Week 4 Mental health Part 1 Flashcards
citalopram
Celexa
Central Nervous System
Antidepressant
SSRI
Depression/Anxiety; off-label hot flashes
Nausea/loss of appetite/GI upset; weight affects; sleep affects; sexual dysfunction/decreased libido; anxiety/nerviousness; HA; Xerostomia; diaphoresis
MAOIs; SNRIs; tramadol; ondansetron; antiplatelets; anticoagulants; NSAIDs
Boxed Warning for suicidal ideation; precautions: QTc prolongation, discontinuation syndrome
• Key Counseling Points
o Antidepressants take several weeks (~4-6) to start to see effect
May experience side effects before benefit
Will need to continue therapy at least 6-9 months after relief of disease symptoms to prevent from returning
o Discuss signs and symptoms of serotonin syndrome with patient
o Warn patient about risk of suicide (highest during initial therapy) and resources for help
o Minimize alcohol intake and stay hydrated
o Extended release formulations should not be crushed, chewed, or broken to dissolve contents
escitalopram
Lexapro
Central Nervous System
Antidepressant
SSRI
Depression/Anxiety; off-label hot flashes
Nausea/loss of appetite/GI upset; weight affects; sleep affects; sexual dysfunction/decreased libido; anxiety/nerviousness; HA; Xerostomia; diaphoresis
MAOIs; SNRIs; tramadol;
ondansetron; antiplatelets; anticoagulants; NSAIDs
Boxed Warning for suicidal ideation; precautions: QTc prolongation, discontinuation syndrome
• Key Counseling Points
o Antidepressants take several weeks (~4-6) to start to see effect
May experience side effects before benefit
Will need to continue therapy at least 6-9 months after relief of disease symptoms to prevent from returning
o Discuss signs and symptoms of serotonin syndrome with patient
o Warn patient about risk of suicide (highest during initial therapy) and resources for help
o Minimize alcohol intake and stay hydrated
o Extended release formulations should not be crushed, chewed, or broken to dissolve contents
fluoxetine
Prozac
Once-weekly 90 mg delayed release capsule
oral; once weekly tablet
Central Nervous System
Antidepressant
SSRI
Depression/Anxiety; off-label hot flashes
Nausea/loss of appetite/GI upset; weight affects; sleep affects; sexual dysfunction/decreased libido; anxiety/nerviousness; HA; Xerostomia; diaphoresis
MAOIs; SNRIs; tramadol; ondansetron; antiplatelets; anticoagulants; NSAIDs
Boxed Warning for suicidal ideation; precautions: QTc prolongation, discontinuation syndrome
• Key Counseling Points
o Antidepressants take several weeks (~4-6) to start to see effect
May experience side effects before benefit
Will need to continue therapy at least 6-9 months after relief of disease symptoms to prevent from returning
o Discuss signs and symptoms of serotonin syndrome with patient
o Warn patient about risk of suicide (highest during initial therapy) and resources for help
o Minimize alcohol intake and stay hydrated
o Extended release formulations should not be crushed, chewed, or broken to dissolve contents
paroxetine
Paxil
Once-daily controlled release (CR) dosage form
oral; CR capsule
Central Nervous System
Antidepressant
SSRI
Depression/Anxiety; off-label hot flashes
Nausea/loss of appetite/GI upset; weight affects; sleep affects; sexual dysfunction/decreased libido; anxiety/nerviousness; HA; Xerostomia; diaphoresis
MAOIs; SNRIs; tramadol; ondansetron; antiplatelets; anticoagulants; NSAIDs
Boxed Warning for suicidal ideation; precautions: QTc prolongation, discontinuation syndrome
Pregnancy category: X
sertraline
Zoloft
Central Nervous System
Antidepressant
SSRI
Depression/Anxiety; off-label hot flashes
Nausea/loss of appetite/GI upset; weight affects; sleep affects; sexual
dysfunction/decreased libido; anxiety/nerviousness; HA; Xerostomia; diaphoresis
MAOIs; SNRIs; tramadol; ondansetron; antiplatelets; anticoagulants; NSAIDs
Boxed Warning for suicidal ideation; precautions: QTc prolongation, discontinuation syndrome
• Key Counseling Points
o Antidepressants take several weeks (~4-6) to start to see effect
May experience side effects before benefit
Will need to continue therapy at least 6-9 months after relief of disease symptoms to prevent from returning
o Discuss signs and symptoms of serotonin syndrome with patient
o Warn patient about risk of suicide (highest during initial therapy) and resources for help
o Minimize alcohol intake and stay hydrated
o Extended release formulations should not be crushed, chewed, or broken to dissolve contents
desvenlafaxine
Pristiq
Central Nervous System
Antidepressant
SNRI
Depression/Anxiety; neuropathic pain; off-label hot flashes
BP elevation; nausea/loss of appetite/GI upset; Weight affects; sleep affects; sexual dysfunction; HA; xerostomia
MAOIs; SSRIs; tramadol; ondansetron; antiplatelets; anticoagulants; NSAIDs
Boxed Warning for suicidal ideation; precautions: QTc prolongation/cardiovascular disease, discontinuation syndrome
• Key Counseling Points
o May cause an elevation in blood pressure
Patients with high blood pressure will need to increase monitoring when initiated
o Antidepressants take several weeks (~4-6) to start to see effect
May experience side effects before benefit
Will need to continue therapy at least 6-9 months after relief of disease symptoms to prevent from returning
o Discuss signs and symptoms of serotonin syndrome with patient
o Warn patient about risk of suicide (highest during initial therapy) and resources for help
o Minimize alcohol intake and stay hydrated
o Extended release formulations should not be crushed, chewed, or broken to dissolve contents
venlafaxine
Effexor
Central Nervous System
Antidepressant
SNRI
Depression/Anxiety; neuropathic pain; off-label hot flashes
BP elevation; nausea/loss of appetite/GI upset; Weight affects; sleep affects; sexual dysfunction; HA; xerostomia
MAOIs; SSRIs; tramadol; ondansetron; antiplatelets; anticoagulants; NSAIDs
Boxed Warning for suicidal ideation; precautions: QTc prolongation/cardiovascular disease, discontinuation syndrome
• Key Counseling Points
o May cause an elevation in blood pressure
Patients with high blood pressure will need to increase monitoring when initiated
o Antidepressants take several weeks (~4-6) to start to see effect
May experience side effects before benefit
Will need to continue therapy at least 6-9 months after relief of disease symptoms to prevent from returning
o Discuss signs and symptoms of serotonin syndrome with patient
o Warn patient about risk of suicide (highest during initial therapy) and resources for help
o Minimize alcohol intake and stay hydrated
o Extended release formulations should not be crushed, chewed, or broken to dissolve contents
duloxetine
Cymbalta
Central Nervous System
Antidepressant
SNRI
Depression/Anxiety; neuropathic pain; off-label hot flashes
BP elevation; nausea/loss of appetite/GI upset; Weight affects; sleep affects; sexual dysfunction; HA; xerostomia
Boxed Warning for suicidal ideation; precautions: QTc prolongation/cardiovascular disease, discontinuation syndrome
• Key Counseling Points
o May cause an elevation in blood pressure
Patients with high blood pressure will need to increase monitoring when initiated
o Antidepressants take several weeks (~4-6) to start to see effect
May experience side effects before benefit
Will need to continue therapy at least 6-9 months after relief of disease symptoms to prevent from returning
o Discuss signs and symptoms of serotonin syndrome with patient
o Warn patient about risk of suicide (highest during initial therapy) and resources for help
o Minimize alcohol intake and stay hydrated
o Extended release formulations should not be crushed, chewed, or broken to dissolve contents
SSRIs and SNRIs can only be used to treat
depression?
A. True
B. False
B. False
Which of the following is an SSRI? A. Effexor XR® B. Lexapro® C. Cymbalta® D. Wellbutrin®
B. Lexapro®
Patients should be warned that use of an
antidepressant may increase their risk of
suicidal thinking
A. True
B. False
A. True
Which of the following is an SNRI? A. Paxil® B. Remeron® C. Cymbalta® D. Zoloft®
C. Cymbalta®
Which antidepressant should be avoided in pregnancy? A. Zoloft B. Prozac C. Paxil D. Zofran
C. Paxil
Which antidepressant may be inappropriate in a patient with uncontrolled high blood pressure? A. Zoloft® B. Paxil® C. Effexor® D. Lexapro®
C. Effexor®
Patients should be advised to stop taking an SSRI if symptoms of depression do not improve
within 2 weeks.
A. True
B. False
B. False
