Antidepressants

Question 1

Depression is associated with decreases in

Answer 1

Serotonin, norepinephrine, and dopamine

Question 2

Most antidepressants increase levels of

Answer 2

Serotonin, NE, and DA

Question 3

The anti-histamine effects of antidepressants often causes

Answer 3

Sedation and dry mouth

Question 4

An NE blockade can cause

Answer 4

Hypotension (alpha-1)

Question 5

Results in tachycardia and urinary retention

Answer 5

Muscarinic blockade

Question 6

Old antidepressants that blocked reuptake of 5-HT and NE

Answer 6

Tricyclic Antidepressants (TCAs)

Question 7

Is a broad spectrum antidepressant with anti-histaminergic, anti-muscarinic, and alpha-1 blocking properties

Answer 7

TCA’s

Question 8

What are the three anti-histaminergic side effects of TCAs?

Answer 8

Sedation, weight gain, confusion (especially in elderly)

Question 9

What are the 4 anti-muscarinic (anti-cholinergic) effects of TCAs

Answer 9

Blurry vision, constipation, dry mouth, and urinary retention

Question 10

When a patient is taking TCAs, we need to monitor ECG for

Answer 10

Increased QRS interval

Question 11

Block cardiac sodium channels

Answer 11

TCAs

Question 12

The most prominent manifestation of TCA toxicity

Answer 12

Increased QRS interval

Question 13

What is the treatment for TCA overdose?

• provides excess Na+
• also increased pH favors inactive form of drug

Answer 13

Sodium bicarbonate

Question 14

Also used for OCD, diabetic neuropathy, chronic pain, and prevention of migraines

Answer 14

TCAs

Question 15

Inhibits monoamine oxidase, which decreases the breakdown of monoamines

Answer 15

MAO inhibitors

Question 16

Responsible for the breakdown of dopamine, serotonin, and norepinephrine

Answer 16

MAO-A

Question 17

Responsible fo the breakdown of Dopamine only

Answer 17

MAO-B

Question 18

Tranylcypromine, phenelzine, and isocarboxazid are the three forms of

Answer 18

Non-selective MAO inhibitors

Question 19

Rarely used in the modern era, but can be used for refractory depression and anxiety

Answer 19

MAO inhibitors

Question 20

An MAO-B selective inhibitor that is used in Parkinson’s

Answer 20

Selegilline

Question 21

Often caused by MAOi plus another serotonin drug

Answer 21

Serotonin syndrome

Question 22

If an MAOi is given with any drug that increases serotonin activity, we can see

Answer 22

Serotonin syndrome

Question 23

Naturally occurring monoamine that causes sympathetic activation

Answer 23

Tyramine

Question 24

Patients on MAOI’s have tyramine in the blood and can have a hypertensive crisis if they eat

Answer 24

Cheese, red wine, some meats

“Cheese effect”

Question 25

Inhibits 5-HT reuptake by neurons -leads to increased 5-HT in synaptic cleft

Answer 25

SSRIs

Question 26

how long does it take for SSRIs to have their effect?

Answer 26

4-8 weeks

Question 27

A major side effect of SSRIs is -Due to increased serotonin effects in the spinal cord

Answer 27

Sexual dysfunction

Question 28

Commonly cause GI upset, drowsiness, and weight gain

Answer 28

SSRIs

Question 29

Inhibits 5-HT AND NE reuptake by neurons -takes 4-8 weeks to have effects

Answer 29

SNRIs

Question 30

SNRI used in fibromyalgia

Answer 30

Duloxetine

Question 31

SNRI used in diabetic neuropathy

Answer 31

Venlafaxine

Question 32

Due to it’s NE effects, SNRIs may increase

Answer 32

Blood Pressure

Question 33

The SNRI with the highest rate of sexual dysfunction is

Answer 33

Venlafaxine

Question 34

Blocks reuptake of NE and dopamine and increased presynaptic release of catecholamines

Answer 34

Bupropion

Question 35

Bupropion has no effects on

Answer 35

Serotonin

Question 36

Used in depression and smoking cessation -May improve sexual dysfunction of SSRIs

Answer 36

Bupropion

Question 37

Bupropion toxicity is related to its stimulant effects and results in

Answer 37

Anxiety, insomnia, and seizures

Question 38

Blocks PREsynaptic alpha-2 receptors resulting in more norepinephrine and serotonin release

Answer 38

Mirtazapine

Question 39

Mirtazapine also blocks

Answer 39

POSTsynaptic 5-HT2 and 5-HT3 serotonin receptors

Question 40

Has anti-histamine side effects such as sedation, dry mouth, and increased appetite

Answer 40

Mirtazapine

Question 41

Trazodone, vilazodone, and vortioxetine are the three -Minimal effects on NE or DA

Answer 41

Serotonin modulators

Question 42

Weak serotonin reuptake inhibitor -affects 5-HT2A and 5-HT2C receptors

Answer 42

Trazodone

Question 43

No longer used as an antidepressant and its main clinical use is insomnia

Answer 43

Trazadone

Question 44

Partial agonist at postsynaptic 5-HT1A receptors -blocks reuptake of serotonin

Answer 44

Vilazodone

Question 45

Can cause diarrhea (28%), sexual dysfunction, and serotonin syndrome

Answer 45

Vilazodone

Question 46

Functions as a full and partial agonist and antagonist of various serotonin receptors

Answer 46

Vortioxetine