Mental Health Exam 1

Fluoxetine

aka Prozac

A selective serotonin reuptake inhibitor (SSRI) → blocks the reuptake of serotonin making it more available in the synapse

Indications:

• MDD

• bulimia

• OCD

• panic disorder

• premenstrual dysphoric disorder

Side Effects of Fluoxetine

Dry mouth

Weakness

Insomnia

Headache

Anorexia

Nausea and diarrhea

Sexual dysfunction

Anxiety, dizziness, drowsiness

Suicidal ideation

AE: serotonin syndrome

→ most dec. or resolve within 1-4 weeks

Sertraline

aka Zoloft

SSRI → blocks the reuptake of serotonin

Indications:

• MDD

• anxiety disorders

Safety:

• never combine with MAOIs

Side Effects of Sertraline

Nausea and GI distress

Restlessness or jitteriness

Sleep disturbances

Sexual dysfunction

→ resolve within 1-4 weeks

Duloxetine

aka Cymbalta

Serotonin norepinephrine reuptake inhibitor (SNRI) → inc. serotonin and norepinephrine by inhibiting their reuptake

Indications:

• MDD

• generalized anxiety disorder

• diabetic peripheral neuropathy

• fibromyalgia

• chronic musculoskeletal pain

Safety:

• monitor BP and HR

• monitor liver function

• tapper slowly

Side Effects of Duloxetine

Dizziness and drowsiness

Headache

GI upset and anorexia

Excessive sweating

Hepatotoxicity

Venlafaxine

aka Effexor

Serotonin norepinephrine reuptake inhibitor (SNRI) → inc. serotonin and norepinephrine (higher dose required)

Indications:

• MDD

• anxiety disorders

Safety:

• monitor BP and HR

• do not stop abruptly → discontinuation syndrome

Side Effects of Venlafaxine

inc. BP and HR

Similar to SSRIs

Excessive sweating

AE: discontinuation syndrome (flu-like syndromes, insomnia, nausea, dizziness, paresthesia, anxiety)

Trazodone

aka Desyrel

Serotonin antagonist and reuptake inhibitor (SARI) → inhibits neuronal uptake of serotonin

Indications:

• depression

• insomnia

Safety:

• fall prevention (ortho hypo)

• take at night (sedation)

• taper drug discontinuation

Side Effects of Trazodone

Sedation

Headache

Nausea

Dizziness

Minimal sexual dysfunction

Blurred vision

Orthostatic hypotension

AE: priapism (prolonged erection)

Bupropion

aka Wellbutrin

Norepinephrine and dopamine reuptake inhibitor (NDRI) → inhibits neuronal uptake of norepinephrine and dopamine

Indications:

• Depression

• Smoking cessation

Safety:

• contraindicated in seizure disorders, eating disorders, or the discontinuing alcohol or sedatives (inc. risk of seizures)

• minimal sexual dysfunction

• weight loss

• take in morning

Side Effects of Bupropion

Weight loss

Anorexia

Insomnia

Tremor

Mirtazapine

aka Remeron

Norepinephrine and serotonin specific antidepressant (NaSSA) → enhances norepinephrine and serotonin neurotransmission

Safety:

• fewer GI symptoms

• less sexual dysfunction

• take at bedtime (sedation)

• monitor weight

• given to pt with insomnia, dec. appetite, weight loss

Side effects of Mirtazapine

Sedation

Appetite stimulation

Weight gain

Amitriptyline

Phenelzine

Lithium

Lamotrigine

Valproic Acid

Carbamazepine