SSRI adverse effects are critical to know. In part 2 of this 2-part series on SSRIs, we cover the most important adverse effects to know, in addition to putting a nice bow on the most important clinical practice pearls on each SSRI. Enjoy the show!
In this episode, we break down the pharmacology of selective serotonin reuptake inhibitors (SSRIs) with a focus on the high-yield clinical pearls pharmacists, medical students, and healthcare professionals need to know. We compare the major SSRIs—including fluoxetine, sertraline, paroxetine, citalopram, escitalopram, and fluvoxamine—based on adverse effects, drug interactions, pharmacokinetics, and board exam relevance. Topics include serotonin syndrome, discontinuation syndrome, CYP450 interactions, QT prolongation, sexual dysfunction, weight changes, and SSRI selection in special populations such as older adults and pregnancy. Whether you are preparing for exams, clinical rotations, or looking to sharpen your psychopharmacology knowledge, this episode provides practical and memorable insights into one of the most commonly prescribed medication classes. This is Part 1 of 2.
On this podcast episode, I discuss vortioxetine pharmacology, adverse effects, drug interactions, and much more.
Because of vortioxetine’s long half-life, antidepressant discontinuation syndrome is going to be less prominent compared to ADPs with shorter half-lives.
Vortioxetine is metabolized by CYP2D6. Drugs that inhibit this enzyme will likely raise concentrations and place the patient more at risk for adverse effects.
I discuss rare vortioxetine adverse effects like hyponatremia and bleeding in this podcast episode.
Nortriptyline is a TCA that can be used for depression and various pain syndromes. I discuss other less common diagnoses in this podcast episode as well.
There are a lot of drug interactions with nortriptyline. It is metabolized by CYP2D6, can have additive anticholinergic effects and has been associated with QTc prolongation.
Nortriptyline is very anticholinergic and can blunt the effects of dementia medications.
Dry mouth, dry eyes, sedation, urinary retention, and constipation are a few of the more common adverse effects of nortriptyline.
Atomoxetine is a norepinephrine reuptake inhibitor that can be used in the management of ADHD.
Atomoxetine is a non-controlled substance option for patients seeking this alternative to traditional stimulants.
CYP2D6 is an important enzyme in the breakdown of atomoxetine.
CYP2D6 inhibition or poor metabolizers via CYP2D6 can lead to higher concentrations of atomoxetine and put our patients at greater risk for adverse effects.
Benzodiazepines act by enhancing the effect of GABA, an inhibitory neurotransmitter.
Benzodiazepines can cause confusion, sedation, and respiratory depression.
There are many potential indications for benzodiazepines. They can be used in anxiety, status epilepticus, insomnia, and alcohol withdrawal amongst other things.
There is a boxed warning for the use of opioids with benzodiazepines. The primary risk of the combination is respiratory depression.
