Major Depressive Disorder Flashcards
(19 cards)
What three antidepressants are strong CYP2D6 inhibitors?
fluoxetine, paroxetine, and bupropion (fluoxetine also inhibits CYP3A4)
Which SSRIs/SNRIs have cardiovascular related side effects?
citalopram, escitalopram, and venlafaxine
Which antidepressants are known for inducing weight gain?
paroxetine and mirtazapine (in addition to many TCAs)
Which antidepressants are known to cause weight loss?
duloxetine and bupropion
What are the 5 contraindications for bupropion?
- abrupt discontinuation of alcohol, benzodiazepines, or antiepileptics
- bulimia and anorexia nervosa
- seizure disorder
- Use of MAOI within 14 days
- Use with another bupropion product
What are the two “sex friendly” antidepressants?
bupropion and vilazodone
Which two antidepressants have the highest risk of discontinuation syndrome?
paroxetine and vortioxetine
What’s the black box warning for all antidepressants?
Increased risk of suicide in children, adolescents, and young adults
What antidepressant is FDA approved for postpartum depression?
brexanolone
What is the serious/rare side effect associated with mirtazapine?
agranulocytosis (0.1% risk)
What is the serious/rare side effects associated with trazodone?
priapism
What is the mnemonic device used to remember the subjective symptoms of depression?
DIGS-CAPES D- Depressed mood I- Loss of interest G- Guilt S- Sleep disturbance C- Loss of Concentration A- Appetite changes P- Psychomotor agitation/retardation E- Loss of energy S- Suicidal ideations
If a patient has 2 prior episodes of depression, what is the likelihood that they will have a recurrent depressive episode?
70%
Which antidepressant can be stopped cold-turkey due to it’s long half-life?
fluoxetine (stopping this antidepressant abruptly will not cause discontinuation syndrome since it’s long half-life (4-6 days) will allow for self-tapering)
DLC memory tool 4-6 days is how long a flu typically lasts in our system
Which antidepressant is known for causing diarrhea?
Sertraline
DLC memory tool Remember squirt-raline!
What patient population should we avoid duloxetine in?
Hepatitis C and severe alcoholism
DLC memory tool Both hepatitis C and severe alcoholism affects the liver. The liver has a DUAL blood supply (portal vein and hepatic artery)! DUAL= DULoxetine
Which of the SSRI antidepressants has more anticholinergic side effects?
Paroxetine
Paroxetine has a lot of anticholinergic side effects, in addition to weight gain, and sexual dysfunction
DLC memory tool You will be PARCHED while on PARoxetine
What types of foods should be avoided with MAOIs and why?
Tyramine containing foods (wine, aged cheese, avocado, chocolate, beer).
If taken with MAOIs, this can lead to life threatening reactions!
What is the first line treatment option (non-medication) for major depressive disorder with a seasonal pattern (i.e. seasonal affective disorder)?
Bright light therapy
