Side Effects of Psychiatric Drugs

Question 1

What are some side effects of monoamine oxidase inhibitors e.g. phenelzine?

Answer 1

Cheese reaction causes hypertension
Postural hypotension
Peripheral oedema

Question 2

What are some side effects of TCAs?

Answer 2

Cardiotoxic in overdose
Weight gain
Sedation
Postural hypotension, tachycardia, arrhythmias
Reduces smooth muscle activity –> blurred vision, dry mouth, constipation, urinary retention

Question 3

What are some side effects of SSRIs e.g. fluoxetine, citalopram, sertraline?

Answer 3

Nausea, headache, sweating, suicidal ideation, sexual dysfunction, hyponatraemia
NSAID + SSRI causes increased risk of bleeding so give PPI

Question 4

What are some side effects of SNRIs e.g. venlafaxine?

Answer 4

Hypertension, long-QT

Question 5

What are some side effects of mirtazapine?

Answer 5

Weight gain, sedation and abnormal dreams

Question 6

What are some side effects of lithium?

Answer 6

Dry mouth, polyuria, polydipsia, tremor
Reduced renal function - monitor U&Es
Hyperparathyroidism and hypercalcaemia - monitor TFTs and calcium
Worsens psoriasis

Question 7

What symptoms indicate lithium toxicity?

Answer 7

Vomiting, diarrhoea, ataxia, coarse tremor, drowsiness, convulsions, coma

Question 8

What are some side effects of 1st generation antipsychotics (D2 antagonists)?

Answer 8

Sexual side effects due to hyperprolactinaemia

Extra-pyramidal side effects e.g. parkinsonism, acute dystonic reaction, akathisia

Question 9

What are some side effects of 2nd generation anti-psychotics?

Answer 9

Weight gain (esp olanzapine)
Metabolic syndrome
Sedation, CVS risk

Question 10

What are the side effects of clozapine?

Answer 10

Agranulocytosis, seizures, myocarditis, constipation and drooling