SSRIs + Side Effects Flashcards
Hypotension
Antiadrenergic
Sedation, weight gain
Antihistamine
Dry mouth, blurry vision, intimacy retention.
Antimuscarinics
Confusion, flushing, diaphoresis, tremor, myoclonus jerks, hyperthermia, hypertonicity, rhabdo, renal failure, death, delirium, electric jolt limb
Serotonin Syndrome
SSRI +MAOI
Serotonin syndrome
MAOI + Tyramine
Hypertensive crisis
Restlessness and agitation
Akathisia
Sustained contraction of muscles of neck, tongue, eyes, diaphragm, able normal postures
Dystonia
Parkinsonism, Akathisia, Dystonia
Within days of starting med
Life threatening
High potency antipsychotics
Hyperprolactinemia
Traditional antipsychotics and risperidine
Choreoathetoid muscle movements of mouth and tongue, tongue protrusion
Years of high potency typical antipsychotics aka tardive dyskinesia
Fever, tachycardia, HTN, tremor, increased CPK, lead pipe rigidity.
Neuroleptic malignant syndrome
All antipsychotics after short or long time
Smoking
Carbamazepine
Barbiturates
St johns wort
CYP450 inducers
Increased metabolism
Lower drug level
Extra pyramidal side effects treatment
Benzotropine
Fluvoxamine Fluoxetine Paroxetine Duloxetine Sertraline
CYP450 inhibitors
Prevents metabolism
Increase drug levels
All antidepressants have…
Similar response rates for major depression but different side effect profiles and safety.
70% respond, 30% is placebo
3-4 weeks to take effect
Withdrawal phenomenon (dizziness, headaches, nausea, insomnia, malaise).
Exacerbate Alzheimer’s
Anticholinergics
Weekly dosed SSRI
Intermittent explosive disorder
Fluoxetine
Relationship between SSRI efficacy and side effects to plasma concentration
None
SSRI
Long half life
Safe in pregnancy
Increase neuroleptic a
Fluoxetine Prozac
SSRI
Highest risk of GI upset
Few drug interactions
Sleep changes
Sertraline Zoloft
SSRI Highly protein bound Several drug interactions Antichol(sedation, constipation, weight gain) Short half life more like withdrawal
Paroxetine Paxil
SSRI
Only for OCD
Nausea vomiting
Lots of drug interactions
Fluvoxamine Luvox
SSRI
Fewest drug interactions
Fewer sexual side effects
Citalopram celexa
Levi-enantiomer
Fewer side effects to citalopram
Escitalopram lexapro
Safer in over dose Sexual dysfunction (do not resolve) GI, insomnia, headache, anorexia, restlessness at initiation and termination
SSRI Side effects
SSRI plus cough syrup or triptans
Serotonin syndrome
