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What is the clinical presentation of depression?
- Suicidal thoughts and ideations
Which SSRI is the most activating?
Which SSRI is the most sedating?
Which SSRIs have the most drug intxts?
Prozac and Paxil
Which SSRIs have the least drug intxts?
Zoloft, Celexa, Lexapro
Which SSRI causes the most diarrhea?
How long do antidepressants take to work?
- For physical sxts, like energy: 2 wks
- For psychological sxts, like low mood: 4-6 wks, maybe longer
Can you d/c an antidepressant abruptly?
No, especially Prozac (long t1/2) - this may cause withdrawal sxts. Taper over several wks
How long should pt be on a drug before he/she can say it doesn't work?
At least 6 wks, and dose must be therapeutic
How should you react to incomplete response to antidepressant?
- Dose increase or
- Add antipsychotic: Abilify, Seroquel XR, or Symbyax (olanzapine+fluoxetine) or
- Antidepressant combo tx (maybe?)