SSRIs SNRIs Cyproheptadine

Question 1

what is the mechanism of action of SSRIs ?

Answer 1

-inhibit presynaptic reuptake of Serotonin

(“worker in sitcom keeps post-it stick notes out of the drawer”)

Question 2

name the SSRIs

(“travel posters behind expreSS tRIps”)

Answer 2

Selective Serotonin Re-uptake Inhibitors

Paroxetine
(“Parrot air” poster)

Fluoxetine
(“Fly out”poster)

Sertraline
(“Desert Airline” poster)

Citalopram
(“the City” poster)

Question 3

MOA of SNRIs

Answer 3

-inhibit presynaptic re-uptake of Norepinephrine and Serotonin

(“North and South compass poster above dual copy machine “)

Question 4

Name the SNRIs

Answer 4

SNRIs

-Venlafaxine
(“fax machine infront of compass poster”)

-Duloxetine
(“Dual copy machine below compass poster”)

Question 5

what can SSRIs AND SNRIs be used for ?

Answer 5

• 1st line treatment for depression {M.D.D}
• *slower onset than Benzos so not useful for treatment of acute symptoms *

-1st line treatment of G.A.D
(Anxious coworker holding “preformance repot”)

-useful for treatment of panic disorder
(“the scream saver”)

-useful for treatment of PTSD
(coworker holding dog tags saying “PT” and SD”)

(“happy/sad masks logo on right edge of sitcom”)

Question 6

what can SSRIs specifically be used for?

Answer 6

-useful in managment of OCD
(“obsessively neat coworker re-arranging his table”)

-
useful in treatment of Bulimia
(blonde coworker opening “binge snack drawer”)

-useful in treatment of Social Anxiety Disorder
(“shy coworker hiding behind desk “)

Question 7

what can SNRIs specifically be used for?

Answer 7

-useful for treatment of Diabetic Neuropathy
(“coworker feeling pain from Diasweeties machine”)

-useful in treatment of chronic pain (neuropathic)
(“chronically frayed wires from diasweeties machine”)

-useful in treatment of fibromyalgia
(“fiber bars at top shelf in diasweeties machine” )

Question 8

how long should you wait before considering an alternative treatment for SSRIs/SNRIs ?

Answer 8

-SSRIs and SNRIs take 1-2 months to achieve maximum effect

(“2 months calendar behind shy guy”)

Question 9

what are the Side effects of SSRIs ?

Answer 9

-hyponatremia as a result of SIADH {incr. ADH}
(“inappropriately wet head of blacky coworker”)

-SSRIs can cause Sexual Dysfunction
(“patty rejects and throws paper clips in ugly guy’s face”)

-SSRIs can cause weight gain
(“fat guy next to expreSS tRIps counter”)

-SSRIs can cause Drowsiness
(“purple shirt coworker sleeping on the job”)

Question 10

what condition may percipitate as a result of SSRIs and SNRIs abuse ? what are the characterisitc findings of this condition ?

Answer 10

-SSRIs and SNRIs may cause Serotonin Syndrome
(“excessive smiley post-it sticky notes in back office”)

-combination of SSRIs/SNRIs with other drugs may also cause serotonin syndrome {e.g. TCAs,MAOis}
(“Tricycle and mouse traps in smiley backoffice”)

-serotonin syndrome is characterized by hyperthermia and hypertension
(“michelle boss of the office is hot and has steam coming out of his ears”)

-characterized by neuromuscular hyperactivity , hyperreflexia , clonus
(“boss of office hyperactive foot tap”)

Question 11

what is the treatment for Serotonin Syndrome ?

Answer 11

Cyproheptadine (5-HT2 blocker)

(boss of the office holding sign saying “silly pranks prohibited”)

Question 12

what are the side effects of SNRIs?

Answer 12

-SNRIs can cause hypertension

(“hypertensive coworker has steam coming out of his ears because of the fax machine”)

Question 13

what are the withdrawl symptoms observed after stopping adminstration of SSRIs/SNRIs ?

Answer 13

• withdrawl symptoms from SSRIs/SNRIs include Flu-like symptoms

(office phone has sticky note saying “out with the flu”)