Save
Busy. Please wait.
Log in using Clever
or

show password
Forgot Password?

Don't have an account?  Sign up 
Sign up using Clever
or

Username is available taken
show password


Make sure to remember your password. If you forget it there is no way for StudyStack to send you a reset link. You would need to create a new account.
Your email address is only used to allow you to reset your password. See our Privacy Policy and Terms of Service.


Already a StudyStack user? Log In

Reset Password
Enter the associated with your account, and we'll email you a link to reset your password.
focusNode
Didn't know it?
click below
 
Knew it?
click below
Don't know
Remaining cards (0)
Know
0:00
share
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.

  Normal Size     Small Size show me how

Antidepressants

pharm

QuestionAnswer
MAJOR DEPRESSIVE DISORDER (MDD) – DSM-5 DIAGNOSTIC CRITERIA(APA) 5 or more s/s must be present for 2 weeks, noticeable change from previous fx, at least 1 must be depressed mood, or loss of interest/pleasure Depressed mood(irritability/anger), anhedonia, appetite, sleep, Psychomotor agitation or retardation, Fatigue, worthlessness or guilt, Diminished concentration, SI
ACUTE Phase treatment for depression Goal is ensuring patient safety. May require hospitalization to safeguard against possible suicidality, and restore treatment/stabilize.
CONTINUATION Phase treatment for depression Usually through outpatient services
MAINTENANCE Phase treatment for depression Outpatient clinic
DISCONTINUATION Phase treatment for depression Slow taper, if clinically prudent/close monitoring. Abrupt discontinuation may cause discontinuation syndrome/relapse
Antidepressant Classes (SSRIs)-Zoloft Serotonin- (SNRIs)- Effexor, Monoamine oxidase inhibitors (MAOIs)- Selegiline, (TCAs)-imipramine
Serotonin partial agonist/reuptake inhibitors (SPARIs) Example, vilazodone
Norepinephrine-Dopamine reuptake inhibitors (NDRIs) Example, buproprion
Serotonin Multimodal Antidepressant Medications (SMM) Example Vibryd
The serotonin transporter (SERT) is a monoamine transporter protein. This is a membrane protein that transports serotonin from synaptic spaces into presynaptic neurons. SSRIs block the SERT transporter= increased availability of serotonin in the synaptic space.
SNRIs do what bind to 5-HT and NA transporters to selectively inhibit the reuptake of these neurotransmitters from the synaptic clefts. the reuptake of both 5-HT and NA with differing selectivity.
OTHER TYPES OF TREATMENT Electroconvulsive Therapy(ECT) , Transcranial Magnetic Stimulation(TMS), Vagal Nerve Stimulation(VNS), Phototherapy: light for 30 minutes up to 2 hours, 1to 2 times daily
TCAs increase both norepinephrine and serotonin concentrations can ↑ serotonin more than ↑norepinephrine (clomipramine), others ↑ norepinephrine more than serotonin (nortriptyline or desipramine)- also amitriptyline (can decrease BP- alpha adrenergic effect)- anticholinergic s/e, used to tx chronic pain and migraine
MAOIs do what inhibit monoamine oxidase and breakdown of monoamine neurotransmitters- watch Tyramine- Amino acid which elevates BP- stay away from soy- HTN crisis
FDA-approved MAOIs Isocarboxazid (Marplan), Phenelzine (Nardil), Selegiline (Emsam), Tranylcypromine (Parnate)
HYPERTENSIVE CRISIS MAOIs(when medication is taken with food containing tyramine, a dietary precursor to norepinephrine)
CARDIOTOXICITY TCAs (especially in overdose, and possibly in patients with cardiac conditions) SEROTONIN SYNDROME
Black Box WARNING Antidepressants increased the risk compared to placebo of suicidal thinking and behavior (suicidality) in children, adolescents, and young adults in short-term studies of (MDD) and other psychiatric d/o, ↑ risk in children, 18 – 25, No actual suicides
ASSESSING FOR SUICIDAL BEHAVIOR Past hx of SAor completed suicide by family members, Negativity/morbidity, current SI, Plan and intent, Means and access to commit suicide
Lethality of intended suicide action High lethality: gun, hanging- Moderate lethality: Overdose of toxic agents like aspirin, sleeping pills- Low lethality: superficial wrist cutting, breath-holding
Mirtazapine enhances neurotransmission by ↑ the concentrations of both serotonin and norepinephrine. Unlike the SSRIs, mirtazapine blocks specific serotonin receptors, reducing the potential to cause side effects such as sexual dysfunction
Bupropion (Wellbutrin)- add on to SSRI, avoid if hx of psychosis or at risk for seizures.
Mirtazapine (Remeron) sedating, stimulates appetite (good for elderly).
Fluoxetine: long half-life good for non-adherent patient, Insomnia is common
Citalopram (Celexa) /Escitalopram (Lexapro) fewer drug interactions.
Newer Antidepressants in the past 4 years, the FDA has approved 3 antidepressants—Vilazodone (SMM) Vibryd, Levomilnacipran (SNRI) Fetzima, Vortioxetine (SMM) Trintellix
The overall goal of the STAR*D trial was to assess the effectiveness of depression treatments in patients diagnosed with major depressive disorder, in both primary and specialty care settings. It is the largest and longest study ever conducted to evaluate depression treatment.
Created by: arsho453
 

 



Voices

Use these flashcards to help memorize information. Look at the large card and try to recall what is on the other side. Then click the card to flip it. If you knew the answer, click the green Know box. Otherwise, click the red Don't know box.

When you've placed seven or more cards in the Don't know box, click "retry" to try those cards again.

If you've accidentally put the card in the wrong box, just click on the card to take it out of the box.

You can also use your keyboard to move the cards as follows:

If you are logged in to your account, this website will remember which cards you know and don't know so that they are in the same box the next time you log in.

When you need a break, try one of the other activities listed below the flashcards like Matching, Snowman, or Hungry Bug. Although it may feel like you're playing a game, your brain is still making more connections with the information to help you out.

To see how well you know the information, try the Quiz or Test activity.

Pass complete!
"Know" box contains:
Time elapsed:
Retries:
restart all cards