Antidepressants Flashcards
(29 cards)
Classes of antidepressants and examples
SSRI - sertraline, paroxetine, fluoxetine, citalopram, escitalopram,
Serotonin Noradrenaline Reuptake inhibitors - venlafaxine, duloxetine
Serotonin Antagonist and Reuptake Inhibitor - Trazodone
Noradrenaline Reuptake Inhibitor - Reboxetine
Noradrenaline Serotonin Specific Antidepressants - Mirtazapine
Tricyclic antidepressants - Amitriptyline, dosulepin, lofepramine
Monoamine Oxidase inhibitors - Isocarboxide, Phenelzine, Moclobemide
Side effects of citalopram
GI side effects - nausea, dyspepsia, constipation, diarrhoea, flatulence, bloating Sweating Tremor Rashes Extrapyramidal Sexual dysfunction Somnolence
Symptoms when stopping sertraline
GI - dyspepsia, flatulence, constipation, diarrhoea, nausea, bloating
Hypomania
Chills
Insomnia
When should SSRIs be avoided?
mania
When should you be cautious with sertraline? What can you do for this?
Can increase risk of GI bleeding
Prescribe with PPI if at high risk e.g. on aspirin/warfarin/heparin/DOACs
Which SSRI for PTSD
sertraline, paroxetine
Which SSRI for post MI
sertraline
Which SSRI for adolescents/children?
fluoxetine
What are the side effects of venlafaxine?
Dry mouth nausea headache dizziness sexual dysfunction hypertension
When is fluoxetine contraindicated?
High risk of arrhythmia
Uncontrolled hypertension
What is the indication for mirtazapine
2nd line for depressed patients who would benefit from weight gain and sedation (suffer insomnia)
What are the side effects of mirtazapine?
Increased appetite Weight gain Sleepiness Dry mouth Postural hypotension Oedema Drowsiness Fatigue Tremor Dizziness confusion Anxiety
Indications for reboxetine
2nd/3rd line for major depression
Side effects of reboxetine?
Nausea, dry mouth, constipation, anorexia, tachycardia, palpitations, vasodilation, postural hypotension, headache, insomnia, dizziness, impotence, urinary retention, sweating
Indication for trazadone
Depressive illness where sedation is required
Side effects of trazadone
Dizziness
Sedation
GI symptoms
Indication for lofepramine?
Depressive illness, noturnal enuresis, neuropathic pain
Side effects of amitriptyline?
Anticholinergic - dry mouth, urinary retention, blurred vision, confusion
CVS - arrhythmias, postural hypotension, tachycardia, syncope, sweating
Uticaria/photosensitivity
Psych - hypomania, mania, confusion, delirium
Increased appetite and weight gain
Contraindications for dosulepin?
Recent MI, arrhythmias, mania, severe liver disease, agranulocytosis
Why should TCAs not be given in suicide risk patients?
Overdose causes cardiac dysfunction
Give the indications for phenelzine
3rd line for depression (treatment resistant)
Why is the use of isocarboxide limited? What can be used instead
Use is limited by toxicity and interaction with tyrosine rich foods
Moclobemide has no need for dietary restriction
What are the side effects of phenelzine?
CVS - postural hypotension, arrhythmia
Psych - insomnia/headache
GI increased appetitie and weight gain
Hypertensive reaction with tyrosine rich foods.
What are the clinical features of serotonin syndrome?
Headache, agitation hypomania, confusion, hallucination and coma
Shivering sweating, hyperthermia, hypertension,
Myoclonus, tremor, hyperreflexia
