Antidepressants Flashcards
(22 cards)
What type of antidepressant is imipramine?
Tricyclic
Name 6 common side effects of tricyclic antidepressants
- Drowsiness
- Dry mouth
- Blurred vision
- Constipation
- Urinary retention
- Lengthening of QT interval
Antimuscarinic side effects
Which 2 drug groups increase the risk of serotonin syndrome if taken with SSRIs?
- Triptans
- Monoamine oxidase inhibitors
Which antidepressant is preferred in children and adolescents?
Fluoxetine
Still use with caution
Which antidepressants are preferred in elderly people?
Citalopram or sertraline
Which SSRI is most associated with elongating QT interval?
Citalopram
How long should SSRI be trialled for?
At least 4-6 weeks to see the effects.
After SSRI prescription is commenced, how long until a review should take place?
2 weeks
How long should an SSRI be taken for in total?
At least 6 months.
Which SSRI is most suitable after having a myocardial infarction?
Sertraline
Can SSRIs be taken in pregnancy?
All SSRIs have some teratogenicity. Particularly the case with paroxetine in the first trimester.
If paroxetine is taken in the first trimester, what can the teratogenic effects be?
Congenital malformations - avoid.
In which circumstances may clozapine be prescribed?
Only after trial periods of adequate dose and adequate duration of a 1st generation antipsychotic AND a 2nd generation antipsychotic have proven to be insufficient in treating psychotic symptoms.
Which blood disorder can occur as an adverse effect of clozapine?
Agranulocytosis
When absolute neutrophil count is <100 per microlitre of blood
How often is FBC monitoring required for those taking clozapine?
- Weekly monitoring for 18 weeks
- Then, fortnightly monitoring for 1 year
- Then, monthly monitoring from then onwards
What threshold is lowered by clozapine?
Seizure threshold
What lifestyle factor may mean clozapine dose needs changing?
If the person stops or starts smoking
What type of antipsychotic is olanzapine?
Atypical antipsychotic
Which atypical antipsychotic is most likely to produce weight gain and others metabolic side effects?
Olanzapine
What drugs and substances can cause serotonin syndrome?
- Selective serotonin reuptake inhibitors (SSRIs)
- Monoamine oxidase inhibitors (MAOIs)
- Ecstasy
- Amphetamines
- St John’s Wort
What is the antidote for serotonin syndrome?
IV cyproheptadine
What are the features of serotonin syndrome?
- Confusion
- Restlessness
- Tremor
- Myoclonus
- Diaphoresis
- Convulsions
- Mydriasis
- Hyperreflexia
