NSC 830: ANTIDEPRESSANTS QUESTIONS &
ANSWERS
What causes depression?
deficiency of norepinephrine and seretonin
How do antidepressants typically work?
block reuptake- making more neurotransmitters readily available
inhibit any enzymes from breaking down the neurotransmitters
What black box warning do ALL antidepressants carry?
increased risk of suicidal thoughts and behavior
when is the BBW for antidepressants most likely or occur?
the first 2 months
Who is at increased risk for the BBW on antidepressants?
Children, adolescents, young adults under 24
When should you perform a suicide risk assessment?
prior to prescribing any antidepressant
When should you follow up after prescribing antidepressants?
2 weeks if increased risk for suicide
1 month for no increased risk of suicide
example of tricyclic antidepressant
amitriptyline (Elavil)
imipramine (Tofranil)
MOA of tricyclic antidepressant
blocks reuptake of serotonin and norepinephrine
Indication for tricyclic antidepressants
, depression
anxiety
insomnia
panic disorders
ENURESIS- bed wetting
neuropathic (chronic) pain
Adverse effects of tricyclic antidepressants
weight gain
sedation (blocks histamine response)
anticholinergic effects
tachycardic & prolongation of QRS & PR/QT intervals
lower seizure threshold
orthostatic hypotension
special teaching for tricyclic antidepressant
baseline ECG & repeat in 3 weeks
increase fluids & change positions slowly
What category are tricyclic antidepressants?
Category C
What can you not prescribe tricyclic antidepressants with?
MAOI's
MAOI MOA
Inhibit MAO, the enzyme responsible for breakdown of norepinephrine & serotonin
Examples of MAOI
phenelzine (Nardil) PO
selegiline (EMSAM) patch
what is the onlytransdermal antidepressant?
selegiline patch (EMSAM)
indication of MAOI
drug resistant, refractory depression (3rd line drug d/t drug/ food interactions & poor
safety profile)
ANSWERS
What causes depression?
deficiency of norepinephrine and seretonin
How do antidepressants typically work?
block reuptake- making more neurotransmitters readily available
inhibit any enzymes from breaking down the neurotransmitters
What black box warning do ALL antidepressants carry?
increased risk of suicidal thoughts and behavior
when is the BBW for antidepressants most likely or occur?
the first 2 months
Who is at increased risk for the BBW on antidepressants?
Children, adolescents, young adults under 24
When should you perform a suicide risk assessment?
prior to prescribing any antidepressant
When should you follow up after prescribing antidepressants?
2 weeks if increased risk for suicide
1 month for no increased risk of suicide
example of tricyclic antidepressant
amitriptyline (Elavil)
imipramine (Tofranil)
MOA of tricyclic antidepressant
blocks reuptake of serotonin and norepinephrine
Indication for tricyclic antidepressants
, depression
anxiety
insomnia
panic disorders
ENURESIS- bed wetting
neuropathic (chronic) pain
Adverse effects of tricyclic antidepressants
weight gain
sedation (blocks histamine response)
anticholinergic effects
tachycardic & prolongation of QRS & PR/QT intervals
lower seizure threshold
orthostatic hypotension
special teaching for tricyclic antidepressant
baseline ECG & repeat in 3 weeks
increase fluids & change positions slowly
What category are tricyclic antidepressants?
Category C
What can you not prescribe tricyclic antidepressants with?
MAOI's
MAOI MOA
Inhibit MAO, the enzyme responsible for breakdown of norepinephrine & serotonin
Examples of MAOI
phenelzine (Nardil) PO
selegiline (EMSAM) patch
what is the onlytransdermal antidepressant?
selegiline patch (EMSAM)
indication of MAOI
drug resistant, refractory depression (3rd line drug d/t drug/ food interactions & poor
safety profile)
