Antidepressants

Question 1

What is the most common psychiatric illness?

Answer 1

Depression

Question 2

What percent of Americans will experience depression at some point in their lives?

Answer 2

30%

Question 3

What are some non-drug therapies that help treat depression?

Answer 3

Excercise
Nutrition
Spiritual Health
Therapy

Question 4

Common Monoamine Oxidase Inhibitors (MAOIs)

Answer 4

Isocarboxazid
Phenelzine
Selegiline transdermal
Tranylcypromine

Question 5

MAOIs are prescribed for what?

Answer 5

major depression

Question 6

What is the enzyme that breaks down dopamine, norepinephrine, and serotonin?

Answer 6

Monoamine oxidase

Question 7

MAOIs increase what in the brain’s synapses?

Answer 7

Serotonin
Norepinephrine
Dopamine

Question 8

What should clients who are taking MAOIs avoid?

Answer 8

Foods that contain tyramine

Question 9

Rule of thumb for foods containing tyramine

Answer 9

“Old” and “Stinky”

Question 10

What process produces high levels of tyramine in foods?

Answer 10

Aging Process

Question 11

Anytime a client takes an MAOI, what happens to the serotonin, norepinephrine, and dopamine levels?

Answer 11

There is going to be a significant increase in the levels.

Question 12

Clients must avoid what kind of other drugs that increase these MAOI neurotransmitters?

Answer 12

Other antidepressants
Over-the-counter cold medications
Meperidine (pain med)
Triptans (migraine meds)

Question 13

What will happen is a client uses excessive amounts of tyramine?

Answer 13

Their blood pressure will skyrocket.

High norepinephrine levels will do the same.

Question 14

What is characterized by an altered mental status, high fever, sweating, and clonus?

Answer 14

Serotonin Syndrome

Question 15

What is clonus?

Answer 15

An involuntary, rhythmic muscle contraction

Question 16

Many clients taking MAOIs experience what?

Answer 16

Hypertensive Crisis
Serotonin Syndrome
Orthostatic Hypotension

Question 17

Common Trycyclic Antidepressants (TCAs)

Answer 17

Amitriptyline

Nortriptyline

Question 18

TCAs are prescribed for what?

Answer 18

Major Depression
Neuropathic Pain
Anxiety Disorders

Question 19

TCAs work by blocking what?

Answer 19

Serotonin and norepinephrine reuptake pumps.

Serotonin and norepinephrine levels are increased in synapses.

Question 20

TCAs are not selective, so they also block muscarinic cholinergic receptors causing what?

Answer 20

Anticholinergic Effects (Can’t See, Can’t Pee, Can’t Spit, Can’t Defocate)

Question 21

Many clients taking TCAs experience what?

Answer 21

Anticholinergic Effects
Orthostatic Hypotension
Cardiotoxicity

Question 22

What is the most serious problem with TCAs?

Answer 22

They can cause fatal heart dysrhythmias when overdosed. It can also cause suicidal thoughts.

Question 23

Common Selective Serotonin Reuptake Inhibitors (SSRIs)

Answer 23

Escitalopram
Fluoxetine
Paroxetine
Sertraline

Question 24

SSRIs are first-line drugs for what?

Answer 24

Depression

Anxiety

Question 25

SSRIs are very selective and only block what?

Answer 25

Serotonin reuptake pump increasing levels of serotonin in the brain

Question 26

What are some side effects associated with SSRIs?

Answer 26

``` Stomach troubles Slow metabolism Sexual dysfunction Suicidal ideas Sedation (except for Fluoxetine) ```

Question 27

Common Serotonin Norepinephrine Reuptake Inhibitors (SNRIs)

Answer 27

Duloxetine | Venlafaxine

Question 28

SNRIs are prescribed for what?

Answer 28

Major Depression Neuropathic Pain Anxiety

Question 29

SNRIs are very selective and only block what?

Answer 29

Serotonin and norepinephrine reuptake pumps

Question 30

What are some side effects associated with SNRIs?

Answer 30

Similar to SSRIs (5 S's) except they can cause hypertension also

Question 31

Bupropion

Answer 31

Prescribed for Depression, Smoking Cessation, Adult ADHD Inhibits reuptake of dopamine and norepinephrine No significant effect on serotonin INCREASES LIBIDO Side Effects: Anxiety and Insomnia Contraindicated in clients with risk of seizures

Question 32

Trazadone

Answer 32

Prescribed for Depression and Insomnia Weak inhibitor of serotonin with strong sedative and anticholinergic effects Can cause priapism(prolonged, painful erection)

Question 33

Two common themes in clients taking antidepressants

Answer 33

1. It takes a few weeks to start working. Don't give up! | 2. Most have a black box warning regarding an increased risk of suicidal thoughts. Most common <18.