Flashcards in Antidepressants Deck (39):
What drugs are first line for depression?
What is the mechanism of action of SSRIs?
selectively inhibits reuptake of 5HT from postsynaptic cleft
What does SSRI stand for?
selective serotonin reuptake inhibitors
What are some examples of SSRIs?
What SSRI is licensed in children?
What SSRIs are safe in pregnancy?
sertraline and fluoxetine
What SSRI is good for use in patients with epilepsy?
What SSRI can prolong the QTc interval?
What SSRI is good for use in patients with cardiac problems?
What are some discontinuation side effects of SSRIs? How can these be avoided?
gradually decrease dose over 4 weeks instead of coming off all at once
What are the side effects of SSRIs?
SSRIs are safe in overdose - true or false.
When should you take SSRIs?
in the morning
How long should an antidepressant be trialled before trying something else?
Which antidepressant can cause an increase in suicidal idealisation in under 25s?
What antidepressant class should you try if SSRIs aren't working?
What does SNRI stand for?
serotonin and noradrenaline reuptake inhibitors
What is the mechanism of action of SNRIs?
block reuptake of NA and 5HT into presynaptic cleft
What are some examples of SNRIs?
When should you take SNRIs?
IN the morning
What are some examples of tricyclic antidepressants?
Are tricyclics toxic in overdose?
Yes - cardiotoxic
don't give to people with a history of suicide attempt by overdose
What is the mechanism of action of tricyclic antidepressants?
block reuptake of NA and 5HT
When do you take tricyclic antidepressants? Why?
At night - sedation
What are the side effects of tricyclic antidepressants?
anticholinergic effects - dry mouth, constipation, urinary retention
What is the mechanism of action of monoamine oxidase inhibitors?
inhibit MAO A and B enzymes
What are some examples of MAO inhibitors?
When are MAO inhibitors used? Why?
IN resistant depression - due to side effects and diet restriction
Why is diet restricted with MAO inhibitors?
Can cause hypertensive crisis
Build up of tyramine (usually broken down by MAO enzymes) - in certain foods e.g. cheese, chocolate
Potent releasor of NA --> hypertension
What are some symptoms of hypertensive crisis?
How is a hypertensive crisis treated?
What are some side effects of MAO inhibitors?
rare - liver damage
What does NaSSA stand for?
noradrenergic and specific serotonergic antidepressant
What is an example of NaSSA?
When is mirtazapine used?
If SSRI/SNRIs haven't worked
What is the mechanism of action of mirtazapine?
blocks alpha 2 and 5-HT 2 and 3
What can you give with mirtazapine to stop the seratonergic side effects?
What are side effects of mirtazapine?
sedation - good in insomnia