Antidepressant Deck 2

Question 1

TCA are

Answer 1

very sedating and are lethally in overdose.

Question 2

SSRIs

Answer 2

most common

Question 3

SSRIs work at what bases

Answer 3

1st, 2nd, and 3rd

Question 4

SSRI LEA…P effects

Answer 4

L: Decrease libido and sleep
E: Neutral effect on energy*
A: Neutral effect on addiction and craving

Question 5

Which SSRI can you stop abruptly and why

Answer 5

fluoxetine due to it’s long half life.

Question 6

SSRI P in LEAP

Answer 6

y P: Differences within class
y Some may “poop out (just stops working)” (Celexa)
y Sedating and activating properties
y Weak anticholinergic and dopaminergic
y Fluoxetine activating, Paroxetine sedating

Question 7

Fluoxetine is

Answer 7

activating

Question 8

paraoxetine is

Answer 8

sedating

Question 9

NSRI act on what bases

Answer 9

Act at 1st, 2nd, 3rd, home plate and pitcher’s mound

Question 10

NSRI exampels

Answer 10

Venlafaxine (Effexor) and Duloxetine (Cymbalta)

Question 11

NSRI effects

Answer 11

y Libido reduced
y Energy increased
y Addiction/craving neutral to helpful

Question 12

NSRI “P”

Answer 12

May increase GI upset, may increase BP

y Titrate slowly

Question 13

SNDRIs

Answer 13

Triple reuptake inhibitor results in increase in serotonergic, adrenergic and dopaminergic neurotransmission

Question 14

SNDRI LEAP

Answer 14

L:More neutral effect on libido (blocks 5HT2a)
E:Decreases energy
A:Neutral effect on addiction/craving
P: Enzyme system 2D6: slow metabolizers may build up stimulate 5HT2 and stimulate 5HT2a and cause increased sleep
y Alpha 1 blocker: postural hypotension risk

Question 15

SNDRI examples

Answer 15

Mazindol (Sanorex) anorectic
Nefazodone (Serzone) antidepressant*
Nefopam ( Nefadol, Silentan) analgesic
Sibutamine (Meridia) anorectic

Question 16

TCA bases

Answer 16

Act primarily at 1st base, some 2nd and home plate

Question 17

TCA LEAP

Answer 17

y L: decrease libido
y E: increase energy*
y A: Neutral effect
y P: May stimulate HT3
y Anticholinergic effects (Elderly especially)
y High risk of OD

Question 18

at a high dose TCA is

Answer 18

sedating

Question 19

TCA should not be used in

Answer 19

elderly population due to anticholinergic effects

Question 20

Which has greater side effects amytriptaline or nortriptaline

Answer 20

amytriptaline

Question 21

Mirtazepine (Remeron) LEAP

Answer 21

L:Neutral effect on libido
E:Decreases energy
A: Neutral on addiction/craving
P: Alpha 1 blocker: postural hypotension risk

Question 22

Mirtazepine (Remerone) acts at what bases

Answer 22

Acts at 1st, 2nd, 3rd base, and homeplate

Question 23

Remerone is a

Answer 23

alpha 1 blocker : postual hypotension risk

Question 24

Bupropion (wellbutrin acts to

Answer 24

to inhibit reuptake of NE, DA, and serotonin

Question 25

Bupropion (Wellbutrin) uses

Answer 25

Depression, seasonal affective disorder, treats sexual dysfunction relative to SSRI therapy, smoking cessation

Question 26

Bupropion (Wellbutrin) has a

Answer 26

long half life

Question 27

Bupropion (Wellbutrin) lowers

Answer 27

seizure threshold

Question 28

SSRI population

Answer 28

Post-MI DM General

Question 29

SNRI populations

Answer 29

General SSRI not tolerated

Question 30

Important to do what with SNRI

Answer 30

Monitor blood pressure

Question 31

Wellbutrin population

Answer 31

SSRI not tolerated Smokers Wellbutrin does not effect libido. So people with this consideration

Question 32

TCA population

Answer 32

young addults

Question 33

Depression with anxiety drugs

Answer 33

SSRI | SNRI

Question 34

Depression with decreased libido

Answer 34

Welbutrin

Question 35

Depression with Insomina

Answer 35

SSRI | TCA

Question 36

MAOI are used when

Answer 36

all else falis; atypical depression

Question 37

MAOI have

Answer 37

multiple drug intreacions

Question 38

make sure what before starting maoi

Answer 38

fully weaned off SSRI

Question 39

allow time between stopping ___ and starting ___

Answer 39

antidpressant and MAOI

Question 40

Mood stabilizers example

Answer 40

Bipolar: Lithium, lamotrigine, depakote, oxcarbazepine, gabapentin

Question 41

Psychotropics

Answer 41

aripiprazole, risperidone, olanzapine, ziprasidone, | clozapine

Question 42

gabapentin can be used for

Answer 42

chronic pain

Question 43

Young

Answer 43

SSRIs and TCA

Question 44

Old

Answer 44

TCA have anticholingeric effects

Question 45

Young precautions

Answer 45

SSRI (black box warning for SI) TCA overdose

Question 46

Pregnancy

Answer 46

All are mostly contraindicated. If you need to use, use an SSRI