Antidepressants and Mood Stabilizers

Question 1

SSRI with longest half life, is the most stimulating, and is associated with the least amount of weight gain

Answer 1

fluoxetine (Prozac)

Question 2

Which SSRI has the highest risk for serotonin syndrome due to it’s long half life?

Answer 2

fluoxetine (Prozac)

Question 3

Which two SSRIs are associated with the least amount of sexual adverse effects?

Answer 3

Citalopram (Celexa) and Escitalopram (Lexapro)

Question 4

Which SSRI has the highest risk of GI problems?

Answer 4

sertraline (Zoloft)

Question 5

Which SSRI has the shortest half life, is the most sedating, causes the most weight gain, has greatest sexual adverse effects, and greatest anticholinergic activity?

Answer 5

paroxetine (Paxil)

Question 6

Symptoms include: shivering, hyperreflexia, myoclonus, ataxia, n/v/d

Answer 6

serotonin syndrome

Question 7

Which SNRI is sedating and causes HTN?

Answer 7

venlafaxine (Effexor)

Question 8

Which SNRI has less adverse effects and works well for fibromyalgia, sleep and pain?

Answer 8

duloxetine (Cymbalta)

Question 9

Which category of antidepressants may be more effective in the setting of diabetic neuropathy, fibromyalgia, mask pain, stress incontinence, sedation, fatigue, and comorbid anxiety?

Answer 9

SNRIs

Question 10

Name the atypical antidepressant that may increase sexual fxn and is good for comorbid ADHD

Answer 10

Buproprion (Wellbutrin)

Question 11

What mental health disorders contraindicate the use of Buproprion (wellbutrin) as antidepressant med?

Answer 11

anxiety (adverse effect) or eating disorder (weight loss is adverse effect)

Question 12

Name the atypical antidepressant that is the most sedating of ALL antidepressants, but its overdose is generally safe

Answer 12

mirtazapine (Remeron)

Question 13

What adverse effect is associated with trazodone (oleptro)?

Answer 13

priapism

Question 14

What is the MOA of TCAs?

Answer 14

inhibits the reuptake of both serotonin and norepi

Question 15

Name the TCA that is good for sleep, pain, and depression

Answer 15

amitripyline (Elavil)

Question 16

Name the TCA that is the least sedating

Answer 16

desipramine (norpramin)

Question 17

What is the main adverse effect of all TCAs?

Answer 17

anticholinergic

Question 18

What is the brand name for generic TCA agent clomipramine?

Answer 18

anafranil

Question 19

What is the brand name for the generic TCA agent doxepin?

Answer 19

silenor

Question 20

What is the brand name for the generic TCA agent imipramine?

Answer 20

tofranil

Question 21

What is the brand name for the generic TCA agent nortriptyline?

Answer 21

pamelor

Question 22

What is the MOA of MAOIs?

Answer 22

block destruction of monoamines centrally and peripherally

Question 23

What type of diet is necessary for patients receiving MAOIs?

Answer 23

tyramine free (no wine, beer, cheese, aged food, or smoked meats)

Question 24

How long must you wait before intiating therapy with a MAOI if the patient was previously on other antidepressants?

Answer 24

2 weeks in order to prevent serotonin syndrome

Question 25

Name the MAOI that is reversible and administered transdermally

Answer 25

selegiline (Emsam)

Question 26

Name the two MAOIs that are irreversible

Answer 26

phenelzine (Nardil) and tranylcypromine (Parnate)

Question 27

Mood stabilizer that is an antiepileptic and works by inhibiting voltage-gated Na+ channels

Answer 27

Carbamazepine (Tegretol)

Question 28

What meds does carbazepine (Tegretol) decrease the effectiveness of?

Answer 28

OCPs and warfarin

Question 29

What condition is contraindicated with the use of carbazepine (Tegretol)?

Answer 29

bone marrow depression

Question 30

What pregnancy category is carbazepine (Tegretol), valproate (Depakote), and lithium (Eskalith)?

Answer 30

D

Question 31

What needs to be monitored with carbazepine (Tegretol) use?

Answer 31

CBC, LFTs, mental status, bone density, levels

Question 32

Mood stabilizer that is antiepileptic and increases GABA

Answer 32

Valproate (depakote)

Question 33

What needs to be monitored with valproate (depakote) use?

Answer 33

CBC, LFTs, levels

Question 34

What condition is contraindicated with use of valproate (depakote)?

Answer 34

liver disease

Question 35

Mood stabilizer that blocks voltage-gated Na+ channels and inhibits glutamate release

Answer 35

lamotrigine (Lamictal)

Question 36

What pregnancy category is laotrigine (Lamictal)?

Answer 36

C

Question 37

What mood stabilizer interacts with lamotrigine (Lamictal)?

Answer 37

valproate (Depakote)

Question 38

Mood stabilizer that inhibits adenylate cyclase

Answer 38

lithium (Eskalith, Lithobid)

Question 39

What two medical conditions that can be caused by lithium therapy?

Answer 39

diabetes insipidus and hypothyroidism

Question 40

How often should a BMP and TSH be done for a pt receiving lithium therapy?

Answer 40

every 6-12 months

Question 41

Mood stabilizer with adverse effects that include: somnolence, dizziness, ataxia, leukopenia, weight gain, and SJS

Answer 41

gabapentin (Neurontin)