Therapeutics of MDD Flashcards Preview

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Flashcards in Therapeutics of MDD Deck (13):
1

TCA TDM

After 5 days (steady state)
Get trough 12 hours after first dose

2

Which SSRIs do we want to avoid in elderly and WHY?

Fluoxetine and fluvoxamine
Longest half lives

3

Who is the dirty SSRI and WHY?

Paroxetine
Highest anticholinergic and antihistaminergic side effects
Greatest weight gain
Shortest acting

4

What are the SSRI drug interactions and who has the least/most?

CYPs
Citalopram and escitalopram have the least
Fluvoxamine has the most

5

Which SSRI has the greatest risk of QTc prolongation?

Citalopram

6

Which SNRI has the least drug interactions?

Duloxetine

7

SARIs

Trazodone

8

First Line Treatment Options (Pharma)

SSRIs, SNRIs, Remeron, Bupropion

9

Treatment Resistant: Next Steps

Switch (same or different class)
Add another antidepressant
Add augmentation med

10

Augmentation Meds

Lithium
Stimulants
Pindolol
Anticonvulsants
Thyroid hormone
SGAs (Abilify and Seroquel XR)

11

What is crucial about MAOi and serotonin syndrome?

Happens for sure if you don't allow for a washout period
D/c med for 2 weeks before switching

12

Discontinuation Syndrome

Flu-like prodrome 1-2 days after stopping and lasting about 1-2 weeks!

13

DSIGECAPS

Depressed mood
Sleep
Interests
Guilty
Energy
Concentration
Appetite
Psychomotor
Suicidal