PA Antidepressants (Exam #3) Flashcards
What does SIG-E-CAPS stand for, and what condition is it associated with?
MDD
- Sleep disturbances
- Interest
- Guilt
- Energy
- Concentration
- Appetite
- Psychomotor changes
- SI
What is the primary screening tool for MDD? What other screening tool can be used if Bipolar too?
PHQ-9
- If Bipolar too, MDQ
What are the two tx goals for MDD? Describe each
- Response: 50+% improvement
- Remission: PHQ <5
What is the recommended follow up for MDD tx, and why (3)?
Follow up in 1-2 weeks
- Evaluate for improvement, AEs and new sxs
With use of Antidepressants, what possible underlying disorder should always be considered?
Caution underlying Bipolar Disorder
- Antidepressants can unmask mania
What is the 1st line med tx for MDD, and why (2)?
SSRIs = 5HT only
- Low AE profile
- Low OD risk
What are the top three SSRIs often used in the tx of MDD?
- Fluoxetine (Prozac)
- Sertraline (Zoloft)
- Paroxetine (Paxil)
Which SSRI can also be used in the tx of nocturnal eating and SAD?
Sertraline (Zoloft)
Which SSRI can also be used in the tx of Bulimia?
Fluoxetine (Prozac)
Which SSRI can also be used in the tx of Panic Disorder and SAD?
Paroxetine (Paxil)
Which two SSRIs can also be used in the tx of SAD?
- Sertraline (Zoloft)
- Paroxetine (Paxil)
Which two SSRIs are more selective and more potent?
- Citalopram (Celexa)
- Escitalopram (Lexapro)
What is the top SNRI often used in the tx of MDD?
Venlafaxine (Effexor)
Besides MDD, what other three conditions can Venlafaxine (Effexor) be used to tx?
- GAD
- SAD
- Panic Disorder
Besides MDD, what other two conditions can Duloxetine (Cymbalta) be used to tx?
- DM Neuropathy
- Fibromyalgia
When is use of Duloxetine (Cymbalta) CI?
Liver disease
Which SNRI can also be used in the tx of DM Neuropathy and Fibromyalgia?
Duloxetine (Cymbalta)
Which two meds have fewer sexual AEs than SSRIs, and may be used if this is an issue with SSRIs?
- Bupropion (Wellbutrin)
- Mirtazapine (Remeron)
Which antidepressant is a DA and NE reuptake inhibitor?
Bupropion (Wellbutrin)
Which antidepressant is an alpha2 antagonist?
Mirtazapine (Remeron)
Which antidepressant is good for the elderly with depression, sleep or appetite issues?
Mirtazapine (Remeron)
Besides MDD, what other two conditions can Bupropion (Wellbutrin) be used to tx?
- SAD
- Smoking cessation
With what two conditions is the use of Bupropion (Wellbutrin) CI?
- Seizure disorder
- Anorexia
What is often the duration of tx for MDD?
4-9 months (after finding therapeutic dose)
How long can it take for antidepressants to take full effect?
2-8 weeks
Under what four conditions would referral to Psychiatrist or Psychotherapy be warranted with MDD?
- Refractory
- Severe MDD with Bipolar or SI/HI
- Co-morbid psych/med issues
- Unsure of dx
Under what three conditions would hospitalization for MDD be warranted?
- SI/HI
- Severe psychomotor changes
- Associated psychosis
