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In this case scenario, I explore some of the possible reasons that you may see a patient on duplicate SSRIs. A 68 year old female has a history of depression, breast cancer, diabetes, hypertension, and mild osteoarthritis. Current medications include: Fluoxetine 20 mg daily Dapagliflozin 10 mg daily Lantus 15 units at night Tamoxifen 20 […]
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If you are a healthcare professional, inevitably, questions about the use of antidepressants in pregnancy come up in clinical practice. Why is paroxetine generally avoided in pregnancy? The primary reason that paroxetine is avoided in pregnancy is that it has demonstrated fetal risks. Through the previous FDA rating system, it was considered an FDA pregnancy […]
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As I’m working on 2020 updates for all of our board certification study material, I couldn’t help but recognize that I did not have a dedicated lecture on pharmacogenomics. Below I discuss how genetic alterations in CYP2D6 activity can affect two commonly used medications. CYP2D6 is a well known metabolic enzyme that causes structural changes […]
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The SSRI and NSAID interaction kind of drives me crazy. It is one of those interactions where you don’t really know how seriously to take it. SSRI has the potential to impact platelet function. NSAIDs have the potential to impact platelet function. The SSRI and NSAID interaction is represented by an increased risk of bleeding […]
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57 year old patient diagnosed with depression and was initiated on Zoloft (sertraline) 50 mg daily. The physician in this case felt the patient was very depressed, and wanted to titrate the dose up fairly quickly. Zoloft was increased to 100 mg daily after two weeks, and then further to 150 mg two weeks after that. […]
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