Antidepressants

Question 1

The half-life of this SSRI is about one week

Answer 1

fluoxetine (prozac)

Question 2

SSRI is the abbreviation for this

Answer 2

Selective Serotonin Reuptake Inhibitor

Question 3

If an SSRI with a short half life
is abruptly stopped it
may result in this

Answer 3

Discontinuation Syndrome

Question 4

SSRI’s and MAOI’s used in combination carry a high

risk of this side effect

Answer 4

serotonin syndrome

Question 5

This is the most likely SSRI
to cause the side effect
of weight gain

Answer 5

paroxetine (paxil)

Question 6

The washout period when
switching from an MAOI
to any SSRI is this

Answer 6

2 weeks

Question 7

This SSRI is the S-enantiomer of citalopram (celexa)

Answer 7

escitalopram (lexapro)

Question 8

These two SSRI’s have very
short half lives & should
be tapered to be
discontinued

Answer 8

paroxetine (paxil) & fluvoxamine (luvox)

Question 9

This is a common side effect of 
all SSRI’s & the doctor should specifically ask about it as 
the patient may otherwise 
be too embarrassed to 
talk about it

Answer 9

sexual side effects

Question 10

The mechanism of action of

SNRI’s is this

Answer 10

Serotonin Norepinephrine Reuptake Inhibitor

Question 11

This SNRI is the psychoactive metabolite of another SNRI

Answer 11

desvenlafaxine (pristiq)

Question 12

Whether the dose is very high,

moderate, or low, this neurotransmitter’s reuptake is blocked by venlafaxine (effexor)

Answer 12

serotonin

Question 13

At very high doses (>375mg/d) 
of venlafaxine (effexor) this neurotransmitter’s reuptake 
may begin to be blocked

Answer 13

dopamine

Question 14

This SNRI is preferred for painful symptoms of depression or diabetic neuropathy pain

Answer 14

duloxetine (cymbalta)

Question 15

Patients taking SNRI’s for depression have an initial response, but then experience this

Answer 15

poop-out syndrome (relapse)

Also seen with SSRIs

Question 16

As with all antidepressants, a depressed patient started on an SNRI who experiences activation & agitation may be having this

Answer 16

induced bipolar state

Question 17

While venlafaxine (effexor) may cause the side effect of sweating, ironically it may be helpful to perimenopausal women with this

Answer 17

hot flashes/flushes

Question 18

Venlafaxine (effexor) has
this relatively common, dose
dependent, cardiac system
related side effect

Answer 18

increased blood pressure

Question 19

This medication is the most

well known NDRI (norepinephrine-dopamine reuptake inhibitor)

Answer 19

Bupropion (Wellbutrin)

Question 20

NDRI’s are useful in treating cravings from dependence

on this substance

Answer 20

nicotine (useful in treating smoking cessation)

Question 21

Not only do NDRI’s not have this common SSRI side effect, NDRI’s may be used to treat patients who have this SSRI side effect

Answer 21

Sexual dysfunction

Question 22

Like most anti-depressants, at typical doses NDRI’s carry a small risk of this serious side effect but the risk increases from 0.4% to 4% at very
high doses

Answer 22

Seizure

Question 23

Compared to SSRI’s or SNRI’s,
NDRI’s are less effective
in treating this class of
psychiatric illnesses

Answer 23

Anxiety Disorders

Question 24

NDRI’s may be especially helpful in treating this sleep disturbance that is seen in atypical depression

Answer 24

Hypersomnia (> 10 hours/nite)

Question 25

NDRI’s commonly do this | to a patient’s weight

Answer 25

Decrease (or no change)

Question 26

While not a first line treatment, | NDRI’s “stimulating” effects may be helpful in treating children and adults with this disorder

Answer 26

Attention Deficit Hyperactivity Disorder (ADHD)

Question 27

Onset of therapeutic action for NDRIs is usually not immediate, but is delayed until this time period

Answer 27

2-4 weeks

Question 28

NaSSA stands for this

Answer 28

Noradrenergic and Specific Serotonergic Agent

Question 29

NaSSA’s novel mechanism of action by which norepinephrine and serotonin system activity is increased is this

Answer 29

Pre-synaptic alpha 2 adrenergic antagonist

Question 30

``` The medication that is in the NaSSA class is this ```

Answer 30

mirtazepine (remeron)

Question 31

SSRIs or venlafaxine (effexor) may cause these common side effects which NaSSA’s 5HT3 antagonism may help reduce or remove

Answer 31

GI side effects (nausea, diarrhea, stomach cramps)

Question 32

This mirtazapine (remeron) side effect is more likely in women than men, before menopause than after, and is unlikely to be a problem if it has not occurred within the first 6 weeks of treatment

Answer 32

weight gain

Question 33

Patients taking mirtazapine (remeron) and an MAO-I at the same time, or within 2 weeks of the other, are at risk for this serious side effect

Answer 33

serotonin syndrome

Question 34

Mirtazapine (remeron) | is an antagonist of what receptors?

Answer 34

a presynaptic receptor, serotonin post synaptic receptors, and histamine post synaptic receptor

Question 35

NaSSA onset of therapeutic effect on insomnia and anxiety is typically in this time period

Answer 35

almost immediately

Question 36

The cytochrome P450 enzyme system that is significantly effected by mirtazepine (remeron) is

Answer 36

None!

Question 37

A tertiary amine, amitriptyline (elavil), is metabolized to a secondary amine which is this TCA

Answer 37

nortriptyline (pamelor)

Question 38

Blurred vision, urinary hesitancy, dry mouth, and constipation are due to this neurotransmitter receptor activity by TCA’s

Answer 38

anticholinergic activity

Question 39

A tertiary amine, imipramine (tofranil), is metabolized to a secondary amine which is this TCA

Answer 39

desipramine (norpramin)

Question 40

TCA’s may be more effective than SSRI’s in treating depression for this sex of the clinical population

Answer 40

Men

Question 41

Fluoxetine (prozac), paroxetine (paxil), bupropion (wellbutrin), duloxetine (cymbalta) and other medications may increase all TCA’s concentration by inhibiting this p450 enzyme

Answer 41

cytochrome p450 2D6

Question 42

Which psych drugs inhibit cytochrome p450 2D6, increasing TCA concentration?

Answer 42

Fluoxetine (prozac), paroxetine (paxil), bupropion (wellbutrin), duloxetine (cymbalta)

Question 43

Side effects of dizziness, sedation, and hypotension likely result from TCA’s antagonist activity of this receptor

Answer 43

alpha adrenergic-1 receptor

Question 44

Side effects of sedation and weight gain from TCA’s are likely due to antagonist activity at this receptor

Answer 44

histamine (H1)

Question 45

TCA’s mechanism of action for treating depression is this

Answer 45

serotonin and norepinephrine reuptake inhibition

Question 46

The dangerous side effects from a TCA overdose are cardiac arrhythmias caused by blockade of this

Answer 46

sodium channels