SSRIs and SNRIs Flashcards

1
Q

List the SSRIs

A

EFFective for Sadness Panic and Compulsion

Escitalopram
Fluoxetine
Fluvoxamine
Sertraline
Paroxitine
Citalopram
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2
Q

SSNRIs

A

Velafaxine above 200mg
Desvenlafaxine

Duloxetine

Milnacipram
Levomilnacipram

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3
Q

What is the NRI

what is its indication

A

Reboxetine

Not approved in US,

Used in eruope for MDD, Panic disorder, and ADHD.

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4
Q

Indications for the SSRIs

A

1st line:

  • major depressive disorder
  • panic disorders
  • OCD
  • PTSD
  • GAD and Social anxiety disorders
  • Bulemia
  • Premature ejaculation - fluoxetine.
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5
Q

Indications for the SNRIs

A
  • major depressive disorder, esp if patients also have sedation
  • Fibromyalgia - Duloxetine and Levomilnaciprame
  • Neuropathic pain and chronic pain syndromes
  • Osteoarthritis chronic pain
    Duloxetine and Venlafaxine
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6
Q

SSRI side effects

A

Have both onset and discontinuation side effects:
Initial phase, lasts a few days:
- CNS stimulation, anxiety agitation, increased chance of suicide from increased energy but unchanged depression

Discontinuation reaction:
Flu-like syndrome lasting a few days if abruptly stopping the medication

  • Headache
  • GI irritation, nausea, and weight loss or gain
  • Sexual dysfunction – major problem and cause for discontinuation.
  • CNS stimulant, agitation
  • Sleep disturbances, insomnia and/or drowsiness

Serious side effects:

  • SIADH, and dilutional hypervolemic hyponatremia
  • Serotonin syndrome
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7
Q

What is the treatment for Serotonin syndrome

A

Cyproheptadine

first-generation antihistamine with additional anticholinergic, antiserotonergic, and local anesthetic properties.

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8
Q

SSRI drug interactions

A

Are CYP inhibitors,
Increase the amount of

TCAs
Lithium
Warfarin
Theophylline

Fluoxetine inhibits both 2D6 and 3A4

Paroxetine 2D6

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