where should MOAIs be managed?
not at the primary care level
psychiatrist
which SSRIs are structurally similar?
lexapro and celexa
what are other indications of SSRI?
OCD, panic d/o, GAD, PMDD, SAD, eating disorders
which SSRI has the longest half life?
prozac 4-6 days
what is the peak action of SSRIs?
3-8 hrs
where are SSRIs metabolized?
CYP450 enzyme in the liver
which SSRI has most liver metabolic problems?
luvox
what is the MOA of SSRI?
inhibit re-uptake of 5HT making more serotonin available
little effect on dopamin and norepi
which SSRI has significant anticholinergic activity at higher doses?
paxil
how does SSRI withdrawal present?
flu like
N. fatigue, myalgia, vertigo
what are SE of SSRI?
h/a, dizziness, N, D, insomnia, sexual dysfunction (everything goes away with long term use except for sexual dysfunction)
what are drug interactions that can cause serotonin excess?
SSRI + MAOI OR Triptan OR lithium
what is hallmark of serotonin syndrome?
**mental status change
**autonomic hyperactivity
**neuomuscular abn
D, restlessness, agitation, hyperreflexives, myoclonus, seizures, hyperthermia, AMS, death
