Antidepressants: SSRIs

Question 1

What does SSRI stand for?

Answer 1

Selective serotonin reuptake inhibitors

Question 2

What is the mechanism of action for SSRIs?

Answer 2

Selectively block/inhibit the reuptake of serotonin

Question 3

What are some examples of SSRIs?

Answer 3

Fluoxetine
Sertaline
Paroxetine
Fluvoxamine

Question 4

Can you take an SSRI with an MAOI (monamine oxidase inhibitor)? Why or why not?

Answer 4

No; SSRIs can interact adversely with MAOIs and other serotonergic drugs; these combinations must be avoided

Question 5

What is the most common complaint with SSRIs?

Answer 5

Sexual side-effects

Question 6

For SSRIs, who is at higher risk for suicidal ideation: Younger ages or older ages?

Answer 6

Younger ages;

Question 7

When are people most likely to commit suicide?

Answer 7

After discharge

Question 8

What is the chemical name for serotonin?

Answer 8

5-hydroxytryptamine (5-HT)

Question 9

SSRIs selectively block the reuptake of serotonin, what kind of neurotransmitter is serotonin?

Answer 9

Monamine

Question 10

Since the reuptake of serotonin is blocked, the concentration of serotonin (5-HT) in the synapse ______, causing increased activation of post-synaptic 5-HT receptors.

Answer 10

Increases

Question 11

SSRIs block 5-HT receptors within hours of dosing, but relief of depression takes several weeks to fully develop. What is this suggesting?

Answer 11

Therapeutic effects are the result of adaptive cellular changes that take place in response to prolonged reuptake blockade

Question 12

Do SSRIs block reuptake of dopamine or norepinephrine?

Answer 12

No

Question 13

SSRI: Fluoxetine

Does fluoxetine block cholinergic, histaminergic, or alpha1-adrenergic receptors?

Answer 13

No

Question 14

SSRI: Fluoxetine

Does fluoxetine produce CNS excitation or sedation?

Answer 14

Excitation

Question 15

SSRI: Fluoxetine

Has death from overdose with fluoxetine been reported?

Answer 15

No

Question 16

SSRI: Fluoxetine- Adverse effects

What are the most common side effects for fluoxetine?

Answer 16

Sexual dysfunction
Nausea
Headache
Manifestations of CNS stimulation (nervousness, insomnia, and anxiety)
Weight gain

Question 17

Can SSRIs cause serotonin syndrome?

Answer 17

Yes; Begins 2-72 hours after treatment onset

Question 18

If you are taking a SSRI drug, what would increase your risk of serotonin syndrome?

Answer 18

Concurrent use of MAOIs and other drugs

Question 19

Of the SSRIs, which one (fluoxetine, sertraline, paroxetine, or fluvoxamine) is the least likely to cause a withdrawal reaction?

Answer 19

Fluoxetine

Question 20

SSRIs: Use of fluoxetine and other SSRIs LATE in pregnancy poses a small risk for what 2 effects in the newborn?

Answer 20

• Neonatal abstinence syndrome (NAS)

- Persistent pulmonary hypertension of the newborn (PPHN)

Question 21

Do fluoxetine and other SSRIs cause birth defects?

Answer 21

Probably not; and if they do, the risk is very low

Question 22

What two SSRIs may cause septal heart defects in a newborn? Is this risk high or low?

Answer 22

Paroxetine and fluoxetine

Very low

Question 23

SSRI: Sertraline
Sertraline blocks the reuptake of _____.
Sertaline relieves ______.
Sertaline causes CNS stimulation or sedation?

Answer 23

Sertraline blocks the reuptake of serotonin.
Sertraline relives symptoms of major depression.
Sertaline causes CNS stumulation

Question 24

SSRI: Can sertraline be combined with MAOIs?

Answer 24

No

Question 25

If you are on sertraline, and you need to start taking an MAOI, how long must the prescriber wait to start the MAOI after finishing the sertraline?

Answer 25

14 days

Question 26

If you are taking an MAOI, and you need to start taking a sertraline, how long must the prescribe wait to start sertraline after finishing the MAOI?

Answer 26

14 days

Question 27

SSRI: Paroxetine | What is this drugs mechanism of action?

Answer 27

Blocking the reuptake of seratonin

Question 28

SSRI: Paroxetine | What pregnancy risk category is this drug and why?

Answer 28

D | Because of the small risk that the baby will of cardiovascular birth defects (primary ventricular septal defects)

Question 29

SSRI: Fluvoxamine | Does this SSRI cause CNS stimulation or sedation?

Answer 29

Moderate sedative effects

Question 30

All the SSRI drugs poses risks for what 4 things

Answer 30

HYPOnatremia GI bleeding NAS (neonatal abstinence syndrome) PPHN (persistent pulmonary hypertension of the newborn)

Question 31

ALL the SSRI drugs CANNOT be taken with what other antidepressant?

Answer 31

MAOIs

Question 32

Which 3 of the 4 SSRIs cause CNS stimulation?

Answer 32

Fluoxetine Sertraline Paroxetine

Question 33

Which of the SSRIs causes moderate CNS sedative effects?

Answer 33

Fluvoxamine