Anti-depressant Basics
How long can it take to see improvement with antidepressants?
4-8 weeks
Name two SSRIs
1. Fluoxetine
2. Sertraline
3. Paroxetine
4. Escitalopram
Bupropion, mirtazapine, trazodone
What must patients on MAOIs avoid in their diet?
Tyramine-rich foods (aged chees, cured meats, red wine, chocolate)
What does ECT stand for?
Electroconvulsive therapy
What is the FDA-approved boxed warning for antidepressants
Increased risk of suicidality in children and adolescents.
Name one SNRI
Duloxetine or venlafaxine
What antidepressant is also used for smoking cessation?
Bupropion (wellbutrin)
Why are TCAs rarely used today?
High anticholinergic burden and overdose risk
How often is ECT typically administered
2-3 times per week for 6-12 treatments
Why should patients continue medication even when they feel better?
To prevent relapse; depression is often chronic
List two common side effects of SSRIs
Sexual dysfunction, insomnia, drowsiness, weight gain, nausea
Which atypical is often prescribed in older adults for insomnia/weight gain
Mirtazepine
What cardiac risk is associated with TCAs
QT prolongation, and arrythmias
When might ECT be chosen over medications?
Severe depression, suicidality, or poor response to meds.
What can happen if someone abruptly stops taking their antidepressants?
Serotonin Discontinuation Syndrome (brain zaps, fatigue, mood changes)
What side effect risk is increased in SNRIs compared to SSRIs
Anticholinergic Effects (dry mouth, constipation)
Which antidepressant is freq. used off-label for insomnia?
Trazodone
Why are MAOIs considered dangerous in overdose?
Hypertensive crisis or severe interactions
Name one possible adverse effect of ECT
Memory loss, headaches, nausea
What is the nurse's biggest concern if a patient suddenly has more energy after starting an antidepressant?
They may now have enough energy to act on suicidal thoughts
Which life-threatening condition is linked to excessive serotonin
Serotonin Syndrome
What dangerous side effect is associated with bupropion?
Seizure Risk
Explain the difference between serotonin syndrome and serotonin discontinuation syndrome.
Syndrome = medical emergency (too much)
Discontinuation = withdrawal (not life-threatening)
Who performs ECT?
Psychiatrist, anesthesiologist, nurse/PA