Antidepressants Flashcards
(94 cards)
1
Q
How long should one wait to evaluate a response to antidepressants?
A
6-8w
2
Q
Give examples of SSRIs
A
Fluoxetine Citalopram Escitalopram Paroxetine Sertraline Fluvoxamine
3
Q
Give examples of SNRIs
A
Venlaxafine
Desvenlafaxine
Duloxetine
4
Q
Give examples of TCAs
A
Amitryptiline
Imipramine
Desipiramine
5
Q
Give examples of MAOIs
A
Tranylcypromine
Moclobemide (RIMA)
6
Q
Give examples of NDRIs
A
Bupropion
7
Q
Give examples of SARIs
A
Trazadone
8
Q
Give examples of NASSAs
A
Mirtazapine
9
Q
Give examples of NRIs
A
Reboxetine
Atomoxetine
10
Q
Name 8 drug classes classified as antidepressants
A
SSRIs SNRIs NDRIs NRIs TCAs/TDAs MAOIs RIMAs SARIs NaSSAs MAs
11
Q
What does SSRI stand for?
A
Selective serotonin reuptake inhibitor
12
Q
What does SNRI stand for?
A
Serotonin-norepinephrine reuptake inhibitor
13
Q
What does TCA stand for?
A
Tricyclic antidepressant
14
Q
What does MAOI stand for?
A
Monoamine oxidase inhibitors
15
Q
What does NDRI stand for?
A
Norepinephrine-dopamine reuptake inhibitor
16
Q
What does SARI stand for?
A
Serotonin antagonist and reuptake inhibitor
17
Q
What does NaSSA stand for?
A
Noradrenergic and specific serotonergic antidepressants
18
Q
What does NRI stand for?
A
Norepinephrine reuptake inhibitor
19
Q
What kind of drug is reboxetine?
A
NRI
20
Q
What kind of drug is trazadone?
A
SARI
21
Q
What kind of drug is bupropion?
A
NDRI
22
Q
What kind of drug is mirtazapine?
A
NaSSA
23
Q
What kind of drug is atomoxetine?
A
NRI
24
Q
What kind of drug is fluoxetine?
A
SSRI
25
What kind of drug is venlafaxine?
SNRI
26
What kind of drug is citalopram?
SSRI
27
What kind of drug is paroxetine?
SSRI
28
What kind of drug is tranylcypromine?
MAOI
29
What kind of drug is imipramine?
TCA
30
What kind of drug is sertraline?
SSRI
31
What kind of drug is duloxetine?
SNRI
32
What kind of drug is amitryptiline?
TCA
33
What kind of drug is deipramine?
TCA
34
What kind of drug is moclobemide?
MAOI
35
Give examples of antidepressant therapy
```
Cognitive behavioural therapy
Interpersonal psychotherapy
Psychodynamic psychotherapy
Electroconvulsive therapy (ECT)
Transcranial magnetic stimulation (TMS)
Deep brain stimulation (DBS)
```
36
What kind of drug is alprazolam?
Benzodiazepine
37
Give options of drugs for ovulation suppression
GnRH analogue
Danazol
Transdermal estradiol patches
Selected OCP
38
Which drug class does maprotiline belong to?
Tricyclic antidepressants (TTADs?)
39
Danazol in the luteal phase is ineffective for PMDD
| True or false?
True
40
What does RIMAs stand for?
Reversible inhibitors of monoamine oxidase
41
What does MAs stand for?
Melatonin agonists
42
Give the dose for fluoxetine
20-60mg po mane
43
Give the dose for paroxetine
20-50mg po mane
44
Give the dose for citaopram
20-40mg po mane
45
Give the dose for escitaopram
10-20mg po mane
46
Give the dose for sertraline
50-200mg po mane
47
Give the dose for fluvoxamine
50-150mg po bd
48
Name common side effects of SSRIs
```
Sexual dysfunction
N+V
Diarrhoea
Headache
Insomnia
```
49
1st line treatment for MDD?
SSRis
50
2nd line treatment for MDD?
SNRIs
NDRIs
TADs
For MDD augmentation, resistance and prominent pain symptoms
51
Give the dose for venlafaxine
75-300mg po mane
52
Give the dose for desvenlafaxine
50-400mg po mane
53
Give the dose for duloxetine
60-120mg po mane
54
Name common side effects of SNRIs
```
GIT discomfort
Sexual dysfunction
Sedation
Hypotension
Headache
Dry mouth
```
55
Explain the role of NRIs in depression
Mostly ineffective as antidepressant
| For augmentation in MDD
56
Give the dose for reboxetine
4-5mg po bd
57
Name the common side effects of NRIs
```
Urinary hesitancy
Constipation
Headache
Nasal congestion
Perspiration
Dry mouth
Dizziness
Decreased libido
Insomnia
```
58
Explain the role of NRIs in MDD
Mostly ineffective as antidepressant
| For augmentation in MDD
59
Give the dose for bupropion
150-300mg po mane
60
Name the common side effects of NDRIs
Headache
Insomnia
Nausea
61
Which antidepressant carries the risk of lethal arrythmia with overdose?
TADs
62
Explain the role of NDRIs in MDD
Augmentation
Prominent hypersomnia and fatigue
Sexual dysfunction
63
Give the dose for clomipramine
10-250mg po nocte
64
Give the dose for imipramine
10-200mg po nocte
65
Give the dose for trimipramine
30-300mg po nocte
66
Give the dose for lofepramine
140-210mg po nocte
67
Give the dose for maprotiline
75-200mg po nocte
68
Name the most common side effects of TADs
Anticholinergic
Sedation
Orthostatic hypotension
Cardiac arrythmias
69
Name anticholinergic side effects
Constipation
Urinary retention
Dry mouth
Blurred vision
70
Give the dose for tranylcipromine
5-100mg po bd
71
Give the dose for moclobemide
75-300mg po bd
72
Which antidepressant class can cause tyramine-induced hypertensive crisis?
MAOIs
| RIMAs
73
Give examples of tyramine-containing foods
```
Aged cheese
Fish
Biltong
Marmite
Sauerkraut
Beer
Chiati wine
Liquer
```
74
Explain the role of NaSSAs
1st/2nd line
Augmentation
Prominent insomnia
75
Give the dose for mirtazapine
15-45mg po nocte
76
Name common side effects of NaSSAs
Sedation
Weight gain
Increased appetite
Dry mouth
77
Explain the role of NaSSAs in MDD
1st/2nd line
Augmentation
Prominent insomnia
78
Name common side effects of NaSSAs
Sedation
Weight gain
Increased appetite
Dry mouth
79
Explain the role of SARis
Mostly ineffective in MDD
| Prominent insomnia
80
Give the dose for trazadone
75-300mg po bd
81
Name the common side effects of SARIs
```
Sedation
Orthostatic hypotension
Dizziness
Headache
Nausea
```
82
What is the role of MAs in MDD?
Prominent insomnia
83
Give examples of MAs
Agomelatine
84
Give the dose for agomelatine
25-50mg po nocte
85
Name common side effects of MAs
Dizziness
| Nausea
86
Give the dose for vorioxetine
5-20mg po daily
87
Name the most common side effects of vortioxetine
```
Constipation
Nausea
Vomiting
Serotonin syndrome
Abnormal bleeding
Hyponatremia
```
88
What is the most common drug combination that causes serotonin syndrome
SSRI + MAOI OR lithium
89
Name the symptoms of serotonin syndrome as they appear
1. DIarrhoea
2. Restlessness
3. Extreme agitation, hyperreflexia, autonomic instability
4. Myoclonus, seizures, hyperthermia, uncontrollable shivering, rigidity
5. Delirium, coma, status epilepticus, CVS collapse
6. Death
90
Give pharmacological treatment options for serotonin syndrome
```
Nitroglycerin
Cyproheptadine
Chlorpromazine
Dantrolene
BZDs
Anticonvulsants
```
91
Which drugs most commonly cause discontinuation syndrome?
SSRIs
| Short half life eg paroxetine
92
Give the symptoms of discontinuation syndrome
```
Dizziness
Weakness
Nausea
Rebound depression
Anxiety
Insomnia
Poor concentration
Headache
Migraine-like
Parasthesias
URT symptoms
```
93
When do discontinuation syndrome symptoms appear and resolve?
6 weeks after discontinuation
| Resolve after 3 weeks
94
Which drug is best if patient was on an SSRI before presenting with discontinuation syndrome and why?
Fluoxetine
| Long half life
