Ssri Flashcards
What does it stand for
Selective Serotonin re-uptake inhibitor
Name two
Citalopram
Sertaline
Indications for use
Moderate or Severe depression
OCD panic disorder
Mechanism of action
In healthy processes serotonin is released from the presynaptic neuron into the synaptic left and binds onto receptors on the post synaptic neurone.
The presynpatic neurone has reuptske transporters
In depression there is low serotonin levels
The mechanism works by blocking the reuptake receptors. This maximises the serotonin in the synaptic left. There is more serotonin available for binding on the post synaptic neurone.
Name the side-effects of the medication
Gi disturbances weight change and appetite change
Hypersensitivity reaction e.g. rash
Hyponatraemia in elderly presenting as confusion
Pro long QT interval predisposing to arrhythmias
Increased risk of bleeding
Serotonin syndrome
Suicidal thought s may worsen
Lowers seizure threshold
Do not withdraw quickly why
Gi upset sleep disturbance
Iinfluenza to like symptoms
Drug interactions
MAOI
Master protection should be given with aspirin or nsaids due to bleeding risk this is also enhanced one given with anticoagulants
Not be prescribed with. Antipsychotics which prolonged QT interval
Advice for patient
Continue even after six months of feeling better to prevent relapse
Discuss long-term psychological therapy
takes
a few weeks to work
Discuss side-effects so they know what to expect and wean off over the four weeks
The contra indications
Those at risk of epilepsy and peptic ulcer disease
And young people increased risk of suicidal thoughts
Metabolised by the liver therefore reduced dose in liver impairment
What is serotonin syndrome
Tired of the following
- Mental state altered
- muscular excitation - improved with treatment withdrawal
- Autonomic Hyperactivity
