SSRIs Flashcards
SSRIs - 6 drugs
Fluoxetine Fluvoxamine Paroxetine Sertraline Citalopram Escitalopram
SSRIs - MOA
Selectively block neuronal reuptake of SER, much less effect on NE reuptake than TCAs
Administration of SSRIs
In the morning (tend to increase alertness)
SSRIs - contraindications
Caution in seizure disorders, hepatic disorders, diabetes and bipolar disorder.
Should not be given with MAOIs or triptan agents (serotonin syndrome).
Serotonin syndrome - symptoms
Agitation Restlessness Insomnia Confusion Seizures Severe hypertension GI symptoms
SSRIs - adverse effects
Nervousness, dizziness, insomnia. Male sexual dysfunction (priapism, impotence)
SSRIs - interactions
SSRIs increase serum levels of antipsychotic drugs, TCAs, dextromethorphan, alprazolam, diazepam, carbamazepine, phenytoin, others.
Increase hypoptothrombinemic effect of warfarin.
Which SSRI is long acting?
Fluoxetine
Which SSRI has more and which has less interactions than other SSRIs
More interactions: Fluoxetine.
Less interactions: sertraline.
Fluoxetine - adverse effects
SIADH
DIA: Impair regulation of blood glucose
Fluvoxamine - indications
OCD
Depression
Panic disorder
More sedating SSRIs
Fluvoxamine
Paroxetine
Citalopram - adverse effects
Increase of QT interval and torsade de pointes
SSRI preferred in elderly
Sertaline
Clinical use of SSRIs
Depression
Eating disorders (bulimia and anorexia nervosa)
Anxiety disorders (panic disorder, phobic disorders, OCD).
Also effective for: fibromyalgia, autism, premenstrual dysphoric disorder.
