SSRI antidepressants
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| SSRI - prototype: Paroxetine others: sertraline, citalopram, escitalopam, fluoxetine, fluvoxamine. | paroxetine tx: GAD, OCD, panic, social anxiety, trauma & stressor related disorders. Dissociative, depressive, or adjustment disorder.
Setraline tx: panic disorder, OCD, social anxiety disorder, PTSD
Escitalopram tx: GAD & OCD
Fluoxetine tx: panicd
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| SSRI complications | early A/Es: nausea, diaphoresis, tremor, fatigue, drowsiness. they will subside! later A/Es: sexual dysfunction - report to HCP
others: weight gain, GI bleeding, hyponatremia, bruxism, seroto/syndrome, withdr. syndr, postl hypotsn, suicidal ideatio
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| SSRI contraindications/precautions | paroxetine - pregnancy cat D, don't take MAOIs or a TCA
avoid alcohol,
caution in clients w/liver and renal dysfunction, seizure disorders, or HX of GI bleeding
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| SSRI interactions | avoid concurrent use w/MAOIs or TCAs
avoid concurrent use w/antiplatelet meds and anticoagulants which can cause increase risk for bleeding
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| SSRI RN administration | take med w/foods
take med in the morning
take up to 4 weeks to achieve therapeutic effects
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| SSRI effectiveness | client verbalize feeling less anxious and more relaxed, improved mood, sleep, & memory retrieval, participate in social and occupational interactions, cope w/manifestations & identified stressors.
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| Serotonin syndrome | agitation, confusion, disorientation, dif. concentrating, anxiety, hallucinations, myoclonus (spatic, jerky muscle contractions), hyperrreflexia, incoordination, tremors, fever diaphoresis. Begin 2 - 72 hrs after intiation of treatment
resolves when t
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| SSRI - bruxism | griding & clenching of teeth during sleep - use mouth guard
HCP might switch to a different med.
can be treated w/low dose of buspirone
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| SSRI withdrawal syndrome | nausea, sensory disturbances, anxiety, tremors, malaise, unease
adv. to taper med and not to discontinue use abruptly.
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