QUESTIONS AND ANSWERS GRADED A+
MARYVILLE
Define SSRIs
selective serotonin reuptake inhibitors
Seriously Prepare Cities for the Flu Vaccine
-Sertaline (Zoloft)
--Paroxetine (Paxil)
-Citolpram(Celexa)
-Escitalopram (Lexapro)
-Fluoxetine HCl (Prozac)
--Fluvoxamine (Luvox)
-(Viibryd)Citol
,SSRI mechanism of action
Blocks the reuptake of serotonin (only serotonin) thus increasing it's effects
All inhibit the serotonin transporter SERT
SSRI side effects
Gastrointestinal disturbances
Sexual dysfunction
Drowsiness / insomnia
Serotonin Syndrome (rare)
SSRI discontinuation
sx
uMost common side effects include GI upset, sexual dysfunction (30%+!), anxiety,
restlessness, nervousness, insomnia, fatigue or sedation, dizziness
uVery little risk of cardiotoxicity in overdose
uCan develop a discontinuation syndrome with agitation, nausea, disequilibrium
and dysphoria
SSRIs treat
,anxiety
depression
SSRI discontinuation syndrome
A drug withdrawal syndrome associated with the use of at least some of the SSRI
and SNRI antidepressants.
SSRI discontinuation syndrome symptoms
flu-like symptoms, dizziness, weakness, nausea, fatigue, feelings of "unreality,"
loss of balance, light-headedness, "electric-shock" sensations, and other symptoms.
Paroxitine (Paxil) Pros
Short half life with no active metabolite means no build-up (which is good if
hypomania develops)
Sedating properties (dose at night) offers good initial relief from anxiety and
insomnia
Paroxitine (Paxil) Cons
Significant CYP2D6 inhibition
Sedating, wt gain, more anticholinergic effects
, sexual side effects
Notorious for discontinuation syndrome
Sertraline (Zoloft) Pros
Very weak P450 interactions (only slight CYP2D6)
Short half life with lower build-up of metabolites
Less sedating when compared to paroxetine
Sertraline (Zoloft) Cons
Max absorption requires a full stomach
Increased number of GI adverse drug reactions
AD
Fluoxetine (Prozac) Pros
Long half-life (2 weeks) improve compliance
decreased incidence of discontinuation syndromes.
Good for pts with medication noncompliance issues
Initially activating so may provide increased energy