Selective serotonin reuptake inhibitors

Question 1

Selective serotonin reuptake inhibitors

Answer 1

preferred drug for depression

citalopram
fluoxetine
sertraline

Question 2

Adverse effects

Answer 2

gastrointestinal symptoms are the most common side-effect

increased risk of gastrointestinal bleeding in patients taking SSRIs = A proton pump inhibitor should be prescribed if a patient is also taking a NSAID

patients should be counselled to be vigilant for increased anxiety and agitation after starting a SSRI

Question 3

which SSRI prolong qt ?

Answer 3

citalopram

Question 4

SSRI are contraindicated with which drugs ?

Answer 4

NSAIDs:
triptans
warfarin / heparin: NICE guidelines recommend avoiding SSRIs and considering mirtazapine
aspirin
monoamine oxidase inhibitors (MAOIs) - increased risk of serotonin syndrome

Question 5

SSRI are contraindicated with which drugs ?

Answer 5

NSAIDs

triptans

warfarin / heparin: NICE guidelines

monoamine oxidase inhibitors (MAOIs) - increased risk of serotonin syndrome

Question 6

Following the initiation of antidepressant therapy patients should normally be reviewed by a doctor after

Answer 6

2 weeks

Question 7

If a patient makes a good response to antidepressant therapy they should continue on treatment for atlas

Answer 7

6 months - reduces the risk of relapse.

Question 8

When stopping a SSRI the dose should be gradually reduced over

Answer 8

4 week period (this is not necessary with fluoxetine).

Question 9

which ssri has a higher incidence of discontinuation

Answer 9

). Paroxetine

Question 10

increased risk of congenital malformations, particularly in the first trimester

Answer 10

. Paroxetine

Question 11

Discontinuation symptoms of SSRI ?

Answer 11

increased mood change

restlessness

difficulty sleeping

unsteadiness

sweating

gastrointestinal symptoms: pain, cramping, diarrhoea, vomiting

paraesthesia