PA Antidepressants (Exam #3)

Question 1

What does SIG-E-CAPS stand for, and what condition is it associated with?

Answer 1

MDD

• Sleep disturbances
• Interest
• Guilt
• Energy
• Concentration
• Appetite
• Psychomotor changes
• SI

Question 2

What is the primary screening tool for MDD? What other screening tool can be used if Bipolar too?

Answer 2

PHQ-9

- If Bipolar too, MDQ

Question 3

What are the two tx goals for MDD? Describe each

Answer 3

• Response: 50+% improvement

- Remission: PHQ <5

Question 4

What is the recommended follow up for MDD tx, and why (3)?

Answer 4

Follow up in 1-2 weeks

- Evaluate for improvement, AEs and new sxs

Question 5

With use of Antidepressants, what possible underlying disorder should always be considered?

Answer 5

Caution underlying Bipolar Disorder

- Antidepressants can unmask mania

Question 6

What is the 1st line med tx for MDD, and why (2)?

Answer 6

SSRIs = 5HT only

• Low AE profile
• Low OD risk

Question 7

What are the top three SSRIs often used in the tx of MDD?

Answer 7

• Fluoxetine (Prozac)
• Sertraline (Zoloft)
• Paroxetine (Paxil)

Question 8

Which SSRI can also be used in the tx of nocturnal eating and SAD?

Answer 8

Sertraline (Zoloft)

Question 9

Which SSRI can also be used in the tx of Bulimia?

Answer 9

Fluoxetine (Prozac)

Question 10

Which SSRI can also be used in the tx of Panic Disorder and SAD?

Answer 10

Paroxetine (Paxil)

Question 11

Which two SSRIs can also be used in the tx of SAD?

Answer 11

• Sertraline (Zoloft)

- Paroxetine (Paxil)

Question 12

Which two SSRIs are more selective and more potent?

Answer 12

• Citalopram (Celexa)

- Escitalopram (Lexapro)

Question 13

What is the top SNRI often used in the tx of MDD?

Answer 13

Venlafaxine (Effexor)

Question 14

Besides MDD, what other three conditions can Venlafaxine (Effexor) be used to tx?

Answer 14

• GAD
• SAD
• Panic Disorder

Question 15

Besides MDD, what other two conditions can Duloxetine (Cymbalta) be used to tx?

Answer 15

• DM Neuropathy

- Fibromyalgia

Question 16

When is use of Duloxetine (Cymbalta) CI?

Answer 16

Liver disease

Question 17

Which SNRI can also be used in the tx of DM Neuropathy and Fibromyalgia?

Answer 17

Duloxetine (Cymbalta)

Question 18

Which two meds have fewer sexual AEs than SSRIs, and may be used if this is an issue with SSRIs?

Answer 18

• Bupropion (Wellbutrin)

- Mirtazapine (Remeron)

Question 19

Which antidepressant is a DA and NE reuptake inhibitor?

Answer 19

Bupropion (Wellbutrin)

Question 20

Which antidepressant is an alpha2 antagonist?

Answer 20

Mirtazapine (Remeron)

Question 21

Which antidepressant is good for the elderly with depression, sleep or appetite issues?

Answer 21

Mirtazapine (Remeron)

Question 22

Besides MDD, what other two conditions can Bupropion (Wellbutrin) be used to tx?

Answer 22

• SAD

- Smoking cessation

Question 23

With what two conditions is the use of Bupropion (Wellbutrin) CI?

Answer 23

• Seizure disorder

- Anorexia

Question 24

What is often the duration of tx for MDD?

Answer 24

4-9 months (after finding therapeutic dose)

Question 25

How long can it take for antidepressants to take full effect?

Answer 25

2-8 weeks

Question 26

Under what four conditions would referral to Psychiatrist or Psychotherapy be warranted with MDD?

Answer 26

• Refractory
• Severe MDD with Bipolar or SI/HI
• Co-morbid psych/med issues
• Unsure of dx

Question 27

Under what three conditions would hospitalization for MDD be warranted?

Answer 27

• SI/HI
• Severe psychomotor changes
• Associated psychosis