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Flashcards in AntiDepressants Deck (67)
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1

SSRI means

Serotonin-Selective Reuptake Inhibitors

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SSRI MOA

Selectively inhibit reuptake of serotonin from synaptic cleft and increase levels of 5-HT

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SSRI time of action

8 weeks

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***SSRI Side Effects

No anticholinergic toxicity
No "cheese syndrome"
Mainly just serotonin syndrome
Can push a suicidal person over the edge
Agitation, anxiety, panic attacks
Restlessness, psychomotor retardation, mild PD
Rapid muscle movement at night
***Sexual dysfunction (COMMON)
N/V
Diarrhea, GI cramps
HYPONATREMIA

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SSRI work on

Negative affect pts: depressed mood, guilt, disgust, anxiety, irritability
- Dont relieve symptoms of decreased positive affect

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Positive affect means

Joy, happiness, enthusiasm, alertness, self confidence

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So if you have not enough 5HT then you see

Depression, OCD, panic, bulimia

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If you have too much serotonin, then you see

Anxiety, insomnia, sexual dysfunction, GI probs, serotonin syndrome (fever, tremor, seizures) and possibly cardiac valve stuff

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Serotonin Syndrome can happen more often if

SSRI + MAOI

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Who is at higher risk for hyponatremia with SSRIs

Older
Female
Lower Na
Diuretics use
Lower weight

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SSRI Serious ADRs

NE Reuptake blockade and DA reuptake blockade

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Fluoxetine Brand

Prozac

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Fluoxetine classes

SERT (serotonin transporter) Reuptake Blockade
5HT 2C antagonism

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What does fluoxetine do through 2c blockade?

Dis-inhibits NE And DA (increase their levels) which leads to energizing and fatigue reducing effects
Also anorexia and anti-bulimia effects (high dose)

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High dose inhibition and other inhibitions with Fluoxetine (Prozac)

NET and 2D6/3A4 (many drug interactions)

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Sertraline

Zoloft

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Sertraline classes

DA Reuptake Blockade (weakly)
Sigma 1 Agonist

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What does sertraline's classes mean it does?

DA - improve energy and motivation (weak activating)
Signma- Anxiolytic effect

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Paroxetine

Paxil

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Paroxetine effects

Anxiolytic
Weak NET inhibition (good to fight depression)

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Down sides to paroxetine

Inhibits 2D6
Blocks NOS (sexual dysfunction)
Big withdrawal symptoms!

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Fluvoxamine

Luvox

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Fluvoxamine treats

OCD and anxiety

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Fluvoxamine class

Sigma 1 agonists (anxiolytic)

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***Down sides to Fluvoxamine

Metabolized by 3A4 and 1A2 which are induced in smokers

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Citalopram

Cipramil

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Citalopram classes

SERT
Mild H1 blocker

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Pros of citalopram

Better tolerated

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Cons of citalopram

Mild 2D6 inhibition

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S-Citalopram

Escitalopram