SSRIs i.e. Fluoxetine Flashcards
What are the indications of fluoxetine?
Major depression, generalised anxiety disorder, obsessive compulsive disorder, panic disorder, social anxiety disorder, bulimia nervosa.
What are the contraindications of fluoxetine?
Poorly controlled epilepsy, if patient is in a manic phase, QT-interval prolongation.
State the mechanism of action for SSRIs.
SSRIs selectively inhibit the reuptake of serotonin, therefore increasing available levels in the brain. Serotonin is a neurotransmitter that carries signals between nerve cells and is responsible for influencing mood, sleep and emotions. After relaying messages, serotonin is normally reabsorbed by nerve cells. SSRIs block this reuptake meaning more serotonin is available to pass messages between neurons. This is associated with a reduction in symptoms of anxiety and depression.
What are the very common/common unwanted side effects of fluoxetine?
Abdominal pain, abnormal dreams, anxiety, arthralgia, attention disturbances, blurred vision, chills, constipation, decreased appetite, decreases libido, diarrhoea, dizziness, dry mouth, dysgeugia, dyspepsia, ejaculation disorder, electrocardiogram QT prolonged, erectile dysfunction, fatigue, feeling jittery, flushing, frequent urination, GI effects, gynaecological bleeding, headaches, hyperhidrosis, insomnia, lethargy, nausea, nervousness, palpitations, pruritis, rash, restlessness, sleep disorder, somnolence, tension, tremors, urticaria, vomiting, weight loss, yawning.
What is the treatment cessation protocol for SSRIs?
Taper withdrawal over 4 weeks to avoid unwanted effects such as GI disturbances, headaches, anxiety, dizziness, paraesthesia, brain zaps, tinnitus, sleep disturbances, fatigue, flu-like symptoms and sweating. Some patients require longer withdrawal, i.e. 6 months in patients on long-term therapy. Withdrawal effects can occur within 5 days of stopping treatment, risk of withdrawal effects increased if stopped suddenly.
What is the patient/carer advice for SSRIs?
Counsel patients on administration of dispersible tablets, potential effects of dizziness etc. on driving and performing skilled tasks.
