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What is the clinical presentation of depression?
- Sleep
- Interests
- Guilt
- Energy
- Concentration
- Appetite
- Psychomotor
- Suicidal thoughts and ideations
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Which SSRI is the most activating?
Prozac
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Which SSRI is the most sedating?
Paxil
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Which SSRIs have the most drug intxts?
Prozac and Paxil
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Which SSRIs have the least drug intxts?
Zoloft, Celexa, Lexapro
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Which SSRI causes the most diarrhea?
Zoloft
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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
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Can you d/c an antidepressant abruptly?
No, especially Prozac (long t1/2) - this may cause withdrawal sxts. Taper over several wks
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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
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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?)
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