Flashcards in SSRIs Deck (13):
Name some common SSRIs?
How do SSRIs work?
Block the re-uptake of Serotonin (5-HT) from the synaptic cleft
This increases serotonins availability for neurotransmission
How do SSRIs differ from TCAs?
SSRIs do not block the re-uptake of noradrenalin from the synaptic cleft
They also do not block as many other receptors e.g. H2, dopamine, muscranic and alpha adrenergic
Because of this they have less side effects and are less dangerous in the case of overdose
SSRIs are therefore preferred over TCAs
What are the common indications for using SSRIs?
1. Moderate - Severe depression - first line
2. Mild depression - is psychological treatments fail
3. Panic Disorder
4. Obsessive compulsive disorder
What are the contraindications of using SSRIs?
- Do not give with monoamine oxidase inhibitors; they both increase synaptic serotonin levels and together may precipitate serotonin syndrome
When should SSRIs be used with caution?
- Peptic Ulcer disease
- Young people (more at risk of suicdal and self harming thoughts)
- Old people (more at risk of side effects)
- Hepatic Impairment
What are the common interactions with SSRIs?
Monoamine oxidase inhibitors
Aspirin/NSAIDs (increase risk of ulceration)
Anticoagulants (increase risk of bleeding)
Drugs that prolong QT interval e.g. antipsychotics
What SSRI prolongs the QT interval?
Citalopram - can dispose so arrhythmias
What are the common side effects of SSRIs?
Appetite and weight disturbance (loss or gain
Hypersensitivity reactions (skin rash)
Suicidal thoughts and behaviour
Lower the seizure threshold
Prolong the QT interval and can predispose to arrhythmias
Increase the risk of bleeding
Serotonin syndrome (high doses)
One of the side effects of SSRIs is hyponatraemia how may this present?
Confusion and reduced consciousness.
What is serotonin syndrome?
- Autonomic hyperactivity
- Altered mental state
- Neuromuscular excitation
What can sudden withdrawal of SSRIs cause?
Gastrointestinal upset, neurological and influenza-like symptoms and sleep disturbance.