Podcast
Questions and Answers
Which class of antidepressants is FDA-approved for treating obsessive–compulsive disorder in children?
Which class of antidepressants is FDA-approved for treating obsessive–compulsive disorder in children?
What is the peak action time of fluoxetine?
What is the peak action time of fluoxetine?
Which group of antidepressants is preferred for older adults due to fewer adverse effects than TCAs?
Which group of antidepressants is preferred for older adults due to fewer adverse effects than TCAs?
What is a common side effect of benzodiazepines?
What is a common side effect of benzodiazepines?
Signup and view all the answers
What is the primary neurotransmitter affected by SSRIs?
What is the primary neurotransmitter affected by SSRIs?
Signup and view all the answers
What is a caution advised for the use of fluoxetine in critically ill patients?
What is a caution advised for the use of fluoxetine in critically ill patients?
Signup and view all the answers
Which class of antidepressants is considered first-line treatment for obsessive-compulsive disorder (OCD)?
Which class of antidepressants is considered first-line treatment for obsessive-compulsive disorder (OCD)?
Signup and view all the answers
What is a potential concern associated with long-term use of benzodiazepines?
What is a potential concern associated with long-term use of benzodiazepines?
Signup and view all the answers
Which medication may be considered for treatment-resistant OCD?
Which medication may be considered for treatment-resistant OCD?
Signup and view all the answers
Which drug does not cause physical dependence and is used to treat anxiety?
Which drug does not cause physical dependence and is used to treat anxiety?
Signup and view all the answers
Which age group also responds well to behavioral therapy and SSRI antidepressants for OCD treatment?
Which age group also responds well to behavioral therapy and SSRI antidepressants for OCD treatment?
Signup and view all the answers
Which class of antidepressants is mentioned as a first-line choice for OCD treatment in the text?
Which class of antidepressants is mentioned as a first-line choice for OCD treatment in the text?
Signup and view all the answers
What are the adverse effects of venlafaxine?
What are the adverse effects of venlafaxine?
Signup and view all the answers
How is venlafaxine excreted from the body?
How is venlafaxine excreted from the body?
Signup and view all the answers
What is a contraindication to venlafaxine use?
What is a contraindication to venlafaxine use?
Signup and view all the answers
What are the adverse effects of olanzapine?
What are the adverse effects of olanzapine?
Signup and view all the answers
How is quetiapine (Seroquel, Seroquel XR) used?
How is quetiapine (Seroquel, Seroquel XR) used?
Signup and view all the answers
What is a potential drug interaction with olanzapine?
What is a potential drug interaction with olanzapine?
Signup and view all the answers
What is a contraindication for the use of fluoxetine?
What is a contraindication for the use of fluoxetine?
Signup and view all the answers
What is the potential consequence of taking fluoxetine concurrently with an MAO inhibitor?
What is the potential consequence of taking fluoxetine concurrently with an MAO inhibitor?
Signup and view all the answers
What is a possible result of sudden termination of SSRIs such as fluoxetine?
What is a possible result of sudden termination of SSRIs such as fluoxetine?
Signup and view all the answers
What is the recommended timing for taking SSRIs like fluoxetine to prevent interference with sleep?
What is the recommended timing for taking SSRIs like fluoxetine to prevent interference with sleep?
Signup and view all the answers
At what point may the therapeutic effects of fluoxetine be observed?
At what point may the therapeutic effects of fluoxetine be observed?
Signup and view all the answers
What is a potential adverse effect of fluoxetine?
What is a potential adverse effect of fluoxetine?
Signup and view all the answers
What are the adverse effects of venlafaxine?
What are the adverse effects of venlafaxine?
Signup and view all the answers
How is venlafaxine excreted from the body?
How is venlafaxine excreted from the body?
Signup and view all the answers
What is a contraindication to venlafaxine use?
What is a contraindication to venlafaxine use?
Signup and view all the answers
What are the adverse effects of olanzapine?
What are the adverse effects of olanzapine?
Signup and view all the answers
How is quetiapine (Seroquel, Seroquel XR) used?
How is quetiapine (Seroquel, Seroquel XR) used?
Signup and view all the answers
What is a potential drug interaction with olanzapine?
What is a potential drug interaction with olanzapine?
Signup and view all the answers
Which antidepressant medication requires adherence to specific dosing instructions and the use of effective birth control methods due to its contraindication in pregnancy?
Which antidepressant medication requires adherence to specific dosing instructions and the use of effective birth control methods due to its contraindication in pregnancy?
Signup and view all the answers
Which antidepressant medication should not be taken together with escitalopram due to their derivative relationship?
Which antidepressant medication should not be taken together with escitalopram due to their derivative relationship?
Signup and view all the answers
Which class of antidepressants inhibits the uptake of both serotonin and norepinephrine, affecting mood?
Which class of antidepressants inhibits the uptake of both serotonin and norepinephrine, affecting mood?
Signup and view all the answers
Which antidepressant medication is available as Wellbutrin and Zyban, and has specific dosing instructions and precautions to avoid overdoses and adverse effects?
Which antidepressant medication is available as Wellbutrin and Zyban, and has specific dosing instructions and precautions to avoid overdoses and adverse effects?
Signup and view all the answers
Which neurotransmitters do SNRIs like venlafaxine increase levels of in the brain?
Which neurotransmitters do SNRIs like venlafaxine increase levels of in the brain?
Signup and view all the answers
Which enzyme system do SSRIs and SNRIs inhibit, affecting the metabolism of many drugs?
Which enzyme system do SSRIs and SNRIs inhibit, affecting the metabolism of many drugs?
Signup and view all the answers
Which type of drugs are used to treat obsessive-compulsive disorder (OCD)?
Which type of drugs are used to treat obsessive-compulsive disorder (OCD)?
Signup and view all the answers
What is a chief problem encountered with the use of benzodiazepines?
What is a chief problem encountered with the use of benzodiazepines?
Signup and view all the answers
Which drug does not cause physical dependence?
Which drug does not cause physical dependence?
Signup and view all the answers
What are the first-line choices for treating OCD?
What are the first-line choices for treating OCD?
Signup and view all the answers
Which type of drugs may be used for treatment-resistant OCD?
Which type of drugs may be used for treatment-resistant OCD?
Signup and view all the answers
What do children and adolescents with OCD respond well to?
What do children and adolescents with OCD respond well to?
Signup and view all the answers
What is the black box warning for venlafaxine?
What is the black box warning for venlafaxine?
Signup and view all the answers
What should be avoided while taking phenelzine and other monoamine oxidase inhibitors?
What should be avoided while taking phenelzine and other monoamine oxidase inhibitors?
Signup and view all the answers
What is the important consideration for using bupropion for smoking cessation?
What is the important consideration for using bupropion for smoking cessation?
Signup and view all the answers
What are the potential serious adverse effects to report when taking tricyclic antidepressants?
What are the potential serious adverse effects to report when taking tricyclic antidepressants?
Signup and view all the answers
What is the recommendation for taking selective serotonin reuptake inhibitors (SSRIs) to avoid interference with sleep?
What is the recommendation for taking selective serotonin reuptake inhibitors (SSRIs) to avoid interference with sleep?
Signup and view all the answers
What is the potential adverse effect of abrupt discontinuation of vilazodone?
What is the potential adverse effect of abrupt discontinuation of vilazodone?
Signup and view all the answers
What is a serious and sometimes fatal reaction characterized by hypertensive crisis, hyperpyrexia, extreme agitation progressing to delirium and coma, muscle rigidity, and seizures?
What is a serious and sometimes fatal reaction characterized by hypertensive crisis, hyperpyrexia, extreme agitation progressing to delirium and coma, muscle rigidity, and seizures?
Signup and view all the answers
Which drugs, when combined with an SSRI, can lead to serotonin syndrome?
Which drugs, when combined with an SSRI, can lead to serotonin syndrome?
Signup and view all the answers
How long should a patient discontinue fluoxetine before starting an MAO inhibitor?
How long should a patient discontinue fluoxetine before starting an MAO inhibitor?
Signup and view all the answers
What is the range for therapeutic serum levels of fluoxetine?
What is the range for therapeutic serum levels of fluoxetine?
Signup and view all the answers
What should patients typically do to prevent interference with sleep when taking SSRIs like fluoxetine?
What should patients typically do to prevent interference with sleep when taking SSRIs like fluoxetine?
Signup and view all the answers
What is an important consideration for patients taking antidepressants?
What is an important consideration for patients taking antidepressants?
Signup and view all the answers
Which medication is primarily used as an antimanic agent for bipolar disorder?
Which medication is primarily used as an antimanic agent for bipolar disorder?
Signup and view all the answers
What is the response rate in acute mania to lithium therapy?
What is the response rate in acute mania to lithium therapy?
Signup and view all the answers
In addition to lithium, what other medication is used as a mood stabilizer for bipolar disorder?
In addition to lithium, what other medication is used as a mood stabilizer for bipolar disorder?
Signup and view all the answers
What is the purpose of administering an antipsychotic agent to a client in the acute stage of mania or depression?
What is the purpose of administering an antipsychotic agent to a client in the acute stage of mania or depression?
Signup and view all the answers
What is the primary way in which lithium stabilizes bipolar disorder?
What is the primary way in which lithium stabilizes bipolar disorder?
Signup and view all the answers
Which elements is lithium similar to, that are contained in the human body?
Which elements is lithium similar to, that are contained in the human body?
Signup and view all the answers
What is a characteristic of the use of antipsychotic agents in addition to bipolar medications?
What is a characteristic of the use of antipsychotic agents in addition to bipolar medications?
Signup and view all the answers
What is the recommended therapeutic range for serum lithium levels?
What is the recommended therapeutic range for serum lithium levels?
Signup and view all the answers
Which organ function is essential for lithium therapy due to its impact on lithium reabsorption?
Which organ function is essential for lithium therapy due to its impact on lithium reabsorption?
Signup and view all the answers
What is a common adverse effect associated with lithium therapy?
What is a common adverse effect associated with lithium therapy?
Signup and view all the answers
What is a contraindication for lithium therapy?
What is a contraindication for lithium therapy?
Signup and view all the answers
When should lithium be discontinued?
When should lithium be discontinued?
Signup and view all the answers
What should patient teaching emphasize regarding lithium therapy?
What should patient teaching emphasize regarding lithium therapy?
Signup and view all the answers
Why is caution needed when using lithium in patients with hepatic impairment?
Why is caution needed when using lithium in patients with hepatic impairment?
Signup and view all the answers
What is the recommended timing for taking lithium to prevent interference with sleep?
What is the recommended timing for taking lithium to prevent interference with sleep?
Signup and view all the answers
What is the primary route of excretion for lithium?
What is the primary route of excretion for lithium?
Signup and view all the answers
What is the onset of action for lithium?
What is the onset of action for lithium?
Signup and view all the answers
What is the primary reason why lithium use during pregnancy is not recommended?
What is the primary reason why lithium use during pregnancy is not recommended?
Signup and view all the answers
What is the mechanism of action of lithium believed to affect?
What is the mechanism of action of lithium believed to affect?
Signup and view all the answers
What percentage of people with bipolar illness respond effectively to lithium?
What percentage of people with bipolar illness respond effectively to lithium?
Signup and view all the answers
What is the half-life of lithium?
What is the half-life of lithium?
Signup and view all the answers
Which atypical antipsychotic is approved by the FDA for the treatment of acute manic and mixed bipolar disorder in children and adolescents aged 8 to 17 years?
Which atypical antipsychotic is approved by the FDA for the treatment of acute manic and mixed bipolar disorder in children and adolescents aged 8 to 17 years?
Signup and view all the answers
Which atypical antipsychotic has a Black Box Warning issued by the FDA regarding the risk of developing compulsive or uncontrollable urges to gamble, shop, binge eat, or have sex?
Which atypical antipsychotic has a Black Box Warning issued by the FDA regarding the risk of developing compulsive or uncontrollable urges to gamble, shop, binge eat, or have sex?
Signup and view all the answers
Which atypical antipsychotic is not recommended for dementia-related psychosis?
Which atypical antipsychotic is not recommended for dementia-related psychosis?
Signup and view all the answers
Which atypical antipsychotic is administered without food or with 300 calories or less to avoid increasing the peak serum concentration?
Which atypical antipsychotic is administered without food or with 300 calories or less to avoid increasing the peak serum concentration?
Signup and view all the answers
Which atypical antipsychotic is associated with a Black Box Warning reporting increasing mortality in elderly patients with dementia-related psychosis?
Which atypical antipsychotic is associated with a Black Box Warning reporting increasing mortality in elderly patients with dementia-related psychosis?
Signup and view all the answers
Which anticonvulsant is approved by the FDA for treating bipolar disorder and is typically used for patients who do not respond to lithium?
Which anticonvulsant is approved by the FDA for treating bipolar disorder and is typically used for patients who do not respond to lithium?
Signup and view all the answers
Which anticonvulsant is being studied and used off-label for its effects in bipolar disorder, but does not have FDA approval for this use?
Which anticonvulsant is being studied and used off-label for its effects in bipolar disorder, but does not have FDA approval for this use?
Signup and view all the answers
Which anticonvulsant is excreted in the urine and feces and is associated with adverse effects such as somnolence, dizziness, weight gain, constipation, and xerostomia?
Which anticonvulsant is excreted in the urine and feces and is associated with adverse effects such as somnolence, dizziness, weight gain, constipation, and xerostomia?
Signup and view all the answers
Which anticonvulsant is mentioned as not having FDA approval for treating bipolar disorder, but is being studied for its effects in this condition?
Which anticonvulsant is mentioned as not having FDA approval for treating bipolar disorder, but is being studied for its effects in this condition?
Signup and view all the answers
Study Notes
Antianxiety Agents and Antidepressants: Key Points
- Common side effects of benzodiazepines include CNS depression symptoms like drowsiness and impaired memory, and tolerance to these symptoms often develops.
- Buspirone commonly causes dizziness, sedation, nausea, and headache, with elderly clients being more prone to falls and memory deficits.
- Clients should be aware that antianxiety agents alleviate symptoms but do not treat underlying issues, and should avoid alcohol while taking benzodiazepines.
- Abrupt discontinuation of benzodiazepines can be fatal, and elderly clients may have difficulty managing CNS depression effects.
- Clomipramine is FDA-approved for treating obsessive–compulsive disorder in children, and TCAs like amitriptyline and desipramine have similar adverse effects to imipramine.
- SSRIs like fluoxetine are the preferred choice for treating depression due to fewer adverse effects than TCAs, and they primarily affect serotonin.
- Fluoxetine has a peak action of 6 to 8 hours, a long half-life, and steady-state blood levels are achieved slowly over several weeks.
- The use of fluoxetine includes treatment for depression, anxiety, obsessive–compulsive disorder, bulimia nervosa, and premenstrual dysphoric disorder.
- The FDA has issued a BLACK BOX WARNING for increased risk of suicidal ideation in children and young adults taking antidepressants, including fluoxetine.
- Fluoxetine and other SSRIs are preferred in older adults due to fewer adverse effects than TCAs, and caution is warranted in severe liver impairment.
- Critically ill patients may need fluoxetine for depression, but caution is advised due to potential adverse drug effects and interactions with anesthetics.
- Adverse effects of fluoxetine include GI symptoms, sexual dysfunction, CNS stimulation, and increased risk of GI bleeding, with a potential hypoglycemic effect in patients with diabetes mellitus.
Antidepressant Medications: Key Points to Know
- Different antidepressant medications have specific instructions for use, such as taking them at bedtime to aid sleep and decrease adverse effects or in the morning to avoid interference with sleep.
- Certain medications, like escitalopram and citalopram, should not be taken together as they are derivatives of each other.
- Venlafaxine, when used, requires adherence to specific dosing instructions and the use of effective birth control methods due to its contraindication in pregnancy.
- Specific instructions for medications like duloxetine, desvenlafaxine, and phenelzine involve swallowing the medication whole and avoiding certain foods to prevent adverse effects.
- The unique antidepressant bupropion, available as Wellbutrin and Zyban, has specific dosing instructions and precautions to avoid overdoses and adverse effects.
- Other drugs in the same class as bupropion include citalopram, escitalopram, paroxetine, sertraline, and vilazodone, each with its unique characteristics and metabolites.
- Selective serotonin reuptake inhibitors (SSRIs) and serotonin–norepinephrine reuptake inhibitors (SNRIs) have similar therapeutic effects, and SNRIs like venlafaxine inhibit the uptake of both serotonin and norepinephrine, affecting mood.
- Venlafaxine is well absorbed, extensively metabolized in the liver, and excreted in urine, and it increases serotonin and norepinephrine levels in the brain while also weakly inhibiting dopamine reuptake.
- SNRIs are standard first-line treatments for depression and anxiety disorders, and venlafaxine is used to treat depression, generalized anxiety disorder, social phobia, and panic disorder.
- The FDA has issued a black box warning about the increased risk of suicidal ideation in children, adolescents, and young adults when taking antidepressant medications, including venlafaxine, and children taking the drug may experience weight loss.
- Discontinuation syndrome is a concern with certain antidepressant medications, such as paroxetine, which may produce symptoms including nausea, vomiting, fatigue, muscle aches, dizziness, headache, and insomnia.
- SSRIs and SNRIs inhibit the CYP enzyme system, affecting the metabolism of many drugs, and may require half the maximum dose for poor metabolizers of CYP2C19 or concurrent use of moderate-to-strong CYP2C19 inhibitors.
Mood-Stabilizing Agents: Drugs Used to Treat Bipolar Disorder
- Lithium’s mechanism of action is not fully understood, but it is believed to affect the destruction of catecholamines, inhibit neurotransmitter release, and decrease sensitivity of postsynaptic receptors.
- Lithium's action peaks in 30 minutes to 4 hours for regular forms and 4 to 6 hours for slow-release form, crossing the blood-brain barrier and placenta, and is distributed in sweat and breast milk.
- Lithium use during pregnancy is not recommended due to potential first-trimester developmental abnormalities.
- Onset of action for lithium is 5 to 14 days, and combination with antipsychotic or antidepressant agents is used to reduce symptoms in acutely manic or depressed clients.
- The half-life of lithium is 20 to 27 hours.
- About 75% of people with bipolar illness respond effectively to lithium, while the rest may have difficulty taking it due to side effects, treatment regimen, drug interactions, or medical conditions.
- Anticonvulsants like carbamazepine, valproic acid, gabapentin, lamotrigine, topiramate, and clonazepam are used as mood stabilizers for bipolar illness, each requiring specific therapeutic level monitoring and baseline laboratory testing.
- Aripiprazole, brexpiprazole, cariprazine, ziprasidone, lurasidone, and quetiapine are adjunctive medications used alongside mood stabilizers or antidepressants to treat bipolar disorder.
- Research has shown that mood-stabilizing drugs like lithium stimulate neuronal growth and reduce brain atrophy in people with long-standing mood disorders.
- Lithium carbonate is used to treat and prevent manic episodes in bipolar disorder, proving effective in controlling mania and decreasing the frequency and intensity of manic cycles.
- Lithium is well absorbed after oral administration, with peak serum levels in 1 to 3 hours and steady-state concentrations in 5 to 7 days, and is entirely excreted by the kidneys.
- Lithium is the drug of choice for treating manic episodes of bipolar disorder and for maintenance treatment, with long-term therapy being usual practice to decrease recurrence. Gradually tapering the dose over 2 to 4 weeks delays the recurrence of symptoms.
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.
Description
Test your knowledge of antianxiety agents and antidepressants with these key points! From common side effects to specific medication instructions, this quiz covers essential information for healthcare professionals and students studying pharmacology.
