antidepressants

Question 1

examples of SSRIs

Answer 1

citalopram, fluoxetine, paroextine, setraline

Question 2

adverse effects of SSRIs

Answer 2

sexual dysfunction
GI s/e’s - nausea, dyspepsia, constipation, diarrhoea
short term anxiety
in young: ^ risk of self harm in 1st few weeks

Question 3

examples of TCAs

Answer 3

imipramine, clomipramine, amitryptiline

Question 4

adverse effects of TCAs

Answer 4

effects on cardiac function
postural hypotension 
constipation
dry mouth 
blurred vision
sedation

Question 5

what are TCAs good for

Answer 5

hospitalised or severe depression

Question 6

examples of MAOIs

Answer 6

phenelzine

isocarboxazid

Question 7

MAOIs - selective?

Answer 7

non selective

Question 8

what is the disadvantage of MAOIs

Answer 8

strict dietary requirements - cant eat foods containing tyramine e.g. chocolate, cheese - because this can cause hypertensive crisis

Question 9

treatment for hypertensive crisis

Answer 9

alpha blockers

Question 10

why does tyramine cause hypertensive crisis

Answer 10

NA can get into the CV system

Question 11

what can antagonism of DA receptors with some antidepressants cause?

Answer 11

EPSE’s

Question 12

EPSE’s

Answer 12

dystonia
tardive dyskinesia
bradykinesia
tremor

Question 13

when are TCAs useful

Answer 13

when sleep disturbance and anxiety are a problem

Question 14

what are the most dangerous TCA’s in overdose

Answer 14

amitriptyline and dosulepin

Question 15

which type of antidepressant should be stopped in Alzheimers and why

Answer 15

TCA’s

risk of worsening cognitive impairment

Question 16

with which drugs should SSRIs be avoided

Answer 16

Warfarin/heparin - avoid SSRI, consider mirtazapine
NSAIDs - if need to be given, give a PPI too
triptans - avoid