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Psych VivasPsychopharmacology — SNRIs and NRIs

Psych Vivas · Psychopharmacology — SNRIs and NRIs

SNRIs and NRIs — cross-table viva

Fellowship viva on SNRI/NRI mechanisms, doses, comparative evidence, BP and discontinuation safety, and reboxetine publication bias.

clinical1 min readVerification in progress

Target exams

FRANZCPMRCPsychABPNMD-DNB
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Study tools

Target exams

FRANZCPMRCPsychABPNMD-DNB
Prompt
Examiner draws columns: Agent / Transporters / Start dose / Killer monitoring. Cards: Blier/Debonnel dose map, Thase BP meta, Thase remission meta, STAR*D switch, Cipriani 2018, Detke duloxetine 60 mg, Gelenberg venlafaxine GAD, Eyding reboxetine, Hunter criteria, Schatzberg discontinuation, Movig hyponatraemia, Montejo sexual SE.

Station structure

Time: 8–10 minutes. Depth: consultant teaching registrar. Expect mechanism → dose → trial name → safety without dual-action marketing slogans.[1][5]

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References10ShowHide
  1. [1]Blier P, Saint-André E, Hébert C, et al. Effects of different doses of venlafaxine on serotonin and norepinephrine reuptake in healthy volunteers Int J Neuropsychopharmacol, 2007.PMID 16690005
  2. [2]Debonnel G, Saint-André E, Hébert C, et al. Differential physiological effects of a low dose and high doses of venlafaxine in major depression Int J Neuropsychopharmacol, 2007.PMID 16690006
  3. [3]Thase ME, Entsuah AR, Rudolph RL Remission rates during treatment with venlafaxine or selective serotonin reuptake inhibitors Br J Psychiatry, 2001.PMID 11230034
  4. [4]Rush AJ, Trivedi MH, Wisniewski SR, et al. Bupropion-SR, sertraline, or venlafaxine-XR after failure of SSRIs for depression N Engl J Med, 2006.PMID 16554525
  5. [5]Cipriani A, Furukawa TA, Salanti G, et al. Comparative efficacy and acceptability of 21 antidepressant drugs for the acute treatment of adults with major depressive disorder: a systematic review and network meta-analysis Lancet, 2018.PMID 29477251
  6. [6]Thase ME Effects of venlafaxine on blood pressure: a meta-analysis of original data from 3744 depressed patients J Clin Psychiatry, 1998.PMID 9818630
  7. [7]Detke MJ, Lu Y, Goldstein DJ, et al. Duloxetine, 60 mg once daily, for major depressive disorder: a randomized double-blind placebo-controlled trial J Clin Psychiatry, 2002.PMID 12000204
  8. [8]Gelenberg AJ, Lydiard RB, Rudolph RL, et al. Efficacy of venlafaxine extended-release capsules in nondepressed outpatients with generalized anxiety disorder: a 6-month randomized controlled trial JAMA, 2000.PMID 10865302
  9. [9]Eyding D, Lelgemann M, Grouven U, et al. Reboxetine for acute treatment of major depression: systematic review and meta-analysis of published and unpublished placebo and selective serotonin reuptake inhibitor controlled trials BMJ, 2010.PMID 20940209
  10. [10]Dunkley EJ, Isbister GK, Sibbritt D, et al. The Hunter Serotonin Toxicity Criteria: simple and accurate diagnostic decision rules for serotonin toxicity QJM, 2003.PMID 12925718
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