Walden 6630 Psychopharmacology Midterm Study Guide Graded A+

Serotonin regulates - Mood, emotion, feeding, and reproductive behavior This class of antidepressants binds to presynaptic SERT and inhibits them from reuptake of serotonin to increase levels in the synaptic cleft to bind with postsysnaptic 5HT2 receptors - SSRIs First line therapy for MDD due to milder side effect profiles - SSRIs Six Common SSRIs - citalopram, escitalopram, fluoxetine, fluvoxamine, sertraline, paroxetine Onset of therapeutic benefit from SSRIs - 4-6 weeks In addition to MDD, SSRIs also treat - Chronic Anxiety, PTSD, OCD, and eating disorders (bulimia) Five Common side effects of SSRIs include - Anxiety, insomnia, GI distress, sexual dysfunction (ED), SIADH Severe side effect of SSRIs in children/adolescents under age 25 years old - suicidal ideation Life threatening adverse effect of SSRIs, especially when used in combination with other serotonergic drugs (SNRIs, TCAs, MAOIs, etc.) - Serotonin Syndrome Excess accumulation of serotonin resulting in overstimulation of the nervous system - Serotonin Syndrome Seven symptoms of Serotonin Syndrome - Flushing, hyperthermia, agitation, muscle rigidity, seizure, coma, HYPERreflexiaThe treatment for serotonin syndrome - Cyproheptadine (5-HT2 receptor antagonist) Cyproheptadine treats serotonin syndrome by - blocking 5-HT2 receptors (serotonin antagonist) When SSRIs or SNRIs are stopped abruptly, common symptoms of withdrawal include - Irritability, headaches, and insomnia Medicine specific side effect of citalopram - Prolonged QT interval (normal=0.4.-0.44 seconds) This SSRI is pregnancy category D due to associations with congenital heart defects - Paroxetine All SSRIs but paroxetine (D) are pregnancy category - C Three SSRIs that are inhibitors of Cytochrome P450 enzymes - fluoxetine, fluvoxamine, and paroxetine Five common SNRIs include - duloxetine, venlafaxine, desvenlafaxine, milnacipran, levomilnacipran This antidepressant class of medications works by binding to presynaptic SERT and NET to inhibit them from reuptake of serotonin and norepinephrine to increase their levels in the synaptic cleft - SNRIs In addition to MDD SNRIs treat - Anxiety and neuropathic pain (peripheral neuropathy) Medication specific indications of duloxetine: - urinary incontinence and Fibromyalgia