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20 Cards in this Set
- Front
- Back
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How long does it take to see the full effect of antidepressants?
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4-6 weeks (adequate trial if 4-8 weeks)
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What is the mechanism of action of TCA's?
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Block reuptake of serotonin and NE
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What other mechanisms does TCA's have that cause it's side effects?
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Block alpha receptors, antihistaminic, anticholinergic
Orthostasis, sedation and anticholinergic effects |
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What is the MOA of MAOI's?
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Block the enzyme that breaks down serotonin and NE
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What MAOI's are non-selective?
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Phenelzine, trancyclpromine
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How do you switch from an antidepressant to MAOI?
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Wait 2 weeks after the drug is d/c'd. Wait 5-6 weeks for fluoxetine
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What MAOI is available as a patch?
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Selegiline (Emsam)
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What trial showed that patients may respond to different SSRI's?
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STAR*D
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What are common side effects of SSRI?
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GI complaints, insomnia, restlessness, headache, sexual dysfunction
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What drugs with SSRI's may cause serotonin syndrome?
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MAOI, DM, meperidine, sympathomimetics, triptans, lithium, TCA, SNRI
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What other indications does Duloxetine have other than depression?
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Fibromyalgia, diabetic peripheral neuropathy
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What type of inhibitors do you not want to use with Duloxetine?
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CYP2D6
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What are the side effects of trazodone?
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Orthostatic hypotension, sedation, priapism.
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How is nefazodone different from trazodone?
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Sertonin receptor blocker and blocks reuptake of serotonin and norepi. Causes minimal effects on sexual function and hypotension. Short half life makes is BID
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What is the black box warning on nefazodone?
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Liver toxicity
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What is the MOA of buproprion?
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Dopamine and NE reuptake inhibitor
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What are the side effects of buproprion?
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Increased risk of seizures, nervousness, headache and insomnia. May improve sexual function
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What is the MOA of mirtazapine?
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Antagonist of presynaptic alpha receptors, increases NE and serontonin in synapse
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What are the side effects of mirtazapine?
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Sedation, increased appetite, weight gain, constipation, asthenia
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What can you do if treatment fails with monotherapy?
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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 |
