Antidepressants

Question 1

Example of MAOIs

Answer 1

Phenelzine
Moclobemide
Selegiline
Tranylcypromine

Question 2

How long do you have to wait after stopping TCAs before starting MAOIs?

Answer 2

7-14 days

Question 3

How do you have to wait after stopping MAOIs to start another antidepressant?

Answer 3

2 weeks washout

Question 3

How long do you have to wait after stopping SSRIscbefore starting MAOIs?

Answer 3

7 dyas

Question 4

What dietary restrictions have with MAOIs and why?

Answer 4

Cheese and chocolate
Interaction between MAOI and

Question 5

Method of action of MAOis

Answer 5

Block MonoAmineOxidase enzyme from destroying Monoamine oxidase
MAO is responsible for

Question 6

What is MAO responsible for?

Answer 6

(MAO) is an enzyme involved in the degradation process for various monoamines released by neurons and glia cells, including DA, serotonin and norepinephrine (NE).
Therefore MAOIs - stop the degradation of these NTs and allow them to build up more

Question 7

SSRI examples

Answer 7

Fluoxetine
Sertraline
Citalopram
Escitalopram
Paroxetine

Question 8

What is the mode of action of SSRIs?

Answer 8

acts as a reuptake inhibitor of the neurotransmitter serotonin by blocking the action of the serotonin transporter. This in turn leads to increased extracellular concentrations of serotonin and, therefore, an increase in serotonergic neurotransmission

Question 9

What antidepressant group increases bleeding risk?

Answer 9

SSRIs

Question 10

What antidepressants are first line?

Answer 10

SSRIs

Question 10

What antidepressants are first line?

Answer 10

SSRIs

Question 11

What side effect can SSRIs cause electrolyte wise?

Answer 11

Hyponatremia

Question 12

What side effect is a concern with citalopram?

Answer 12

QTc interval prolongation

Question 13

Which SSRI has a significantly shorter half life?

Answer 13

Paroxetine

Question 14

What use when SSRIs fail?

Answer 14

SNRIs - dual effect

Question 15

MOA of SNRIs?

Answer 15

serotonin-norepinephrine reuptake inhibitor. This means that it increases the levels of serotonin and norepinephrine in the brain by blocking their reabsorption (reuptake) into neurons.

Question 16

Examples of SNRIs?

Answer 16

Venlafaxine
Duloxetine

Question 17

Examples of novel antidepressants?

Answer 17

Vortioxetine
Agomelatine

Question 18

Mode of action of vortioxetine

Answer 18

Multimodal modulates serotonergic activity
Antagonist at some 5HT receptors, agonist at others

Question 19

When is vortioxetine used?

Answer 19

Inadequate response to 2 antidepressants

Question 20

What is vortiocetine useful in?

Answer 20

SD
Hyponatremia

Question 21

When is agomelatine useful?

Answer 21

Patients who experience adverse effects with SSRIs
Cipriani meta analysis

Question 22

What novel antidepressant is sleep enhancing

Answer 22

Agomelatine

Question 23

Mode of action of agomelatine

Answer 23

Melatonergic agonist - MT1 and MT2 receptors + 5HT2C antagonist

Question 24

Examples of TCAs?

Answer 24

Amitryptilline Nortiptyline Dosulepin Lofepramine Imipramine Clomipramine

Question 25

What antidepressant is cardiotoxix?

Answer 25

TCAs

Question 26

What is the big problem with TCAs?

Answer 26

Difficult to tolerate side effect burden esp in older patients

Question 27

What antidepressants are anticholinergic?

Answer 27

TCAs

Question 28

When are TCAs prescribed?

Answer 28

By specialists eg RADs in resistant cases

Question 29

What is a NARI?

Answer 29

Noradrenaline/epinephrine reuptake inhibitor

Question 30

What type of antidepressant is reboxetine?

Answer 30

NARI

Question 31

NaSSA mode of action

Answer 31

Noradrenergic and specific serotenergic antidepressant Presynaptic alpha 2 antagonist Acts to disinhibit both NA and 5HT neurones, increasing NA and 5 HT

Question 32

What improves tolerability of NaSSAs>

Answer 32

5HT2,3 antagonism Improved tolerability non selevtive serotonin agents Useful for patients experiencing adverse effects with SSRIs Sleep enhancing