Psych Vivas · Psychopharmacology — SSRIs
Selective serotonin reuptake inhibitors — consultant viva
Fellowship viva covering SSRI agents, doses, black box, QTc, discontinuation, serotonin toxicity and washouts.
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Study tools
Target exams
FRANZCPMRCPsychABPNMD-DNB
Prompt
Examiner cards: six SSRI names, black-box age bands, citalopram 60 mg script, paroxetine stop day 3 symptoms, fluoxetine-to-phenelzine day 7 plan, Hunter clonus stem, Montejo sexual rates, elderly Na 124.
Station structure
Time: 8–10 minutes. Depth: consultant teaching registrar. Expect named doses, black-box operationalisation, QTc ceilings, discontinuation vs relapse, Hunter rules, and fluoxetine MAOI washout without undergraduate waffle.[2][4][7]
References12ShowHide
- [1]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
- [2]Hammad TA, Laughren T, Racoosin J Suicidality in pediatric patients treated with antidepressant drugs Arch Gen Psychiatry, 2006.PMID 16520440
- [3]Stone M, Laughren T, Jones ML, et al. Risk of suicidality in clinical trials of antidepressants in adults: analysis of proprietary data submitted to US Food and Drug Administration BMJ, 2009.PMID 19671933
- [4]Castro VM, Clements CC, Murphy SN, et al. QT interval and antidepressant use: a cross sectional study of electronic health records BMJ, 2013.PMID 23360890
- [5]Beach SR, Kostis WJ, Celano CM, et al. Meta-analysis of selective serotonin reuptake inhibitor-associated QTc prolongation J Clin Psychiatry, 2014.PMID 24922496
- [6]Schatzberg AF, Blier P, Delgado PL, et al. Antidepressant discontinuation syndrome: consensus panel recommendations for clinical management and additional research J Clin Psychiatry, 2006.PMID 16683860
- [7]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
- [8]Boyer EW, Shannon M The serotonin syndrome N Engl J Med, 2005.PMID 15784664
- [9]Montejo AL, Llorca G, Izquierdo JA, et al. Incidence of sexual dysfunction associated with antidepressant agents: a prospective multicenter study of 1022 outpatients J Clin Psychiatry, 2001.PMID 11229449
- [10]Movig KL, Leufkens HG, Lenderink AW, et al. Association between antidepressant drug use and hyponatraemia: a case-control study Br J Clin Pharmacol, 2002.PMID 11966666
- [11]Malhi GS, Bell E, Bassett D, et al. The 2020 Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for mood disorders Aust N Z J Psychiatry, 2021.PMID 33353391
- [12]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