Selective Serotonin Reuptake Inhibitors Flashcards
what SSRI is used post-MI?
sertraline
what SSRIs are most commonly used first line?
- citalopram
- fluoxetine
what are the adverse effects of SSRIs?
- GI symptoms
- GI bleed
- hyponatraemia
- increased anxiety and agitation
what should be prescribed if a patient is on a SSRI + NSAID?
PPI
name a side-effect most commonly seen in citalopram
dose-dependent QT interval prolongation
what drug interactions are seen with SSRIs?
- +NSAIDs –> prescribe PPI
- warfarin/heparin = avoid
- aspirin = avoid
- triptans = increased risk of serotonin syndrome
- monoamine oxidase inhibitors = increased risk of serotonin syndrome
when should a patient be reviewed upon starting SSRI?
after 2 weeks
if <25 or suicide risk –> review after 1 week
how long should a patient take SSRI for?
at least 6 months
how should an SSRI be stopped?
gradually reduce dose over 4 week period
what are the discotinuation symptoms associated with SSRIs?
- increased mood change
- restlessness
- difficulty sleeping
- unsteadiness
- sweating
- GI symptoms
- paraesthesia
what is SSRI + 1st trimester associated with?
congential heart defects
what is SSRI + 3rd trimester associated with?
persistent pulmonary hypertension of the newborn
which SSRI has an increased risk of congential malformations, particularly when used in the 1st trimester?
paroxetine
how does serotonin syndrome present?
- autonomic instability
- neuromuscular hyperreactivity
- mental status changes
what is the SSRI of choice in children and adolescents?
fluoxetine
