Primer 6 - Antidepressant Flashcards
What are syndromes of Serotonin Syndrome?
- Mental status changes
- Autonomic instability
- Neuromuscular abnormalities
What is the treatment for Serotonin syndrome?
- Cooling and Benzodiazepines
2. Cyproheptadine but it is not first line.
What are side effects of SNRIs?
- Elevated blood pressure
- Sedation
- Nausea
How do tricylic antidepressants work?
They inhibit the reuptake of norepinephrine and seratonin. They are like SNRI but a lot older.
What are side effects of tricyclic antidepressants?
- Sedation
- Alpha-blocking effects- hypotension, sedation, dizzyness.
- Low antipsychotic effect
- Anticholinergic effects
What TCA is the least sedating of all the TCAs?
Desipramine.
What are the tri-C’s that TCA can cause in overdose?
- Convulsion
- Coma
- Cardiotoxicity
Can also cause Respiratory depression, hyperpyrexia, confusion and hallucination.
What is the treatment for TCA overdose?
Sodium bicarbonate if there is cardiovascular toxicity from TCA overdose to alkalinize the urine (TCAs are weak acids).
What is MAOIs washout period?
A 2 week period of time that you are to abstain from any MAOIs before taking other drugs.
What are 3 atypical antidepressants?
- Bupropion
- Mirtazapine
- Trazodone
How does Bupropion work?
Inhibits the reuptake of dopamine and norepinephrine. It has a stimulant effect. Lowers seizure threshold. Does not cause sexual side effects.
How does Mirtazapine work?
An alpha 2 antagonist: the receptors are located on the pre-synaptic nerve terminal on adrenergic neurons: Stimulating alpha 2 inhibits further norepinephrine release (blocking these increases norepinephrine.
Also a potent serotonin2 and serotonin3 receptor antagonist.
What are side effects of Mirtazapine?
- Anti-histamine.
How does Trazodone work?
Inhibits serotonin antagonist and reuptake inhibitor.
What are 2 medications that can be safely added to SSRI?
Bupropion and Trazodone.
What are 2 side effects of Trazodone?
- Sedation
2. Priapism
What drugs are associated with Serotonin syndrome when a patient is on SSRIs?
- SSRIs
- SNRIs
- MAOIs
- St. John’s Wort
- Kava Kava
- Trytophan
- Cocaine
- Amphetamines
What medication has the side effect of dry mouth, tinnitus, blurred vision and mania?
Amitriptyline.
What type of medication is nortriptyline?
TCA.
What type of medication is selegiline?
MAOI
What type of medication is bupropion?
NDRI - Norepinephrine and dopamine reuptake inhibitor.
What type of medication is mirtazapine?
Tetracyclic.
What type of medication is fluvoxamine?
SSRI
What type of medication is doxepin?
TCA
What type of medication is phenelzine?
MAOI
What type of medication is fluoxetine?
SSRI
What type of medication is clomipramine?
TCA
What type of medication is imipramine?
TCA
What type of medication is amitriptyline?
TCA
What type of medication is nefazodone?
SNRI
What type of medication is milnacipran?
SNRI
What type of medication is desipramine?
TCA
What type of medication is sertraline?
SSRI
What type of medication is venlafaxine?
SNRI
What type of medication is paroxetine?
SSRI
What type of medication is tranylcypromine?
MAOI
What type of medication is duloxetine?
SNRI
What type of medication is citalopram?
SSRI
What type of medication is desvenlafaxine?
SNRI
What type of medication is trazodone?
Tetracyclic
Which drug works well with SSRIs and increases REM sleep?
Trazodone
