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Nursing Mental Health Drugs: Antidepressants Cheat Sheet (DRAFT) by

Commonly used Antidepressants in mental health

This is a draft cheat sheet. It is a work in progress and is not finished yet.

SSRIs- selective serotonin reuptake inhibitors

Mode of Action
Blocks reuptake of serotonin, makes MORE Seratonin available.
Drugs
Fluoxe­tine, Sertra­line, paroxe­tine, citalo­pram, escita­lopram
Side Effects
Sexual Dysfun­ction (apathy, anorga­smia) , GI Dysfun­ction (N/V)
SSRIs First Line in treatment for depression but also First Line for Suicide

NDRI- Norepi­nep­hrine Dopamine reuptake inhibitor

Mode of Action
Blocks reuptake of NE and Dopamine to make MORE available.
Drugs
Bupropion
Side Effects
SE: Insomnia, anorexia, weight­less, tremor.
Contra­ind­icated with seizure disorders, anorex­ia/­bulemia

No seroto­nergic activities = no sexual dysfun­ction
  

SNRI- seroto­nin­-no­rep­ine­phrine reuptake inhibitors

Mode of action
Increases both Serotonin and Norepi­nep­hrine
Drugs
Venlaf­laxine, Desven­laf­axine, Duloxetine, Levomi­lna­cipran.
Side Effects
NE (tremors, tachyc­ardia, ED) Serotonin (Sexual dysfun­ction, GI Dysfun­ction).
 
ALERT Monitor HTN & Tachyc­ardia (espec­ially Levomi­lna­cipran) due to greater NE uptake.
Duloxetine used for depression & genera­lized anxiety disorder, chronic muscul­osk­eletal pain.

TCAs- Tricyclic Antide­pre­ssants

Mode of Action
blocks reuptake of NE and NE/ser­atonin, increasing availa­bility
Drugs
Nortri­pty­line, Amitri­ptyline
Side Effects
SE: (too many) but includes sedation, antich­oli­nergic effects, postural hypote­nsion.
Can take longer to reach therap­eutic dose (10-14­days) and max effect (4-8 weeks).

TCAs far more lethal in OD due to cardiac conduction distur­bances from increased sodium channel blockade. was first developed but no longer first choice

memory trick Amy-Tr­ips-on things (sedation, postural hypote­nsion etc)
  

NaSSA- Norepi­nep­hrine & serotonin specific AntiD

Mode of Action
increase transm­ission of serotonin specific antide­pre­ssant
Drugs
Mirtaz­apine
Side Effects
SE: Sedation, increased appetite, weight gain.
Benefits anti anxiety & antide­pre­ssant effects with minimal sexual dysfun­ction, improved sleep, minimal GI symptoms

MAOIs- monoamine Oxidase Inhibi­tors

Mode of Action
Inhibit the action of MAO prevents destru­ction of monoamines results in increased levels of neurot­ran­smi­tters.
Drugs
Isocar­box­azid, Phenelzine
Side Effects
Consid­era­tion: Tyramine is a monoamine. If consumed cannot be broken down by liver. If consumed can produce vasoco­nst­riction = increased BP, risk of hypert­ensive crisis.
 
Patient Education with MAOIs give list of food/drugs to avoid/­mod­era­tion) Foods rich in Tyramine: aged cheeses, anything pickled, smoked fish. Drugs intera­ctions: anything that increases seratonin or epinep­hrine can increase risk of hypert­ensive crisis or risk of Seratonin syndrome (dangerous levels of Serato­nin).
Monoamines are neurot­ran­smi­tters: NE, Epinie­phrine, dopamine, seratonin and other foods/­drugs.
MAO is a enzyme that destroys Monoam­ines.

Seratonin Syndrome: think hot and sweaty.