antidepressants

Question 1

Factors that can contribute to depression

Answer 1

• Genetics
• Biochemical factors
• Illness
• Personality style
• Ageing
• Long term pressure such as abusive relationships
• Bullying
• Stressful or traumatic events

Question 2

Diagnostic criteria

Answer 2

• Depressed mood most of the day
• Diminished interest or pleasure in all or most activities of the day
• Significant weight loss
• Insomnia or hypersomnia
• Psychomotor agitation
• Fatigue

Question 3

Monoamine neurotransmitters

Answer 3

• Serotonin
• Dopamine
• Noradrenaline

Question 4

SSRI

Answer 4

•	Cliatopram 
•	Dapoxteine 
•	Fluoxetine 
•	Adverse effects 
o	Nausea vomiting insomnia 
o	Drowsiness tremor sweating anxiety 
o	Sexual dysfunction 
o	Rhinitis 
•	A patient on multiple meds serotonin syndrome 
o	Mild to life threating toxicity

Question 5

Drugs that contribute to serotonin toxicity

Answer 5

antidepressants
opioids
stimulants
illict drugs

Question 6

TCAS

Answer 6

•	Depression 
•	Urge incontinence
•	Nocturnal enuresis 
•	ADHD 
•	Migraine prophylaxis 
o	Amitriyline 
o	Clomipramine 
•	Anticholinergic effects 
o	Sedation 
o	Dry mouth 
o	Blurred mouth 
o	Constipation 
o	Urinary retention
o	Cognitive impairment 
o	Cardiotoxicity 
o	QT interval prolongation 
o	Increase in HR 
o	Postural hypotension 
o	Arrhythmia 
o	Slow cardiac conduction
o	Reduced seizure threshold

Question 7

SNRIs

Serotonin–norepinephrine reuptake inhibitor
examples and adrs

Answer 7

•	Deve\lafaxine 
•	Duloxetine 
•	Venlafaxine 
o	Nausea 
o	Dry motuh 
o	Constipation 
o	Yawning 
o	Sweating 
o	Dizziness 
o	Increased BP 
o	Insomnia 
o	Headache 
o	Blurred vision 
o	Mydriasis 
•	Check bp before treatment

Question 8

MAOIS side effects

Answer 8

•	Major depression 
•	Anxiety 
•	Panic 
•	Phenazine 
•	Tranylcypromine 
•	Side effects 
o	Orthostatic hypotension 
o	Sleep disturbances 
o	Heachade 
•	Avoid foods containing tyramine while taking this medicine for 2 weeks after stopping treatment 
•	Preferability eat fresh or fresh frozen foods

Question 9

MAIOS moa

Monoamine oxidase inhibitor

Answer 9

MAOIs act by inhibiting the activity of monoamine oxidase, thus preventing the breakdown of monoamine neurotransmitters and thereby increasing their availability.

Question 10

TCAS moa

Answer 10

block the reuptake of serotonin and norepinephrine in presynaptic terminals, which leads to increased concentration of these neurotransmitters in the synaptic cleft.