Notes on Medications for Depression and Anxiety

Overview

• This lecture covers medications used for both depression and anxiety.
• Focus is on SSRIs and SNRIs.

Selective Serotonin Reuptake Inhibitors (SSRIs)

• Common Drugs: Paroxetine, Sertraline, and Fluoxetine.
  • Recognizable by the 'teen' suffix.
• Uses:
  • Anxiety
  • Depression
  • OCD
  • PTSD
• Mechanism:
  • Inhibit serotonin reuptake, increasing serotonin levels.
• Side Effects:
  • Sexual dysfunction
  • Weight gain
  • Insomnia
• Black Box Warning:
  • May increase suicidal thoughts in some patients.
• Serotonin Syndrome:
  • Monitor patients for symptoms: agitation, hallucinations, fever, diaphoresis, tremors.
  • Risk increases with St. John's Wort.
• Onset:
  • Effects take several weeks.

Serotonin Norepinephrine Reuptake Inhibitors (SNRIs)

• Common Drugs: Duloxetine, Venlafaxine.
• Mechanism:
  • Inhibit reuptake of serotonin and norepinephrine, increasing their levels.
• Side Effects:
  • Fatigue
  • Insomnia
  • GI upset including nausea and constipation
  • Dysuria
  • Decreased libido
• Black Box Warning:
  • May increase risk of suicidal thoughts.
• Monitoring:
  • Watch for serotonin syndrome similar to SSRIs.

Memory Tips

• SSRIs: "If you live with a teen, you might need SSRIs."
• SNRIs: "Don't need a deluxe apartment, just duloxetine for depression."

Next Topic

• Upcoming lecture will cover medications for bipolar disorder.