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That helps you study more efficiently by focusing on the highest yield material. this is the 8th video in my playlist covering we are going to review mechanisms, indications classes including tricyclic antidepressants, ssris, snri and atypicals. also, but it was getting way too long so i it is tough to break the high yield rating time i will just give you the high yield
Rating overall antidepressants get a high yield rating this means based on a number of factors (including 1 questions) you are almost definitely going by far the most important aspect is the side effects for these medications. maois are very old, rarely used anymore and i’m going to focus on pharmacologic treatment questions are on, but remember there are alternatives to
Meds. also electroconvulsive therapy (or ect) can but the stigma for ect and common side effect in severe depression with patients who can’t tolerate medications. then we will talk more specifically about each class. of monoamine neurotransmitters (mainly serotonin, norepinephrine and dopamine). they do this by slowing the reuptake of the cleft longer and interact with
Post synaptic receptors more often. lead to lots of side effects and safety issues related to toxicity. unfortunately, antidepressants take at least a month to start working. patients can become hopeless if they expect this may be one reason why antidepressants another proposed mechanism is that a depressed there is now a black box warning for suicide on antidepressants.
In clinical practice, and that the thing that treating a depressed person with the proper medications. usually this will involve a follow up visit at this visit the drug will not have started but you can monitor for side effects like suicidality. if a bipolar individual is incorrectly diagnosed another very serious side effect that has this usually occurs when you combined
Multiple an antidepressant with another medication it presents with tremor, diaphoresis, tachycardia, flushing and hypertension. treatment includes medication cessation and the use of cyproheptadine (a serotonin antagonist). so you taper the 1st medication down and then with no antidepressant and then start adding the new medication slowly. a principle that applies to all
Of the antidepressants this means that you start with a lower dose the dose you start the patient on may not some will inevitably be partial responders oddly, patients may react differently even to drugs within the same class. since there is a delayed onset of effect you wait for about 6 weeks before switching to another medication. therefore, treatment is usually continued
After 2-3 episodes of depression the odds high that most docs would treat with antidepressants for life. it can presents with a wide variety of symptoms antidepressants with short half-lives like to prevent withdrawal most antidepressants so we will start with tricyclic antidepressants (or tcas). of the drugs in this class (even those i didn’t tricyclic antidepressants
(Tcas) block reuptake of norepinephrine and to a lesser extent serotonin. this is why they have largely been replaced by ssris/snris as first line depression treatments. use for a number of other conditions including and enuresis (or loss of control of urination such as bedwetting). the most common side effects fall under the category of anticholinergic. these at
Anti-muscainic, antihistamine or anti-adrenergic effects. these symptoms are not nearly as common in newer antidepressants. tcas can cause qt interval prolongation, which an ekg should be done before starting a patient on tcas. tcas are also fatal in overdose due to arrhythmias. this is very risky considering that antidepressants tcas are correlated with seizures and
Coma selective-serotonin reuptake inhibitors increase they are “selective” because they have they are first line treatment options for anxiety, eating disorders and other psychiatric conditions. and don’t know the answer just selecting the ssri is probably the safest bet. paroxetine, fluoxetine, sertraline, citalopram & escitalopram. each of these has slightly
Different indications right by just knowing the general characteristics of the entire group. unlikely tcas, ssris are usually not fatal in overdose. ssris can also have gi problems (nausea, diarrhea these adverse reactions will usually diminish is sometimes added to an ssri to lessen the insomnia side effect. thankfully this side effect can largely be the sexual side
Effects can also be a plus ssris are also associated with bleeding as serotonin-norepinepherine reuptake inhibitors block the reuptake of serotonin and norepinephrine. other than that snris have very similar indications, the most commonly used snris are duloxetine, venlafaxine & desvenlafaxine. are similar to the drugs we have already discussed, they work by slightly
Different mechanisms the highest yield medications in this group side effects and may actually increase sexual function. another important thing to know is that bupropion so if you have a patient who is depressed so this medication is contraindicated in people antidepressant anymore, because the side effect of sedation is so strong. the rare but dangerous side effect of
This drug to remember is priapism. some people remember this side effect by the mnemonic “traza-bone”. this may actually be a positive thing if you a frail elderly patient) that needs to gain weight. subscribe button here, which also helps me out a lot. our next video and the last video in the psychiatry to be taken directly to that video you can thank you so much
For watching and good luck with the rest of your studying.
Transcribed from video
Antidepressants: SSRI, SNRI & Tricyclic Antidepressatns. Citalopram Prozac Amitriptyline By Stomp On Step 1
