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20 Cards in this Set

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How long does it take to see the full effect of antidepressants?
4-6 weeks (adequate trial if 4-8 weeks)
What is the mechanism of action of TCA's?
Block reuptake of serotonin and NE
What other mechanisms does TCA's have that cause it's side effects?
Block alpha receptors, antihistaminic, anticholinergic

Orthostasis, sedation and anticholinergic effects
What is the MOA of MAOI's?
Block the enzyme that breaks down serotonin and NE
What MAOI's are non-selective?
Phenelzine, trancyclpromine
How do you switch from an antidepressant to MAOI?
Wait 2 weeks after the drug is d/c'd. Wait 5-6 weeks for fluoxetine
What MAOI is available as a patch?
Selegiline (Emsam)
What trial showed that patients may respond to different SSRI's?
STAR*D
What are common side effects of SSRI?
GI complaints, insomnia, restlessness, headache, sexual dysfunction
What drugs with SSRI's may cause serotonin syndrome?
MAOI, DM, meperidine, sympathomimetics, triptans, lithium, TCA, SNRI
What other indications does Duloxetine have other than depression?
Fibromyalgia, diabetic peripheral neuropathy
What type of inhibitors do you not want to use with Duloxetine?
CYP2D6
What are the side effects of trazodone?
Orthostatic hypotension, sedation, priapism.
How is nefazodone different from trazodone?
Sertonin receptor blocker and blocks reuptake of serotonin and norepi. Causes minimal effects on sexual function and hypotension. Short half life makes is BID
What is the black box warning on nefazodone?
Liver toxicity
What is the MOA of buproprion?
Dopamine and NE reuptake inhibitor
What are the side effects of buproprion?
Increased risk of seizures, nervousness, headache and insomnia. May improve sexual function
What is the MOA of mirtazapine?
Antagonist of presynaptic alpha receptors, increases NE and serontonin in synapse
What are the side effects of mirtazapine?
Sedation, increased appetite, weight gain, constipation, asthenia
What can you do if treatment fails with monotherapy?
Combo therapy:
Use of combinations at lower doses may lead to fewer ADEs. Adding buproprion to SSRI's may be a good strategy

Augmentation
Lithium, thyroid, buspirone, aripriazole, seroquel XR.
Olanzapine with fluoxetine is approved