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39 Cards in this Set
- Front
- Back
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DSM-5 criteria |
5 in 2 week period Depressed mood Marked diminished pleasure Weight loss/gain Insomnia/hypersomnia Psychomotor agitation/retardation Fatigue Feelings of worthlessness Diminished ability to concentrate Recurrent suicidal ideation |
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Fluoxetine |
Prozac, sarafem(for pmdd) 10-60mg/day Activating-take in morning Pmdd: 20mg/day throughout menstrual cycle +olanzapine Symbyax Take qhs for resistent depression |
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Paroxetine |
Paxil(CR), pexeva, brisdelle (IR)10-60 mg/day (CR) 12.5-75mg/day Preg D, brisdelle is category X |
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Fluvoxamine |
Luvox(CR) 100-300mg/day Has more drug interactions For OCD only |
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Sertraline |
Zoloft 50-200mg/day Pmdd:50-150mg/day of menstrual cyle |
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Citalopram |
Celexa 20-40mg/day >40mg has QT risk Poor CYP2C19 metabolizer or concurrent 2C19 inhibitor- 20mg/day max |
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Escitalopram |
Lexapro 10(20)mg/day >20mg has QT risk Poor 2C19- 10mg max |
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Vilazodone |
Viibryd SSRI + 5-HT1a partial agonist Take with food |
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Vortioxetine |
Trintillex SSRI + 5HT receptor antagonist + 5-HT1a agonist |
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Venlafaxine |
Effexor(XR) 150-375mg/day Also for GAD, SAD and panic Highest BP risk when >150mg |
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Duloxetine |
Cymbalta 40-60mg/day(max 120mg/day) Also for peripheral neuropathy, GAD, pain CYP2D6 inhibitor |
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Desvenlafaxine |
Pristiq 50(100)mg/day Can see empty shell in stool |
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Levomilnacipran |
Fetzima 40-120mg/day Start 20mg for 2 days No alcohol |
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Amitriptyline |
Elavil (not available) 100-150mg BID Neuro pain/migraine prophyl 10-50mg qhs |
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Doxepin |
Zonalon, prudoxin Creams for pruritis Depression-100-300mg daily Silenor For insomnia |
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Clomipramine |
Anafranil |
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Imipramine |
Tofranil(PM) |
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Trimipramine |
Surmontil |
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Tertiary amines |
Amitriptyline Doxepin Clomipramine Imipramine Trimipramine |
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Desipramine |
Norpramin |
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Nortriptyline |
Pamelor 25mg TID-QID |
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Protriptyline |
Vivactil |
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Secondary amines |
Amoxapine Desipramine Maprotiline Nortripyline Protriptyline |
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Isocarboxazid |
Marplan 20 mg/day, divided, max 60mg |
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Phenelzine |
Nardil 15mg TID, max 60-90mg day |
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Tranylcypromine |
Parnate 30 mg/day divided, max 60mg day |
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Selegiline transdermal patch |
Emsam 6mg patch/day, can increase to 9-12mg/day No food issue with 6mg patch Eldepryl and zelapar (ODT) Oral drugs for parkinson |
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Bupropion |
Wellbutrin(SR, XL), aplenzin, forfivo XL 300-450mg daily IR is TID, SR is BID (200mg bid), XL is daily Aplenzin- hydrobromide salt 522mg max daily XL for SAD, start early fall 300mg/day +naltraxone (Contrave)- weight manage Zyban- smoking cessation |
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Mirtazapine |
Remeron (soltab) Alpha2-adrenergic antagonist effect- more NE and 5-HT 15-45mg qhs Increases appetite and helps sleep |
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Trazodone |
Oleptro(ER) IR: 100-300mg BID ER: 150-375mg qhs Off-label for sleep: 50-100mg qhs |
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Nefazodone |
150-600mg BID Rarely used because Hepatotoxic |
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Aripiprazole |
Abilify(discmelt) 2-5mg qam (max 15mg) |
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Olanzapine/fluoxetine |
Symbyax 6/25mg cap qhs |
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Quetiapine |
Seroquel (XR) 150-300mg qhs, start 50mg |
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Brexpiprazole |
Rexulti 0.5-1mg/day, up to 3 mg Titrate weekly |
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Drugs that make depression worse |
Beta blockers(propanolol), clonidine, corticosteroids, cyclosporine, ethanol, isotretinoin, indomethacin, interferons, methadone(chronic opioids), po contraceptives/steroids, methyldopa, methylohenidate/stimulants/atomoxetine, procainamide, reserpine, statins(pt specific), varencicline |
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Conditions that may add to depression |
Stroke, PD, dementia, MS, thyroid disorder(hypo), low vit D?, metabolic conditions, malignancy, Overactive bladder(OAB), infectuous disease |
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Treatment resistant depression |
If failure of proper 6-8wk trial, may: Increase dose Combo Augment with buspirone(Buspar) or atypical antipsychotic-aripiprazole, olanzapine + fluoxetine, quetiapine ER Augment with lithium, thyroid hormone, ECT Ketamine |
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Antidepressants for pregnancy |
Rec. psycotherapy for mild depression SSRI if start, pregnancy C- except paroxetine(D/X) Risk of PPHN Tricyclics are 2nd choice(preg C) |
