somatic therapies Flashcards
metabolism of SSRI
hepatic
lethargy, restlessness, mental confusion, flushing, diaphoresis, termor
serotonin syndrome
serotonin occurs when what are combined
> 1 SSRI, or MAOi
subclinical serotonin syndrome
mild cognitive complaints, mild tremor, diaphoresis
at lower doses, venlafaxine acts on_____, at higher doses it acts on_____
inhibits serotonin reuptake; inhibits NE and DA reuptake
high doses of venlafaxine assc’d with what SE?
sedation
which med is very sensitive to discontinuation syndrome
venlafaxine
buproprion MOA
weak reuptake inhib of DA and NE
at doses >450 of wellbutrin, what SE may occur?
seizure
MOA of vilazodone
SSRI and 5HT receptor partial agonist
MOA of trazadone
weak inhibitor of serotonin + blocks 5HT2 receptors
utilization of trazadone
sleep agent
MOA of mirtazapine
antag at postsynaptic 5HT2, 5HT3, central alpha1
uses of mirtazapine
MDD, sleep aid
what class is chlomipramine
TCA
what makes chlomipramine stand out from other TCA
relatively selective serotonin reuptake inhib
anxiety, irritability, insomnia, HA, nausea, malaise, motor disturbance
discontinuation syndrome
does melancholic depression or bipolar depression respond better to meds
melancholic depression
choice med for tx of MDD during pregnancy
sertraline
the most widely prescribed class of psychotropic drugs
benzos
tx of OCD
- higher doses SSRI
2. clomipramine
MOA of benzos
GABA agonist
buspirone is effective in treating what type of anxiety
GAD
MOA of buspirone
dendritic 5HT agonist
1st line fro acute psychosis
high potency SGA or haloperidol
muscle rigidity, high fever, delirium, autonomic instability, elevated serum CPK and LFT
neuroleptic malignant syndrome
tx of neuroleptic malignant syndrome
- stop med
2. bromocriptine
occurs within 1st 4 days of antipsychotic administration, sustained contraction of neck muscles
acute dystonic rxn
tx of acute dystonia
benztropine or diphenhydramine
can occur within 1st few weeks of antipsychotic initiation, anxiety, tension, restlessness, agiatation
akathesia
tx of akathesia
propranolol
black box warning with risperidone
incr CVA
most effective and least tolerated SGA
clozapine
risk of agranulocytosis assc’d with?
clozapine
antipsychotic Least likely to cause weight gain
ariprazole
what has been shown to minimize weight gain in ppl on antipsychotics
metformin
SE: Hypothyroidism, polyuria/polydipsia, tremor, nausea, weight gain, edema - what drug?
lithium
mental status changes, ataxia, dehydration, hyponatremia
lithium toxicity
most effective tx for depression
ECT
which SNRI is indicated for ADHD
atomoxetine
