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24 Cards in this Set

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Imipramine
TCA
Advantages: cheap works with SSRI nonresponders
Disadvantage: SE, cardiotoxicity, costly blood tests, delayed onset
Clomipramine
TCA
Advantages: cheap works with SSRI nonresponders
Disadvantage: SE, cardiotoxicity, costly blood tests, delayed onset
Phenylzine
MAOI
Adv: Works in non-responders
Dis: SE, orthostatic hypertension, weight gain, sexual dysfunction, dietary restrictions, overdose potential
Tranylcypromine
MAOI
Adv: Works in non-responders
Dis: SE, orthostatic hypertension, weight gain, sexual dysfunction, dietary restrictions, overdose potential
SSRI's
Fluoxetine, Fluvoxamin, Citalopram, Escitalopram, Sertraline, Paroxetine
SSRI's and treatment of anxiety?
First line defense, Paroxetine and sertraline FDA approved and the others show efficacy
SSRI advantages for treatment of anxiety?
Favorable SE profile, broad spectrum, low abuse potential
SSRI disadvantages for treatment of anxiety?
Restlessness, jitteriness, increased anxiety on initial dosing, delayed onset of action
Venlafaxine
SNRI, generally efficacious in pain disorders
Nefazodone
Serotonin Antagonist
can cause liver failure
Mirtazapine?
alpha2 antagonist
Effective for anxiety but causes sedation and weight gain
Benzodiazepine Advantages for treatment of anxiety?
Highly efficacious, Rapidly acting, good SE
Benzodiazepine Disadvantages for treatment of anxiety?
Potential for abuse, withdrawal syndromes, sedation in elderly, short-term memory impairment
Buspirone?
5HT1a agonist
Anti-anxiolytic but not for panic disorders
Beta blockers for treatment of anxiety?
Reduce somatic symptoms, for performance anxiety
First Line for Panic D/O?
Paroxetine, sertraline
First Line for GAD?
Buspirone +/- Benzo
First Line for PTSD?
Paroxetine, sertraline
First Line for OCD?
SSRI's
First Line for social Phobia?
Paroxetine, sertraline
First Line for Performance anxiety?
Beta-blocker
Metabolic changes in elderly?
decrease hepatic/renal function, decrease absorption, increased distribution, decreased protein binding, may need to use lower doses
Metabolic changes in pregnancy?
weigh risks, benefits and Tx alternatives, consider non-pharmacoloical therapies
Considerations with sexually active when treating anxiety?
Sexual dysfunction with SSRI's