Psych Drugs Flashcards
Antidepressant indications
depression, anxiety, neuropathic pain, eating disorders
SSRIs (5)
citalopram/escitalopram, fluoxetine, sertraline, duloxetine, paroxetine
SSRI AEs
BOW SIGHSS - bleeding, orthostatic hypotension, weight gain, sexual dysfunction, GI upset, hyponatremia, sleep serotonin syndrome, sweating (+/- initial anxiety/agitation)
Citalopram - key info
SSSRI, key SE - QT prolongation
Fluoxetine - key info
SSRI, use for adolescents
Paroxetine - key info
SSRI, key SE - sexual dysfunction
Sertraline - key info
SSRI, commonly used (usu well-tolerated), key SE - GI symptoms
Duloxetine - key info
SSRI, best for back pain
SNRIs
Venlafaxine, SEs - same as SSRI + hypertension (not ortho hypotension), more effective than SSRI but more toxic (more SEs)
Mirtazapine
SE - +++weight gain, sedation
1st line antidepressants
SSRIs, SNRIs, mirtazapine
MAOIs
Moclobemide, doesn’t cause sexual dysfunction, SE - cheese reaction
TCAs
Amitriptyline, nortryptiline
TCA - AEs
anti-HAM, major C: anti-Histamine (sedation), anti-Adrenergic (orthostatic hypotension, tachycardia, arrhythmias), anti-Muscarinic (anti-SLUDGE), Convulsions, Coma, Cardiotoxicity (OD = lethal)
2nd line antidepressants
TCAs, MAOIs
Mood stablisers
Ind: bipolar, lithium & anti-epileptics (sodium valproate, carbamazepine)
Lithium - AEs
6 Ts - thirst, thyroid, tremor (fine), tone (weakness), thinking, toxicity (GAIT - GI upset, Ataxia, Impair consciousness, Tremor (coarse)) + nephrotoxicity
Lithium - monitoring
baseline + 6mnthly: lithium lvls (baseline + 8h after dose), PTH, UEC, eGFR, TFT
Sodium valproate - AEs
Hepatotoxicity, thrombocytopenia, hair loss, teratogenic
Carbamazepine - AEs
Agranulocytosis, aplastic anaemia, teratogenic, ataxia
Typical/ first generation antipsychotics
Chlorpromazine, haloperidol, flupenthixol, zuclopenthixol
Typical antipsychotics - AEs
More EPSE, less metabolic: SEA HOW - sedation, EPSE (parkinsonism, akathisia, dystonia, tardive dyskinesia), anticholinergics, hyperprolactinaemia, orthostatic hypotension, weight gain/metabolic
Atypical/ second generation antipsychotics
Risperidone, olanzapine, quetiapine, aripiprazole, amisulpride, clozapine (less EPSE, more metabolic SEs + better for negative symptoms)
Olanzapine - key info
2nd gen antipsychotic, key SE - weight gain (worst)
Quetiapine - key info
2nd gen antipsychotic, key SEs - ++sedation, best in Parkinson’s disease
Aripiprazole - key info
2nd gen antipsychotic, least sedating
Depot antipsychotics
haloperidol, zuclopenthixol, olanzapine