Week 5 Clinical Pearls

SSRIs

First-line treatment for depression

Sexual dysfunction

Side effect common with SSRIs

Rapid cycling

Minimum of 4 episodes per year

Goal of antidepressant treatment

complete remission of symptoms

NT associated with GI side effects

Serotonin - due to presence of 90% of 5HT receptors in the GI tract and only 10% in the brain

Escitalopram

Considered best-tolerated SSRI with fewest CYP interactions

Increase lithium levels

NSAIDs, ACE inhibitors

Decrease lithium levels

Caffeine, mania

Do not change lithium levels

Amiloride, furosemide, sulindac

Lithium

Effective treatment for manic episodes, to prevent recurrence, and to a lower degree is effective in depressive episodes.

Well established to help prevent suicide in clients with mood disorders

Lamotrigine

well-tolerated except for its propensity to cause a rash

Monoamine neurotransmitters

norepinephrine, dopamine, and serotonin

Lamotrigine drug category

Mood stabilizer

Drug with narrow therapeutic window that requires lab draws

Lithium