Review sexual side effects of antidepressant medications
Review sexual side effects of antidepressant medications: DELAYED EJACULATION
- Review augmentation agents used to treat depression: lithium one of the best especially for bipolar depression
- Review antidepressant augmentation with atypical antipsychotics: there are metabolic side effects, weight gain, changes in ekg, eps, tardive dyskinesia. Can be effective but they are not benign
- Review length of time treatment is continued in the remission of depression: the more depressive episodes they have the longer you want to keep them on medication to keep them in remission.
- Review side effects that may improve in regards to dose timing or formulation change: GI upset and insomnia
- Review mechanism of action for selective serotonin reuptake inhibitors: autoreceptor downregulation and desensitization
- Review hyponatremia regarding antidepressants: affect antidiurect hormonr. Especially in elderly. Lethargy, nausea, c onfusion and deliurium. Rule hyponatremia out.
- Review antidepressant least likely to cause sexual side effects: bupropion
- Review unique clinical profile for select SSRI’s (matching)
Fluoxetine: it’s activating. Used for patient’s with fatigue and helps with concentration.
Fluvoxamine: for OCD and anxiety
Sertraline: helpful for anxiety and atypical depression, psychotic depression
Escitalopram: well tolerated, few interactions, no qtc elongation like with citalopram, no weight gain or sedation cuz no antihistamine
Paroxetine (paxil): discontinuation syndrome, weight gain/sedation, worst sex side effects, cognitive slowing, interacts with lots of drugs
Citalopram: max dose, or you need to get ekg . good in the elderly.
- Review dry mouth as a symptoms with antidepressant use: see dentist often
- Review food and monoamine oxidase inhibitors: aged cheese, beer on tap or unpasteuriced beer etc., can increase tyramine and result in hypertensive crisis. Don’t use maois within 2 weeks of ssri
- Review the best treatment for sexual side effects caused by antidepressants: sildenafil?
- Review which drug class serotonin/norepinephrine/dopamine are key targets for: inhibit the transporters
- Review medication profile for tricyclic antidepressants: increase the level of serotonin and norepinephrine and block action of muscarinic, histamergic, alpha adrenergic. Can cause cardiac arrhythmias and death with minimal overdose cuz blocks sodium ion channels. Easily overdose.
- Review medication profile for Trazodone: at lower dose it acts as a hypnotic. Needs high dose to be an antidepressant, not very effective at high dose for an antidepressant.
- Review briefly the findings of the STAR D study:
- Review what medication may cause increase bleeding with antidepressant use. NSAIDS, aspirin,
- Review comparison of desvenlafaxine to venlafaxine: desvenlafaxine usually 50 is good enough?
- Review definition of treatment resistant: failed trial of at least two antidepressants
- Review dietary tyramine and MAO inhibitors: causes hypertensive crisis
- Review factors important to consider when treating a depressed treatment resistant
patient
- Review what effect ECT has on depression:
Induced seizure. Can be rapidly effective but can cause memory loss, has major social stigma.
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