Lecture Notes: SSRIs - Selective Serotonin Reuptake Inhibitors
Introduction
- SSRIs: Class of antidepressants for depression and anxiety.
- Effective but with side effects and adverse reactions.
- Mnemonic association: Sushi and SSRIs (Selective Serotonin Reuptake Inhibitors).
- Function: Block reuptake of serotonin, increasing its availability in the brain (feel-good neurotransmitter).
Drug Names and Mnemonics
- Citalopram (Citi credit card)
- Escitalopram: Related to citalopram.
- Sertraline (Certificate)
- Paroxetine (Parrot fish)
- Fluoxetine (Flour)
Clinical Uses
- Depression: Treats clinical depression by increasing serotonin, preferred due to fewer side effects compared to TCAs or MAOIs.
- Suicidal Thoughts: Potential increase in short term before mood improvement (up to 4 weeks).
- Anxiety: Treats various forms like general anxiety disorder, PTSD, and panic disorders.
Side Effects and Adverse Reactions
- Sexual Dysfunction: Over 50% experience low libido, difficulty in achieving orgasm (nursing priority: patient-provider discussion).
- Weight Gain: Encourage healthy diet and exercise.
- Serotonin Syndrome: Life-threatening with symptoms like tachycardia, hypertension, muscle rigidity, agitation, restlessness, and diarrhea.
- Overactive Systems: High serotonin leads to overactive heart, bowels, muscles.
- Medical Emergency: Notify provider if symptoms present.
Drug Interactions
- MAOIs (Maui): Avoid concurrent use, 14-day gap required.
- St. John's Wort (Saint's Warthog jersey): Avoid due to increased serotonin risk.
- Grapefruit: Avoid as it alters metabolism, increasing drug levels and serotonin.
Summary Review
- SSRIs: Treat anxiety and depression.
- Drug Names: Citalopram, Escitalopram, Sertraline, Paroxetine, Fluoxetine.
- Side Effects: Sexual dysfunction, weight gain.
- Adverse Effects: Serotonin syndrome (life-threatening).
- Avoid: MAOIs, St. John's Wort, grapefruit.
Feel free to review other mnemonic videos for further learning.