what medications can worsen depression
atomoxetine
indomethacin
NRTIs: efavirenz, rilpivirine
beta blockers
OCC
anabolic steriods
systemic steriods
interferons
benzos
varenicline
medical conditions that worsen depression
PD, dementia, MS, hypothyroidism, low Vit D, stroke
Natural products used to treat depression
St Johns Wort
SAMe
5-HTP
valerian
symptoms of serotonin syndrome
N/D, tachycardia, dizziness, HA, agitation, hallucination, muscle rigidity
which SSRI does not need to be tapered
fluoxetine
celexa (citalopram) Max dose
Max dose: 40 mg
Max dose if > 60 y = 20 mg - can cause QT prolongation
Lexapro (escitalopram) Max dose
Max dose: 20 mg
Max dose if > 60 y = 10 mg
which SSRI used in PMDD (premenstrual dysphoric disorder)
fluoxetine, paroxetine CR, sertraline
SSRI SE
decrease libido, ED, somnolence, insomnia, nausea, dry mouth, HA, tremor, bleeding, SIADH/hyponatremia, fall risk
SRNI SE
increased HR, dilated pupils, constipation, excessive sweating, increase BP
Name TCA tertiary amine
amitriptyline, doxepin
Name TCA secondary amines
nortriptyline
cardiotoxicity SE of TCA
QT prolongation, fatal arrhythmias, orthostatasis
anticholinergic SE of TCA
dry mouth, blurred vision, urinary retention, constipation, wt gain, fall risk
bupropion indications
Max dose
SAD - seasonal affective disorder
smoking cessation
weight management
450 - increased sz risk
Name MAOi
phenelzine (Nardil)
selegine patch (Emsam)
mirtazapine (Remeron) indication
sleep, increase appetite
trazodone SE
sedation, priapism, sexual dysfxn
bupropion contraindications
sz disorders, hx of anorexia, bulimia
