Antidepressants - SSRIs and SNRIs: Nursing pharmacology
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Notes
ANTIDEPRESSANTS: SSRIs, SNRIs | ||
DRUG NAME | fluoxetine (Prozac), fluvoxamine (Luvox), sertraline (Zoloft), paroxetine (Paxil, Pexeva), citalopram (Celexa), escitalopram (Lexapro) | duloxetine (Cymbalta), venlafaxine (Effexor), desvenlafaxine (Pristiq), levomilnacipran (Fetzima) |
CLASS | Selective serotonin reuptake inhibitors (SSRIs) | Serotonin-norepinephrine reuptake inhibitors (SNRIs) |
MECHANISM OF ACTION | Inhibit serotonin reuptake, increasing its concentration in the synaptic cleft | Inhibit serotonin and norepinephrine reuptake, increasing their concentration in the synaptic cleft |
INDICATIONS |
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ROUTE(S) OF ADMINISTRATION | PO | |
SIDE EFFECTS |
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CONTRAINDICATIONS AND CAUTIONS |
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NURSING CONSIDERATIONS | Assessment and monitoring: SSRIs and SNRIs
Client education: SSRIs and SNRIs
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Transcript
Antidepressants are medications primarily used to treat major depressive disorder, which is a condition associated with a persistent feeling of sadness and loss of interest in everyday activities.
Even though the exact cause of major depressive disorder is still unknown, there's some evidence that suggests that it’s related to low levels of neurotransmitters called monoamines, which include serotonin, norepinephrine, and dopamine.
In this video, we’re going to cover two of the main classes of antidepressants: selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors.
First, let’s focus on selective serotonin reuptake inhibitors, or SSRIs for short, such as fluoxetine, fluvoxamine, sertraline, paroxetine, citalopram, and escitalopram.
SSRIs are taken orally, and once absorbed into the bloodstream, they travel to the brain. Here, SSRIs inhibit the reuptake of serotonin.
As a result, free levels of serotonin within the synaptic cleft are increased right away, although the effect of SSRIs alleviating symptoms of depression are not evident for a few weeks.
Other indications for SSRIs include anxiety disorders like obsessive-compulsive disorder, or OCD; post traumatic stress disorder, or PTSD; panic disorder and phobias; as well as eating disorders like bulimia.
On the other hand, serotonin-norepinephrine reuptake inhibitors, or SNRIs, include duloxetine, venlafaxine, desvenlafaxine, and levomilnacipran.
Sources
- "Focus on Nursing Pharmacology" LWW (2019)
- "Pharmacology" Elsevier Health Sciences (2014)
- "Mosby's 2021 Nursing Drug Reference" Mosby (2020)
- "Saunders Comprehensive Review for the NCLEX-RN Examination" Saunders (2016)
- "SSRI Antidepressant Medications" The Primary Care Companion to The Journal of Clinical Psychiatry (2001)