Antidepressants

Question 1

MOA of SSRIs

Answer 1

increases serotonin levels by inhibiting serotonin reuptake at the synaptic cleft

Question 2

side effects of and contraindications of

SSRIs

Answer 2

Sexual dysfunction
N/V/D
Agitation
Insomnia
Drowsiness
Weight Gain
SIADH/ hyponatremia
QT prolongation
HA
Serotonin Syndrome

Question 3

MOA of SNRIs

Answer 3

Increases serotonin and Norepi by inhibiting serotonin and norepi reuptake at the synaptic cleft

Question 4

Side effects of SNRI’s

(different from SSRIs)

Answer 4

Increased blood pressure
Sedation
Nausea

Question 5

MOA of TCA’s

Answer 5

1. Increases serotonin and Norepi by inhibiting serotonin and norepi reuptake at the synaptic cleft
2. Inhibits fast cardiac sodium channels
3. Inhibits Muscarinic AChR
4. Inhibits Alpha1 Receptors
5. Inhibits H1 Receptors
6. Inhibits GABAA

Question 6

Side effects of and contraindications of TCA’s

Specify which you see more in which category

Answer 6

Orthostatic hypotension
Cardiotoxicity: arrhythmias, prolonged QT, wide QRS
Tremor
Respiratory depression
Hyperpyrexia

More pronounced in tertiary TCA’s:

CVS: tachycardia, arrhythmia, hypotension
CNS: confusion, hallucinations, sedation, coma, seizures
GI: intestinal ileus, constipation
GU: urinary retention
Dry mouth
Dry eyes
Hyperthermia
Dry skin

Question 7

MOA of MAOi’s

Answer 7

A: Decreases the breakdown of epi, norepi and serotonin to increase their levels by inhibiting monoamine oxidase

B: Selectively inhibits monoamine oxidase to increase levels of dopamine only

Question 8

MAOi Side Effects and contraindications

Answer 8

CNS stimulation
Sexual dysfunction
Orthostatic hypotension
Weight gain

c/i: tyramine: red meat, wine, cheese= HTN Crisis

Question 9

MOA of Mirtazapine

Answer 9

• Increases release of serotonin and norepi by selectively blocking alpha2
• Blocks 5-HT2 & 5-HT3 to increase the effect of serotonin on free 5-HT1 receptors (antidepressant action)
Acts as H1 antagonist

Question 10

side effects of Mirtazapine

Answer 10

Increased appetite
Sedation
Increased cholesterol and triglycerides
Dry mouth

Question 11

Indications for Mirtazapine

Answer 11

Major Depressive Disorder, especially in those who are underweight and/or those with insomnia

Question 12

MOA of Bupropion

Answer 12

• Not fully understood
Increases dopamine and norepi via reuptake inhibition

Question 13

Side effects and contraindications of Bupropion

Answer 13

Reduced seizure threshold
Tachycardia
Palpitations
Dry mouth
Weight loss
Insomnia
HA
Agitation

c/i: Seizures

Question 14

Bupropion indications

Answer 14

Smoking cessation
Major depressive disorder

Question 15

MOA of Vilazodone

Answer 15

• Increases serotonin by inhibiting serotonin reuptake in the synaptic cleft
Partial agonist of 5-HT1A receptors

Question 16

side effects of Vilazodone

Answer 16

HA
N/V
Sleep disturbance
Sexual dysfunction
Dry mouth

Question 17

MOA of Vortioxetine

Answer 17

• Increases serotonin by inhibiting serotonin
• Agonist of 5-HT1A receptors
Antagonist of 5-HT3 receptors

Question 18

Side effects of Vortioxefine

Answer 18

Sexual dysfunction
Nausea
Abnormal dreams
Sleep disturbance

Question 19

MOA of Varenicline

Answer 19

• Partial nicotinic Ach receptor agonist
Decreases nicotine cravings and withdrawal by stimulating dopamine activity

Question 20

Side effects and contraindications of Varenicline

Answer 20

Mood disturbances
Sleep disturbances
Seizures

Question 21

Indications for Varenicline

Answer 21

smoking cessation

Question 22

Fluoxetine

Answer 22

SSRI

Question 23

Paroxetine

Answer 23

SSRI

Question 24

Sertraline

Answer 24

SSRI

Question 25

Citalopram

Answer 25

SSRI

Question 26

Escitalopram

Answer 26

SSRI

Question 27

Fluvoxamine

Answer 27

SSRI

Question 28

Venlafaxine

Answer 28

SNRI

Question 29

Duloxetine

Answer 29

SNRI

Question 30

Desvenlafaxine

Answer 30

SNRI

Question 31

Levolinacipran

Answer 31

SNRI

Question 32

Milnacipran

Answer 32

SNRI

Question 33

Nortriptyline

Answer 33

Secondary TCA

Question 34

Desipramine

Answer 34

Secondary TCA

Question 35

Protriptyline

Answer 35

Secondary TCA

Question 36

Amoxapine

Answer 36

Secondary TCA

Question 37

Amitriptyline

Answer 37

Tertiary TCA

Question 38

Clomipramine

Answer 38

Tertiary TCA

Question 39

Doxepin

Answer 39

Tertiary TCA

Question 40

Imipramine

Answer 40

Tertiary TCA

Question 41

Trimipramine

Answer 41

Tertiary TCA

Question 42

Tranylcypromine

Answer 42

MAOI-A

Question 43

Phenelzine

Answer 43

MAOI-A

Question 44

Isocarboxazid

Answer 44

MAOI-A

Question 45

Selegiline

Answer 45

MAOI-B

Question 46

Mirtazapine

Answer 46

Atypical Antipsychotic

Question 47

Bupropion

Answer 47

Atypical Antipsychotic

Question 48

Vilazodone

Answer 48

Atypical Antipsychotic

Question 49

Vortioxetine

Answer 49

Atypical Antipsychotic

Question 50

Varenicline

Answer 50

Atypical Antipsychotic

Question 51

Indications of MAOis

Answer 51

3rd/4th line therapy for MDD particularly effective in atypical depression

Question 52

which MAOI works particularly well in Parkinson Disease

Answer 52

Selegiline

Question 53

which TCA's work best for DM peripheral neuropathy

Answer 53

Amitriptyline (3) Desipramine (2)

Question 54

which TCA works well for OCD

Answer 54

Clomipramine (3)

Question 55

Which TCA's work well for chronic pain, including fibromyalgia?

Answer 55

Amitriptyline (3) Doxepin (3) Imipramine (3) Nortriptyline (2) Desipramine (2)

Question 56

which TCA's are used as second line treatment in bed wetting (enuresis)

Answer 56

Imipramine (3) Amitriptyline (3) Desipramine (2)

Question 57

Which TCA works well for insomnia

Answer 57

Doxepin

Question 58

Psychiatric Indications for SNRIs

Answer 58

Depression General Anxiety Disorder Social Anxiety Disorder PTSD OCD

Question 59

Which SNRI is used for fibromyalgia

Answer 59

Duloxetine

Question 60

Which SNRI is used for DM neuropathy

Answer 60

Venlafaxine

Question 61

What are SSRI's used for

Answer 61

depression generalized anxiety disorder panic disorder OCD Bulimia Social anxiety disorder PTSD

Question 62

Trazadone

Answer 62

Atypical psychotic used for insomnia