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ANTIDEPRESSANTS: SSRIs, SNRIs

fluoxetine (Prozac),
fluvoxamine (Luvox), duloxetine (Cymbalta),
sertraline (Zoloft), venlafaxine (Effexor),
DRUG NAME
paroxetine (Paxil, Pexeva), desvenlafaxine (Pristiq),
citalopram (Celexa), levomilnacipran (Fetzima)
escitalopram (Lexapro)

Selective serotonin reuptake Serotonin-norepinephrine

CLASS
inhibitors (SSRIs) reuptake inhibitors (SNRIs)

Inhibit serotonin reuptake, Inhibit serotonin and

increasing its concentration in norepinephrine reuptake,
MECHANISM OF ACTION
the synaptic cleft increasing their concentration
in the synaptic cleft

Major depressive disorder Major depressive disorder

Anxiety disorders Generalized anxiety
(obsessive-compulsive disorder
INDICATIONS disorder, posttraumatic Neuropathic pain
stress disorder, panic
disorder, phobias)
Phobias

ROUTE(S) OF PO
ADMINISTRATION

SIDE EFFECTS Anxiety

Nervousness
Agitation
Dizziness
Drowsiness
Insomnia
Loss of appetite
Nausea
Vomiting
Diarrhea
Sexual dysfunction
Headache
Sweating
Hyponatremia

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Dry mouth
Bruxism
Serotonin syndrome
Boxed warning: suicidal thinking in children, adolescents, and
young adults
SNRIs: hypertension, tachycardia, closed-angle glaucoma,
urinary retention

Combination with MAOIs

QT prolongation or myocardial infarction
Pregnancy
CONTRAINDICATIONS
Renal or hepatic disease
AND CAUTIONS
Diabetes
Glaucoma
Severely depressed clients with suicidal thinking

Assessment and monitoring: SSRIs and SNRIs

Baseline assessment of depressive symptoms; continue during
antidepressant therapy
Monitor for suicidal thoughts, especially during the first few
weeks
Baseline mental status, vital signs, weight, serum electrolytes,
kidney and liver function
Pregnancy status

NURSING
Client education: SSRIs and SNRIs
CONSIDERATIONS Therapeutic effects can take 1–3 weeks
Take medication exactly as prescribed
Report any changes in symptoms or suicidal thoughts to
health care provider
Administer medication in the morning
Avoid hazardous activities with fatigue and dizziness
Notify healthcare provider about adverse effects
SNRIs: Void before taking this medication
Never abruptly stop medication therapy

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