• Setraline
• Escitalopram