SSRI

Question 1

what is the mechanism of action of SSRI?

Answer 1

1. selective serotonin receptor inhibitor

2. inhibits the reuptake of serotonin

Question 2

Name 3 features of Fluoxetine?

Answer 2

1. has longer half life

2. does not need dose reduction over 4 weeks

Question 3

which drug does Fluoxetine react with?

Answer 3

• has the highest propensity for drug interaction with Paroxetine

Question 4

What is the major side effect with Citalopram?

Answer 4

1. long Q-T interval

2. avoid in patients with cardiac problems or already long QT intervals

Question 5

Name 5 drugs which cause prolonged QT interval?

Answer 5

1. Tricyclic antidepressants
2. Amitriptyline
3. Haloperidol
4. Erythromycin

Question 6

What are antidepressants used for?

Answer 6

1. Depression
2. OCD
3. Bulimia
4. Social phobia

Question 7

Name 4 major side effects of antidepressants?

Answer 7

1. GI upset
2. sexual dysfunction
3. hyponatraemia
4. increased anxiety, insomnia and agitation

Question 8

Name 3 cases in which SSRI’s are contraindicated?

Answer 8

1. NSAIDs - avoid SSRI prescribing
2. Triptan - avoid SSRI
3. Warfarin/Heparin - give Mirtazapine instead

Question 9

which antidepressant is prescribed when patient is on Warfarin/Heparin?

Answer 9

Mirtazapine

Question 10

How should SSRI’s be initiated?

Answer 10

1. < 30 years old should be reviewed in 1 week due to risk of increased suicide/idealation
2. Patients > 30 should be reviewed within 2 weeks of starting
3. Patients should remain on them for minimum 6 months

Question 11

How should SSRI’s be stopped?

Answer 11

1. gradual dose reduction over 4 weeks

2. except for fluoxetine