Approved Drugs for Major Depressive Disorder Table 14.6

Question 1

Which are Selective Serotonin Reuptake Inhibitors? (SSRI’s)

Answer 1

Fluoxetine
Paroxetine
Sertraline

Question 2

What are the notes for Selective Serotonin Reuptake Inhibitors? (SSRI’s)

Answer 2

First line of treatment for major depression

Some SSRi’ activate and other sedated. Depends on patient symptoms

Risk of lethal overdose is minimizes with SSRI’s

Question 3

A Serotonin Norepinephrine Reuptake Inhibitors (SNRI’s) drug

Answer 3

Duloxetine

Question 4

A Serotonin Norepinephrine Reuptake Inhibitors (SNRI’s) drug

Answer 4

Side effects
nausea
dry mouth
insomnia
somnolence,
constipation, reduced appetite, fatigue, swetaing, blurred vision

Question 5

What are the side effects for Selective Serotonin Reuptake Inhibitors? (SSRI’s)

Answer 5

agitation
insomnia
headache
nausea
vomiting
sexual dysfunction
hyponatremia

Question 6

Tricycles Antidepressants (TCA’s)

Answer 6

Amitriptyline
Doxepin
Nortriptyline

Question 7

Tricycles Antidepressants (TCA’s) notes

Answer 7

Therapeutic effect as with SSRI’s but side effects are more prominent.
May work better in melancholic depression and in people with comorbid medical conditions
Some therapeutic serum levels may ne monitored

Question 8

Tricycles Antidepressants (TCA’s) Side effects

Answer 8

Dry mouth
constipation
urinary retention
blurred vision
hypotension
cardiac toxicity
sedation
Tachycardia (fast heart rate)
Esophageal reflux

Question 9

Tricycles Antidepressants (TCA’s) Warning

Answer 9

Letha in overdose
use caution in older adults with cardiac disorders
elevated intraocular pressure
urinary retention
hyperthyroidism
seizure disorders
liver and kidney dysfunction

Question 10

Monoamine Oxidase Inhibitors (MAOI’s)

Answer 10

Isocarboxazid
Phenelzine

Question 11

Monoamine Oxidase Inhibitors (MAOI’s) notes

Answer 11

Effects similar to SSRI’s but strict dietary restriction (tyramine)

less desirable drug class

Question 12

Monoamine Oxidase Inhibitors (MAOI’s) side effects

Answer 12

insomia
nausea
agitation
confusion
hypersensitive crisis

Question 13

Monoamine Oxidase Inhibitors (MAOI’s) warning

Answer 13

contraindicated for people taking SSRI’s

use cautiously in people taking Tricyclic Antidepressants (TCA’s)

tyramine rich food can bring about hypersensitive crisis

Question 14

Box 14.3
Symptoms of Serotonin Syndrome Symptoms

Answer 14

Hyperactivity or restlessness
Tachycardia (cardiovascular shock)
Fever ( hyperlexia)
Elevated BP
Altered mental states (delirium)
Irrationality, mood swings, hostility
Seizures (status epilepticus
Myoclonus, incoordination, tonic rigidity
Abdominal pain, diarrhea, bloating
Apnea

Question 15

Box 14.3
Symptoms of Serotonin Syndrome
Interventions

Answer 15

remove offending agent(s)
initiate symptomatic treatment
seratonin receptor blockade with cyproheptadine
methysergige
propranolol
cooling blankets
chlorpromazine for hyperthermia
dantrolene, diazepam, for muscle rigidity or rigors
anticonvulsants
artificial ventilation
induction of paralysis