Flashcards in 519-520: Psych Drugs 2 Deck (33):
Name 4 SSRI's
"Flashbacks paralyze senior citiznes"
What are the clinical uses for SSRIs?
How long does it take for antidepressants to take effect?
Are SSRIs or TCAs more toxic?
What are the toxicities of SSRIs?
Sexual dysfunction (anorgasmia, ↓ libido)
What drugs can cause serotonin syndrome?
Any drug that ↑ SSRIs (e.g. MAO inhibitors, SNRIs, TCAs)
What are the symptoms of serotonin syndrome?
What do you treat serotonin syndrome?
Cyproheptadine (5-HT2 receptor antagonist)
List 2 SNRIs
Mechanism of SNRIs:
Inhibit 5-HT and NE reuptake
Clinical use of SNRIs:
GAD and panic disorder - venlafaxine
Diabetic peripheral neuropathy - duloxetine
Toxicity of SNRIs:
Increased BP - most common
List as many TCAs as you can:
-triptyline: amitriptyline, nortriptyline
-imprame: imipramine, desipramine, clomipramine
Mechanism of TCAs:
Block reuptake of NE and 5-HT
Clinical use of TCAs:
Toxicities of TCAs:
Anticholinergic: tachycardia, urinary retention, dry mouth; confusion and hallucinations in elderly
α1-blocking effects (e.g. postural HTN)
Tri-C's: convulsions, coma, cardiotoxicity (arrhythmias)
Name the MAO inhibitors
Selegiline (selective MAO-B inhibitor)
(MAO Takes Pride In Shanghai)
MAO inhibitor effects on levels of amine transmitters:
↑ levels of NE, 5-HT, dopamine
Clinical use of MAO inhibitors:
Toxicities of MAO inhibitors:
Hypertensive crisis (esp. w/ tyramine ingestion)
Contraindicated with SSRIs, TCAs, St. John's wort, meperidine, and dextromethorphan (to prevent serotonin syndrome)
What is the difference in side effect profiles between second and third generation TCAs?
third generation TCAs (amitriptyline) have more anticholinergic effects than second (nortriptyline)
List three atypical antidepressants
Bupropion, mirtazapine, trazodone
What are the clinical uses for bupropion?
Depression, smoking cessation
What neurotransmitters are involved in the actions of bupropion?
↑ NE and dopamine (unknown mechanism)
What are the toxicities of bupropion?
stimulant effects (tachycardia, insomnia)
seizure in bulimic paitents
Regarding its side effect profile, what is an advantage to the use of bupropion for treating depression?
no sexual side effects
What receptor does mirtazapine act on, and what neurotransmitters are involved?
α2-antagonist (↑ release of NE and 5-HT)
Toxicity of mirtazapine
Which antidepressant might you consider using for a depressed patient with insomnia?
Which antidepressant might you consider using for a depressed patient with anorexia, or an elderly patient who is in danger of wasting away?
mirtazapine - it causes weight gain
What is the mechanism of trazodone?
Primarily blocks 5-HT and α1-adrenergic receptors
What are the clinical applications for trazodone?
Insomnia is the primary use b/c high doses are needed for antidepressant effects