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Antidepressants (Therapy Exam 2)
Terms in this set (33)
For TCAs, which group has a more favorable side effect profile and why?
secondary amines have an improved side effect profile compared to tertiary amines (secondary amines are the metabolites of tertiary amines)
Where is there no difference in severity of SEs when it comes to secondary and tertiary amines (TCAs)?
QT prolongation and sexual dysfunction
-secondary amines improved for anticholinergic, weight gain, sedation and hypotension SEs
What population do we want to avoid use of TCAs in and why?
anticholinergic and cognitive dysfunction effects
What side effect of TCAs creates the risk of death in OD?
How long do you have to wait before using another antidepressant after stopping use of an MAOI?
14 days (2 weeks)
What is the wait time like switching from a previous antidepressant to an MAOI?
5 half-life wash out
What foods have to be avoided when using MAOIs and why?
foods high in tyramine;
MAO breaks down tyramine in the gut, inhibiting this can lead to buildup of tyramine and thus a hypertensive crisis
What's the difference between acute and chronic SEs in second generation antidepressants?
acute SEs generally will tolerate out in 1-4 weeks at a consistent dose;
if chronic SEs occur they will not tolerate out
Which agents are most likely to cause sedation?
Which agents avoid (lowest risk) sexual side effects?
What agent almost always causes insomnia?
What is the order (from lowest to highest prevalence) for sexual side effects from antidepressant agents?
lowest: mirtazapine, trazadone, bupropion
middle: SNRIs, vilazodone, vortioxetine
highest: SSRIs, TCAs, MAOIs, venlafaxine
Which SSRI has been most strongly implicated in prolonging the QT interval?
citalopram (dose dependent) - metabolized by 2C19 so inhibitors can be an issue
Which antidepressant has the longest half life and what implications does this have?
-good for patients with poor adherence
-one of only antidepressants that doesn't have to be tapered when discontinued
Which antidepressant is highly sedating and most commonly used in treating OCD?
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