SSRIs Flashcards
What is the neurotransmitter pathophysiology of depression ?
It postulates that depression is caused by low synaptic availability of dopamine, norepinephrine, and serotonin.
What are the main functions of serotonin ?
Regulation of mood, emotions and feeding behaviour.
How is serotonin synthesised ?
It is synthesised by the enzymes tryptophan decarboxylase (TDC) and tryptamine 5-hydroxylase (T5H) from the amino acid Tryptophan within the presynaptic neurone.
What is the main post synaptic receptor of 5HT?
5-HT2.
What is the action of SERT?
Serotonin re-uptake transporteres when activated by sodium, chlorine or serotonin itself will transport serotonin from the synaptic cleft to the presynaptic neurones.
What are the firstline SSRIs used in MDD and their MOA?
Citalopram, Ezitalopram, Fluoxetine , Fluvoxamine, Sertraline, and paroxetine. They inhibit the activation of SERTs.
What is the average duration for the therapeutic effects of SSRIs?
4 to 6 weeks are needed for the SSRIs to accumulate in sufficient quantity in the synaptic cleft to inhibit SERTs. They have no effect on other neurotransmitters such as dopamine and norepinephrine. Therefore, fewer side effects.
What are the other conditions that can be treated with SSRIs?
PTSD, OCD, Bulimia Nervosa, and chronic anxiety.
What are the side effects of SSRIs ?
Anxiety, insomnia, drowsiness, sexual dysfunction, SIADH, and serotonin syndrome.
The most dangerous side effect of SSRI?
Suicidal ideation in people <25 years.
What is the management of mild to moderate serotonin syndrome ?
Benzodiazepham and supportive care.
What is the management of severe serotonin syndrome ?
An anti-histamine that also blocks 5-HT2 receptors known as cyproheptadine is the choice.
What are the symptoms of Abrupt SSRI withdrawal?
Irritability, headache, and insomnia.
What is the side effect of SSRI citalopram ?
Prolongation of QT interval.
Fluoxetine and ______ are 2 SSRIs that are CYP450 enzyme inhibitors.
Paroxetine
