Antidepressants

Question 1

These drugs block metabolism of catecholamines

Answer 1

MAOI

Question 2

MAOI drugs

Answer 2

Phenelzine
Isocarboxazid
Tranylcypromine
Selegiline

(PITS in cheese)

Question 3

Serotonin Syndrome

Answer 3

Hyperthermia, muscle rigidity, myoclonus due to serotonergic agent +MAOI

Question 4

How to manage serotonin syndrome

Answer 4

Cyproheptadine

Question 5

Cheese RXN

Answer 5

Cannot degrade Tyramine in cheese, wines etc causing tachy, hypertension, arrhythmias, seizures

Question 6

How to manage Cheese RXN

Answer 6

Phentolamine or prazosin

Question 7

Which MAOI is least likely to cause a hypertensive crisis

Answer 7

Transdermal selegiline

Question 8

These drugs block SERT and NET

Answer 8

TCAs

Question 9

List the TCAs

Answer 9

Clomipramine
Amitriptyline
Nortriptyline
Desipramine
Imipramine

(CANDI)

Question 10

TCA Blockage

Answer 10

• Blockade of muscarinic receptors leads to blurred vision, xerostomia, urinary retention, constipation and aggravation of narrow-angle glaucoma.
• Blockade of α1-adrenoceptors causes orthostatic hypotension and reflex tachycardia.
• Blockade of H1 receptors causes sedation and weight gain.
• Blockade of cardiac fast sodium channels may cause arrhythmias:
most common cause of death in patients with TCA intoxication.
• Sexual effects

Question 11

How to reverse conduction block caused by TCA

Answer 11

Sodium Bicarbonate

Question 12

List the SSRIs

Answer 12

Citalopram
Escitalopram
Fluoxetine
Fluvoxamine
Paroxetine
Sertraline

Question 13

Benefit of SSRIs over TCAs?

Answer 13

orthostatic hypotension, sedation, dry mouth, and blurred vision, are not seen with the SSRIs

Question 14

Which SSRIs have low potential for drug interactions

Answer 14

Citalopram
Escitalopram
Sertraline

Fluoxetine, fluvoxamine, paroxetine have high potential for drug interacts due to CYP inhibition.

Question 15

Increased serotonergic tone at the level of the spinal cord and above is associated with

Answer 15

Diminished sexual function

Question 16

Name the SARIs

Answer 16

Nefazodone and Trazadone
- are weak inhibitors of SERT and NET and potent antagonists at the 5-HT2 receptor

Question 17

AE of Nefazodone

Answer 17

Hepatotoxicity

Question 18

AE of Trazodone

Answer 18

• Blocks α1and H1 receptors
• Extremely sedating
• Excellent hypnotic (main use is as hypnotic)
• priapism- persistent painful erection

Question 19

Who are the SNRIs

Answer 19

Venlafaxine
Duloxetine

Question 20

Name a Norepinephrine & Dopamine Reuptake Inhibitors

Answer 20

Bupropion

Question 21

Since Bupropion is not serotonergic, what AE is not seen with it?

Answer 21

Sexual dysfunction

Question 22

Mirtazapine

Answer 22

Noradrenergic & Specific Serotonergic Antidepressant
- antagonist of alpha 2, 5-HT2 and 5-HT3 receptors
• H1 antagonist: sedation and weight gain

Question 23

Antidepressant Discontinuation Syndrome is most likely seen with which drugs?

Answer 23

Paroxetine or venlafaxine due to
their short half-life

Question 24

Which antidepressant is approved for smoking cessation

Answer 24

Bupropion

Question 25

Drug of choice for bipolar disorder

Answer 25

Lithium

Question 26

When is lithium contraindicated?

Answer 26

Pregnancy