ANTIDEPRESSANTS Overview (SSRIs, MAOIs, TCAs) | Nursing Pharmacology | NurseInTheMaking

Summary

Christine from Nurse in the Making discusses antidepressants, focusing on SSRIs, TCAs, and MAOIs. She highlights the increased suicide risk upon starting medication and the importance of not stopping them abruptly. SSRIs increase serotonin levels, with common side effects including sexual dysfunction and serotonin syndrome. TCAs block the reuptake of serotonin and norepinephrine, causing side effects like dizziness and anticholinergic effects. MAOIs increase multiple neurotransmitters and require a tyramine-restricted diet to prevent hypertensive crisis. The video provides mnemonics for medication names and emphasizes patient education on side effects and compliance.

Takeaways

• 💊 All antidepressants increase the risk for suicide, especially when starting the medication, as they can increase energy levels.
• 🔄 Never stop antidepressants abruptly; they need to be tapered off to prevent withdrawal symptoms.
• 🌅 SSRIs (Selective Serotonin Reuptake Inhibitors) are used for depression, anxiety, OCD, and eating disorders.
• 🧠 SSRIs work by inhibiting the reuptake of serotonin in the brain, which increases serotonin levels and improves mood.
• 💡 SSRI medications often end with the suffixes 'talopram', 'oxidine', 'zodone', and 'seroteen'.
• ⚠️ Be aware of SSRI side effects like sexual dysfunction, GI upset, weight gain, and Serotonin Syndrome.
• 📅 SSRIs can take 4-6 weeks to take effect, so it's important for patients to maintain compliance during this period.
• 🌤️ SSRIs are typically taken in the morning to avoid sleep disturbances.
• 🚫 Do not combine MAOIs (Monoamine Oxidase Inhibitors) or St. John's Wort with SSRIs to prevent Serotonin Syndrome.
• 🚫 TCAs (Tricyclic Antidepressants) are used for depressive episodes, bipolar disorder, OCD, and neuropathy.
• 🔄 TCAs block the reuptake of both serotonin and norepinephrine in the brain, increasing their levels.
• 💡 TCA medications often end with the suffixes 'tryptolene', 'pramine', and 'maxipine'.
• ⚠️ TCAs can cause side effects like dizziness, orthostatic hypotension, and anticholinergic effects.
• 🍽️ Patients on TCAs should be educated on the importance of a healthy diet and regular exercise to combat weight gain and constipation.
• 🚫 MAOIs are used for depression and work by blocking monoamine oxidase, increasing levels of various neurotransmitters.
• 🍽️ Patients on MAOIs must follow a tyramine-restricted diet to prevent a hypertensive crisis.
• 🌤️ MAOIs should be taken in the morning and can take up to 4 weeks to reach therapeutic levels.

Q & A

What are the main types of antidepressants discussed in the script?

The main types of antidepressants discussed are SSRIs, TCAs, and MAOIs.

What is a common risk associated with all antidepressants mentioned in the script?

A common risk associated with all antidepressants is the increased risk for suicide, particularly due to increased energy levels that might enable a patient to carry out a pre-existing suicide plan.

How should antidepressants be discontinued according to the script?

Antidepressants should not be stopped abruptly. They need to be tapered off, and patients should be educated not to stop them suddenly.

What do SSRIs stand for and what is their primary function?

SSRIs stand for Selective Serotonin Reuptake Inhibitors, and their primary function is to inhibit the uptake of serotonin in the brain, leading to increased serotonin levels which can elevate mood.

What are the suffixes that can help remember SSRI medications?

The suffixes that can help remember SSRI medications are 'talopram', 'oxidine', and 'zodone'. An outlier is 'seroteen'.

What are the 'S's of SSRIs that represent common side effects?

The 'S's of SSRIs represent sexual dysfunction, stomach issues (GI upset), swollen (due to weight gain), and serotonin syndrome.

What is Serotonin Syndrome and why is it important to be aware of it with SSRIs?

Serotonin Syndrome is a condition where there is too much serotonin in the brain, which can be caused by SSRIs. It is important to be aware of because it can lead to serious symptoms like muscle rigidity, restlessness, high heart rate, high blood pressure, and mental changes.

What is the significance of the memory trick 'Take at sunrise' in relation to SSRIs?

The memory trick 'Take at sunrise' suggests that SSRIs should be taken in the morning to help with compliance and effectiveness of the medication.

What is the advice given for patients on SSRIs regarding diet and exercise?

Patients on SSRIs should be advised to eat a healthy diet and exercise regularly to combat potential weight gain.

Why should patients not combine MAOIs or St. John's Wort with SSRIs?

Patients should not combine MAOIs or St. John's Wort with SSRIs because it can lead to too much serotonin in the brain, causing Serotonin Syndrome.

What are TCAs and what are their uses?

TCAs are Tricyclic Antidepressants used for depressive episodes, bipolar disease, OCD, and neuropathy.

What are the common side effects associated with TCAs?

Common side effects associated with TCAs include dizziness, orthostatic hypotension, and anticholinergic effects such as urinary retention, blurred vision, dry mouth, and constipation.

What is the significance of the number 14 days in the context of switching between different types of antidepressants?

The number 14 days is significant because it represents the washout period required between stopping one type of antidepressant (like MAOIs) and starting another (like TCAs or SSRIs) to prevent dangerous interactions.

What are MAOIs and how do they work?

MAOIs are Monoamine Oxidase Inhibitors used for depression. They work by blocking monoamine oxidase, leading to increased levels of epinephrine, norepinephrine, dopamine, and serotonin in the brain.

What dietary restrictions should patients on MAOIs follow?

Patients on MAOIs should follow a tyramine-restricted diet to avoid a hypertensive crisis. They should avoid foods high in tyramine such as aged cheese, fermented meats, overripe fruits, and sour cream and yogurt.

What is the memory trick for remembering when to take MAOIs?

The memory trick for remembering when to take MAOIs is 'morning', as the medication can cause sleep disturbances and should not be taken at night.

How long does it take for MAOIs to reach therapeutic levels?

It takes four weeks for MAOIs to reach therapeutic levels.