SSRIs and SNRIs Flashcards
List the SSRIs
EFFective for Sadness Panic and Compulsion
Escitalopram Fluoxetine Fluvoxamine Sertraline Paroxitine Citalopram
SSNRIs
Velafaxine above 200mg
Desvenlafaxine
Duloxetine
Milnacipram
Levomilnacipram
What is the NRI
what is its indication
Reboxetine
Not approved in US,
Used in eruope for MDD, Panic disorder, and ADHD.
Indications for the SSRIs
1st line:
- major depressive disorder
- panic disorders
- OCD
- PTSD
- GAD and Social anxiety disorders
- Bulemia
- Premature ejaculation - fluoxetine.
Indications for the SNRIs
- 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
SSRI side effects
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
What is the treatment for Serotonin syndrome
Cyproheptadine
first-generation antihistamine with additional anticholinergic, antiserotonergic, and local anesthetic properties.
SSRI drug interactions
Are CYP inhibitors,
Increase the amount of
TCAs
Lithium
Warfarin
Theophylline
Fluoxetine inhibits both 2D6 and 3A4
Paroxetine 2D6