antidepressants (test 3)

Question 1

Name 5 examples of Tricyclics (TCA)?

Answer 1

amitriptyline, nortriptyline, clomipramine, desipramine, imipramine

Question 2

What do TCAs do?

Answer 2

boost serotonin and norepinephrine

Question 3

What are the clinical uses of TCAs?

Answer 3

depression, neuropathic and chronic pain, migraine prevention, may help primary insomnia

Question 4

What are side effects of TCAs?

Answer 4

weight gain, dry mouth, constipation, urinary retention, sexual side effects, cardiac adverse effects; may be LETHAL in OD

Question 5

Notes on TCA amitriptyline?

Answer 5

dosing = 25 mg QHS initially, target dose 50-150 mg/day

Question 6

Notes on TCA clomipramine?

Answer 6

the most serotoninergic TCA, as such works for OCD

Question 7

Notes on TCA desipramine?

Answer 7

fewer anticholinergic side effects compared to other TCAs

Question 8

Notes on TCA imipramine?

Answer 8

also approved for enuresis

Question 9

Notes on TCA nortriptyline?

Answer 9

plasma levels well studied and may be used to monitor compliance and metabolism

Question 10

What two suffixes do TCAs generally end with?

Answer 10

-iptyline or -ipramine

Question 11

What two suffixes do TCAs generally end with?

Answer 11

-iptyline or -ipramine

Question 12

Name 4 examples of SSRIs and the mnemonic to remember they with.

Answer 12

Fluoxetine, Paroxetine, Sertraline, Citalopram; FLashbacks PARalyze SEnior CITizens

Question 13

What do SSRIs do?

Answer 13

boost mostly serotonin

Question 14

What are clinical uses of SSRIs?

Answer 14

depression, premenstrual dysphoric disorder, generalized anxiety disorder, OCD, PTSD

Question 15

What are adverse effects of SSRIs?

Answer 15

GI side effects initially, sexual side effects

Question 16

Notes on SSRI citalopram?

Answer 16

dosing = 20 mg QD initially, may increase to 40 mg QD. At higher doses may cause QT prolongation

Question 17

Notes on SSRI fluoxetine?

Answer 17

also FDA approved for bulimia nervosa, panic disorders, and bipolar depression – in conjunction with olanzapine

Question 18

Notes on SSRI Paroxetine?

Answer 18

can cause constipation, dry mouth, and sedation

Question 19

Notes on SSRI Sertraline?

Answer 19

has some ability to block dopamine reuptake, which may lead to activation or increased energy

Question 20

Notes on SSRI Sertraline?

Answer 20

has some ability to block dopamine reuptake, which may lead to activation or increased energy

Question 21

Name 2 Serotonin Norepinephrine reuptake inhibitors (SNRIs).

Answer 21

Venlafaxine and Duloxetine

Question 22

What do SNRIs do?

Answer 22

boost serotonin and norepinephrine

Question 23

What are adverse effects of SNRIs?

Answer 23

GI side effects initially; sexual side effects

Question 24

Notes on SNRI venlafaxine?

Answer 24

watch for blood pressure increases; may cause withdrawal syndrome

Question 25

Notes on SNRI duloxetine?

Answer 25

also used for diabetic peripheral neuropathic pain and fibromyalgia

Question 26

Name one Monoamine oxidase inhibitor (MAOI).

Answer 26

selegiline

Question 27

What are MAOIs used for?

Answer 27

recommended for atypical depression and treatment resistant depression. MAOIs are rarely used today due to dietary restrictions.

Question 28

Notes on MAOI selegiline?

Answer 28

transdermal approach for depression, oral for Parkinson disease

Question 29

Name 4 atypical antidepressants (don't fit in the other categories).

Answer 29

bupropion, mirtazapine, trazodone, nefazodone

Question 30

What are the clinical uses of bupropion?

Answer 30

depression, seasonal affective disorder, SMOKING CESSATION; may be added to SSRI to reverse or alleviate sexual side effects

Question 31

What are the two antidepressants that don't have sexual side effects?

Answer 31

bupropion and mirtazapine

Question 32

What are some problems with mirtazapine?

Answer 32

can cause sedation and increased appetite.. BUT its unlikely to cause sexual side effects so that's a bonus

Question 33

What are some problems with mirtazapine?

Answer 33

can cause sedation and increased appetite.. BUT it's unlikely to cause sexual side effects so that's a bonus

Question 34

What are some side effects with trazodone?

Answer 34

sedation but with low weight gain. PRIAPISM (long-lasting, painful erection) is a rare but important adverse effect to consider.

Question 35

Why is nefazodone rarely used?

Answer 35

VERY HEPATOTOXIC!!!