SSRI's

Question 1

Give examples of SSRI’s

Answer 1

fluoxetine, citalopram(safest in epilepsy), escitalopram, sertraline(safest in cardiac problems)
Paroxetine (rarely used due to discontinuation syndrome and anticholinergic effects

Question 2

What are the actions of SSRI’s?

Answer 2

Block the reuptake of serotonin which increases the concentration of the neurotransmitters in the synaptic cleft

Question 3

How long until SSRI’s work?

Answer 3

at least 2 weeks for improvement. up to 12 weeks for maximum benefit

Question 4

What are the therapeutic uses of SSRI’s?

Answer 4

Depression, OCD, panic disoder, GAD, PTSD, social anxiety disorder

Question 5

What considerations should be taken when prescribing SSRI’s?

Answer 5

Reduce dosage in patients with hepatic impairment because CYP450 enzymes are involved in SSRI metabolism

Question 6

What are the benefits of SSRI’s?

Answer 6

Effective and have little side effects. They are relatively safe in overdose

Question 7

What are the side effects of SSRI’s?

Answer 7

N&V, diarrhea, anxiety, agitation, headache, sleep disturbances, sexual dysfunction, cardiac arrhythmia (in overdose of citalopram), discontinuation syndrome (esp in agents with shorter half life), seizures (may lower seizure threshold). Hyponatremia esp in elderly and patients who are volume depleted/on diuretics

Question 8

What are the effects of SSRI’s in children and teenagers?

Answer 8

Suicide ideation.

Question 9

Which SSRI drugs are suitable for children with depression?

Answer 9

fluoxetine and escitalopram

Question 10

Which SSRI drugs are approved for children with OCD?

Answer 10

fluoxetine, sertraline and fluvoxamine