Pharmacology

Question 1

SSRI

• Mechanism
• Examples
• Indications
• Side effects

Answer 1

Selective serotonin re-uptake inhibitor
- Inhibits 5-HT re-uptake transporter at presynaptic membrane, increasing its availability

Examples:

• Citalopram
• Fluoxetine
• Paroxetine
• Sertraline

Indications:

• Clinical depression
• Anxiety
• PTSD
• OCD
• Panic disorder

Side effects:
- Agitation, especially fluoxetine

Question 2

Paroxetine half life

Answer 2

Shortest of the SSRIs
- 20 hours

Consequences

• If user is not compliant, the discontinuation syndrome effects become prevalent quickly.
• Better to use drug with longer half life (i.e fluoxetine).

Question 3

SSRI onset of actions

Answer 3

Can take 10-14 days to start to see its onset of actions.

May not have peak effect for 4-6 weeks

Advised to keep on course for 6 months.

Question 4

SNRI

• Mechanism
• Examples
• Indications
• Side effects

Answer 4

Serotonin-noradrenaline re-uptake inhibitor
- Inhibits reuptake of serotonin and noradrenaline

Examples:

• Venlaflaxine
• Duloxetine

Indications

• Clinical depression–> when severe, or 2nd/3rd line
• GAD

Side effects

• Nausea
• Headache
• Hypetension

Question 5

Monoamine oxidase inhibitors/ RIMAs

• Mechanism
• Examples
• Indications
• Side effects

Answer 5

Selectively and reversibly inhibits Monoamine oxidase A
- Prevents breakdown of monoamine neurotransmitters: serotonin, noradrenaline, adrenaline, melatonin

Examples:

• Selegiline
• Moclobamide

Indications:

• Depression
• Anxiety
• Panic disorder

Side effects
- Inhibits the breakdown tyramine, found in many foods (food interactions): wine, cheese, = hypertensive crisis

Question 6

MAOIs interactions

Answer 6

Foods high in tyramine= hypertensive crisis

• Fermented beverages
• Fermented diary/ plants
• Pork, meats

Drugs:
- Other serotonin and NA uptake inhibitors.