Antidepressants

Question 1

What is depression?

Answer 1

A mood disorder that causes a persistent feeling of sadness and loss of interest.

Question 2

What are the types of depressive disorders classified by DSM-5?

Answer 2

1. Disruptive mood dysregulation disorder 2. Major depressive disorder 3. Persistent depressive disorder (dysthymia) 4. Premenstrual dysphoric disorder 5. Depressive disorder due to another medical condition.

Question 3

List the common features of depressive disorders.

Answer 3

Sadness, emptiness, or irritable mood.

Question 4

What does the monoamine hypothesis of depression state?

Answer 4

It states that depression is caused by a functional deficiency of catecholamines, particularly norepinephrine (NE).

Question 5

What neurotransmitter imbalance is associated with major depressive disorder?

Answer 5

Disturbances in serotonin (5-HT), norepinephrine (NE), dopamine (DA), glutamate, and brain-derived neurotrophic factor (BDNF).

Question 6

How many symptoms from DSM-5 must be present to diagnose depression?

Answer 6

Five or more symptoms must be present during a 2-week period.

Question 7

What are three symptoms of depression along with their key neurotransmitter?

Answer 7

1. Depressed mood - ↓ 5-HT 2. Anhedonia - ↓ DA 3. Fatigue - ↓ NE, ↓ DA.

Question 8

What is the function of selective serotonin reuptake inhibitors (SSRIs)?

Answer 8

SSRIs block the reuptake of serotonin, increasing its concentration in the synaptic cleft.

Question 9

List some common SSRIs.

Answer 9

Citalopram, Escitalopram, Fluoxetine, Fluvoxamine, Paroxetine, Sertraline.

Question 10

What are the common side effects of SSRIs?

Answer 10

Nausea, dry mouth, headache, insomnia, somnolence, dizziness, erectile dysfunction.

Question 11

What are SNRIs?

Answer 11

Serotonin-Norepinephrine Reuptake Inhibitors, which inhibit the reuptake of both serotonin and norepinephrine.

Question 12

Name two SNRIs used in treating depression.

Answer 12

Desvenlafaxine, Duloxetine.

Question 13

What is an atypical antidepressant?

Answer 13

A mixed group of agents with actions at multiple sites, such as Bupropion and Mirtazapine.

Question 14

What neurotransmitter does Bupropion primarily affect?

Answer 14

It is a weak dopamine and norepinephrine reuptake inhibitor.

Question 15

What are the side effects commonly associated with SNRIs?

Answer 15

Nausea, headache, sexual dysfunction, insomnia, increased blood pressure and heart rate.

Question 16

Which drugs are referred to as tricyclic antidepressants (TCAs)?

Answer 16

Amitriptyline, Amoxapine, Clomipramine, Desipramine, Doxepin, Imipramine.

Question 17

What is a significant risk associated with tricyclic antidepressants (TCAs)?

Answer 17

Risk of cardiac dysrhythmias and sudden death.

Question 18

What do monoamine oxidase inhibitors (MAOIs) do?

Answer 18

They cause irreversible inactivation of the MAO enzyme, increasing stores of norepinephrine, serotonin, and dopamine.

Question 19

List some common MAOIs.

Answer 19

Isocarboxazid, Phenelzine, Selegiline, Tranylcypromine.

Question 20

What dietary restriction is critical for patients on MAOIs?

Answer 20

They should avoid tyramine to prevent hypertensive crises.

Question 21

What role does serotonin (5-HT) play in depression?

Answer 21

A disturbance in serotonin activity is an important factor in depression’s pathophysiology.

Question 22

What are the first expected improvements from antidepressants like SSRIs?

Answer 22

Significant improvement in mood typically takes at least 2 weeks.

Question 23

Clozapine is known to affect which neurotransmitter predominantly?

Answer 23

It primarily affects dopamine.

Question 24

What is a common treatment approach for patients unresponsive to one antidepressant?

Answer 24

They may respond to another antidepressant.

Question 25

Clozapine is particularly used for which type of depression?

Answer 25

It is mainly used in treatment-resistant depression.

Question 26

What is the aim of using SSRIs in the treatment of depression?

Answer 26

To increase serotonin levels in the brain.

Question 27

What is the mechanism of action for tricyclic antidepressants (TCAs)?

Answer 27

They inhibit the reuptake of norepinephrine and serotonin.

Question 28

Which brain regions are primarily affected by depressed mood?

Answer 28

Prefrontal cortex and limbic system.

Question 29

What are psychomotor disturbances in the context of depression?

Answer 29

Observable changes in a person’s motor behavior, such as agitation or retardation.

Question 30

Which neurotransmitter is primarily linked to sleep disturbances in depression?

Answer 30

Both norepinephrine (NE) and serotonin (5-HT)/dopamine (DA) are involved.

Question 31

What is the relationship between serotonin (5-HT) and anxiety disorders?

Answer 31

A deficiency in serotonin is often associated with increased anxiety.

Question 32

How do antidepressants affect mood regulation?

Answer 32

Antidepressants help to restore the balance of neurotransmitters involved in mood regulation.

Question 33

What type of side effects can occur with MAOIs?

Answer 33

Blurred vision, dry mouth, constipation.

Question 34

What is a major concern when using SSRIs?

Answer 34

The potential for inducing hyponatremia due to inappropriate antidiuretic hormone secretion.

Question 35

What differentiates atypical antidepressants from other classes?

Answer 35

They operate on multiple neurotransmitter systems and have varied mechanisms of action.

Question 36

What specific receptor does Mirtazapine act on?

Answer 36

It acts as an antagonist at presynaptic α2 receptors.

Question 37

What is the primary neurotransmitter decreased in anhedonia?

Answer 37

Dopamine (DA).

Question 38

List three tricyclic antidepressants (TCAs).

Answer 38

Imipramine, Nortriptyline, Amitriptyline.

Question 39

What effects does sertraline, an SSRI, have on neurotransmission?

Answer 39

It increases serotonin levels in the synaptic cleft by blocking reuptake.

Question 40

Clozapine is effective in which patient population?

Answer 40

Patients with treatment-resistant depression.

Question 41

What should be monitored in patients treated with SNRIs?

Answer 41

Blood pressure and heart rate due to potential increases.

Question 42

What type of cognitive effects are associated with depression?

Answer 42

Concentration and attention impairments.

Question 43

How long might maximum benefit from SSRIs take?

Answer 43

Up to 12 weeks or more.

Question 44

What is a common effect of wellbutrin, an atypical antidepressant?

Answer 44

It increases dopamine and norepinephrine transmission.