Antidepressants: Safety Guidelines for Nurses

Feb 3, 2025

Lecture Notes: Antidepressants and NCLEX Safety Guidelines

Introduction to SimpleNursing

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Overview of Antidepressants

  • Types: SSRIs, SNRIs, TCAs, MAOIs.
  • Focus on NCLEX safety rather than mode of action.

Four Universal Principles for Antidepressants (NCLEX Patient Safety)

1. Increased Risk of Suicide

  • Key Point: Antidepressants can increase suicidal thoughts in the first weeks.
  • High Risk Group: Young adults (18-24 years).
  • Action: Always notify the provider about suicidal thoughts.
  • Monitoring: Look for new thoughts of suicide, unusual behavior, worsening depression, or sudden mood changes.

2. Slow Onset and Taper Off

  • Guideline: Never stop antidepressants abruptly.
  • Patient Education: Therapeutic effect takes a few weeks; inform about potential sexual dysfunction to avoid discontinuation.

3. Mixing Antidepressants

  • Key Point: Never mix SSRIs with St. John's Wort or MAOIs with other antidepressants (TCAs, SSRIs, SNRIs).
  • Risk: Deadly serotonin syndrome.
  • Protocol: Two-week washout period before starting new antidepressants.

4. Effects on Blood Pressure and Weight

  • Effect: Psychiatric drugs typically decrease blood pressure.
  • Advice: Teach slow position changes to prevent falls.
  • Side Effect: Weight changes, mostly gain.

Focus on SSRIs

Common SSRIs

  • Sertraline, Citalopram, Escitalopram, Paroxetine, Fluoxetine.
  • Used for depression, anxiety, PTSD.

Mode of Action

  • SSRIs: Selective Serotonin Reuptake Inhibitors.
  • Function: Inhibit reuptake of serotonin, increasing its levels.

Common Side Effects

  • Weight Gain: Common.
  • Sexual Side Effects: Notable sexual dysfunction.
  • Sleep: Cause insomnia, not sedation.

Priority Key Points (Acronym: SSRI)

  • S: Suicide risk increased when starting/changing dose.
    • Monitor: Age 18-24; report more energy without mood improvement.

Conclusion

  • Access to full video and quiz bank via link.
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  • Acknowledgment to the team of experts.
  • Reminder: Always adhere to safety protocols and guidelines when handling antidepressants to ensure patient safety and compliance.