Antidepressants and Antipsychotics

Question 1

SSRIs

Answer 1

Sertraline,
Citalopram,
Escitalopram, Fluoxetine, Paroxetine

Question 2

SNRIs

Answer 2

Venlafaxine,
Desvenlafaxine, Duloxetine

Question 3

atypical antidepressants

Answer 3

Bupropion,
Mirtazapine

Question 4

serotonin modulators

Answer 4

Trazodone and Vilazodone

Question 5

tricyclic antidepressants (TCA)

Answer 5

Amitriptyline, Nortriptyline

Question 6

MAOI

Answer 6

• Phenelzine (Nardil; generic)
• Tranylcypromine (Parnate; generic)
• Isocarboxazid (Marplan)
  Selegiline

Question 7

FGA

Answer 7

Chlorpromazine (Thorazine)
Promethazine (Phenergan)
Prochlorperazine (Compazine)
Haloperidol (Haldol)
Droperidol -

Question 8

SGA - atypical

Answer 8

Olanzapine (Zyprexa)
Ziprasidone (Geodon)
Risperidone (Risperdal)
Quetiapine (Seroquel)

Question 9

SGA - DA Stabilizer

Question 10

SSRI MOA

Answer 10

Inhibition of 5-HT reuptake transporter (SERT)***

Question 11

SNRI MOA

Answer 11

Blocks SERT and NET activity
* NET blockade associated with effectiveness in treating multiple pain syndromes

Question 12

MOA - Atypical Antidepressants: Bupropion (Wellbutrin)

Answer 12

Increase synaptic NE and DA activity (Block NET and dopamine reuptake transporter/DAT and increase their release) and noncompetitive antagonist of nicotinic receptors.

Question 13

Bupropion (Wellbutrin) AEs?

Answer 13

CNS stimulation (agitation, insomnia, tremor), decreases seizure threshold (but not sexual dysfunction)

Question 14

MOA - * Mirtazapine (Remeron)

Answer 14

a2 adrenergic antagonist blocks presynaptic receptors to elevate both NE and 5-HT in brain synapses. Also blocks postsynaptic 5-HT2 receptors.

Question 15

AE- * Mirtazapine (Remeron)

Answer 15

weight gain and sedation

Question 16

DI with Mirtazapine

Answer 16

pharmacodynamic interactions with MAO-Is, other 5-HT agents with potential for Serotonin Syndrome; Diminishes effects of Clonidine (used for hypertension and ADHD).

Question 17

MOA of Trazadone

Answer 17

o Blocks 5-HT2 receptors, histamine1 and a1 adrenergic receptors, and inhibit SERT at high doses
o Sedating effects at low doses – mainly used as hypnotic (sleep aid)

Question 18

AE of trazadone

Answer 18

include priapism (persistent erection), postural hypotension

Question 19

MOA of vilazadone

Answer 19

o Inhibitor of SERT and is a 5-HT1A partial agonist (anxiety). Both activities of Vilazodone may contribute to anti-depressant and anxiolytic potential.

Question 20

vilazadone DI

Answer 20

o Primarily metabolized by CYP3A4; not significant source of drug interactions in vivo.

Question 21

vilazadone AEs

Answer 21

GI: N/V, diarrhea (most common AEs), withdrawal symptoms, platelet dysfunction (bleeding risk).