Antidepressants

Question 1

5 indications for antidepressants

Answer 1

Depression
Anxiety
OCD
PTSD
Eating disorders (some)

Question 2

Antidepressant classes (11)

Answer 2

SSRI
SNRI
NDRI
SPARI
Alpha-2 antagonist/NaSSa/SNDI
NRI
SARI
TCA
MAO
NMDA receptor antagonist
Multimodal

Question 3

5 Common SSRIs

Answer 3

Citalopram (Celexa)
Escitalopram (Lexapro)
Fluoxetine (Prozac)
Paroxetine (Paxil)
Sertraline (Zoloft)

Question 4

3 Common SNRIs

Answer 4

Duloxetine (Cymbalta)
Venlafaxine XR (Effexor XR)
Desvenlafaxine (Pristiq)

Question 5

Common NDRI

Answer 5

Buproprion (Wellbutrin)

Question 6

Multimodal Agent

Answer 6

Vortioxetine (Trintellix)

Question 7

Common SPARI

Answer 7

Vilazodone (Viibryd)

Question 8

SSRI metabolized by

Answer 8

CYP450 (1A2, 2D6, 3A4)

Question 9

SSRIs for FDA-approved for PTSD

Answer 9

Paroxetine (Paxil)
Sertraline (Zoloft)

Question 10

What can SSRIs interfere with?

Answer 10

Clotting Cascade

Question 11

How do you dose SSRIs?

Answer 11

Start low, go slow, usually increase dose in 2-4 week increments

Question 12

SSRI Common SE

Answer 12

GI upset
Akathisia
Sexual SE
HA
Dry mouth

Question 13

SSRI Serious SE

Answer 13

Serotonin syndrome
Increased suicidal thoughts < 25 years old

Question 14

Indication for Citalopram (Celexa)

Answer 14

FDA Approved for MDD in adults only (favorable in elderly)

Question 15

Concern w/ Citalopram (Celexa)

Answer 15

Can cause QT prolongation > 40mg/day PO

Question 16

What can Citalopram (Celexa) cause?

Answer 16

paradoxical yawning

Question 17

When to give Citalopram (Celexa)?

Answer 17

Give at night (it’s a weak antihistamine)

Question 18

Citalopram (Celexa) Common SE

Answer 18

Nausea
HA
Lightheaded
Anxiety
Sexual dysfunction
Excess sweating
(More than lexapro but not bad)

Question 19

What to monitor for Citalopram (Celexa)?

Answer 19

EKG esp w/ other meds that prolong QT or deplete Mg or K

Question 20

Quintessential SSRI

Answer 20

Escitalopram (Lexapro)

Question 21

Escitalopram (Lexapro) Indication

Answer 21

FDA Approved for MDD, GAD
MDD for children 12+

Question 22

What is Escitalopram (Lexapro) also effective for?

Answer 22

OCD, Panic disorder, PTSD, social anxiety, PMDD, PTSD

Question 23

Pros of Escitalopram (Lexapro)

Answer 23

Fewer SE, lower doses, more predictable (10mg vs 40mg Celexa)
Most well tolerated SSRI
Very effective in treating Anxiety

Question 24

Prozac (Fluoxetine) indication

Answer 24

MDD, OCD, panic disorder, PMDD, bulimia nervosa, bipolar disorder (w/ Zyprexa - Symbyax)

Question 25

Age and Diagnosis indications for Prozac (Fluoxetine)

Answer 25

8-17: OCD 7-17: MDD

Question 26

Pros of Prozac (Fluoxetine)

Answer 26

Energizing effect (good for anxiety), focus/concentration issues Longest 1/2 life (if compliance is an issue) Most studied agent for children (lowest SI risk)

Question 27

Indication for Luvox (Fluvoxamine)

Answer 27

OCD and social anxiety disorder

Question 28

Off label use for Luvox (Fluvoxamine)

Answer 28

Panic disorder and PTSD -better for anxiety, may benefit psychosis

Question 29

Age and diagnosis indication for Luvox (Fluvoxamine)

Answer 29

8-17: OCD

Question 30

Concern with Luvox (Fluvoxamine)

Answer 30

-can interact with other meds -caffeine increases potency up to 5 times

Question 31

Benefit of Luvox (Fluvoxamine)

Answer 31

Most effective agent for social anxiety disorder and OCD

Question 32

Indication for Sertraline (Zoloft)

Answer 32

MDD, OCD, panic disorder, PTSD, PMDD, and social anxiety disorder -may be helpful in psychotic depression

Question 33

Off-label indication for Sertraline (Zoloft)

Answer 33

MDD

Question 34

Age and indication Sertraline (Zoloft)

Answer 34

6-17: OCD

Question 35

Sertraline (Zoloft) side effects

Answer 35

Nausea HA Lightheaded Anxiety Sexual dysfunction Less potential for weight gain

Question 36

Concern with Sertraline (Zoloft)

Answer 36

Some drug interactions, esp. higher dose range

Question 37

Indication for Paroxetine (Paxil)

Answer 37

OCD, panic disorder, social anxiety disorder, GAD, PMDD, PTSD -anticholinergic, sedating calming

Question 38

Most effective medication for PTSD

Answer 38

Paroxetine (Paxil) w/ most side effects

Question 39

What is Paroxetine (Paxil) very effective for

Answer 39

sexually disinhibited patients potentially w/ excessive gambling

Question 40

What is Paroxetine (Paxil) associated with?

Answer 40

Withdrawal syndrome (shortest 1/2 life) -Anticholinergic rebound (akathisia, restlessness, GI upset, dizziness, tingling)

Question 41

Common SE of Paroxetine (Paxil)

Answer 41

Nausea HA Lightheaded Anxiety Sexual Dysfunction

Question 42

What medication is the worst offender for inducing mania in bipolar patients?

Answer 42

Paroxetine (Paxil)

Question 43

What is SPARI? What's an example?

Answer 43

Serotonin Partial agonist re-uptake inhibitor Vilazodone (Viibryd)