Antidepressants for Certain People

Question 1

What drug is best for elderly patient; pt with agitated depression or GI distress?

Answer 1

Citalopram

Question 2

What drug is best for noncompliant or forgetful patients (depot formulation); excessive fatigue?

Answer 2

Fluoxetine

Question 3

Citalopram is least likely to benefit what kind of patient?

Answer 3

elderly pt with excessive sleep and apathy (20% kidney excretion)

Question 4

Fluoxetine is least likely to benefit what type of patient?

Answer 4

Pt on several medications or frequent medication changes anticipated

Question 5

What drug is best for a patient with anxiety or difficulty sleeping?

Answer 5

Paroxetine

Question 6

Paroxetine is least likely to benefit what type of patient?

Answer 6

pts who require high doses or elderly (are more prone to anticholinergic effects–delrium); T 1/2 increased by 170% in elderly

Question 7

What drug is best for medical/surgical patient on 1+ medical drugs (initial activation and increased alertness desired)?

Answer 7

Sertraline

Question 8

Sertraline is least likely to benefit what type of patient?

Answer 8

pt sensitive to typical SSRI ADEs (i.e. increased arousal)

Question 9

What drug is best for a depressed, over-anxious pt with marked difficulty sleeping?

Answer 9

Nefazodone

Question 10

Nefazone is least likely to benefit what type of patient?

Answer 10

pts who sleep excessively with life-long underachievement and excessive contentment. pts with severe depression tend to require max dose

Question 11

What drug is best for pts with menopausal symptoms or failing of an SSRI trial…at higher doses, pts with chronic pain?

Answer 11

Venlafaxine

Question 12

Venlafaxine is least likely to benefit what type of patient?

Answer 12

pts with unstable BP and perhaps, those who are GI sensitive. withdrawal symptoms require taper

Question 13

What drug is best for pt with depression and chronic pain or pt failing SSRI trail?

Answer 13

duloxetine

Question 14

Duloxetine is least likely to benefit what type of patient?

Answer 14

pt with significant anorexia, constipation, or other GI symptoms

Question 15

What drug is best for medical ill pt with weight loss, insomnia, nausea?

Answer 15

Mirtazapine

Question 16

Mirtazepine is least likely to benefit what type of patient?

Answer 16

pts who are obese or have fatigue, hypersomnia, neutropenia

Question 17

What drug is best for pts who are now depressed, and are actually or potentially, bipolar; pts who are apathetic and have low energy; pts motivated to stop smoking or have ADHD?

Answer 17

Buproprion

Question 18

Buproprion is least likely to benefit what type of patient?

Answer 18

agitated, anxious/panicky; pts with risk for seizures and/or hx of head trauma, substance abuse, eating disorder, or electrolyte disturbance

Question 19

Sexual dysfxn is common with which anti-depressants?

Answer 19

SSRIs (citalopram, fluoxetine, paroxetine, sertraline) **unlikely with atypical SSRI nefazodone

Question 20

Sexual dysfxn is LESS common with which anti-depressants?

Answer 20

venlafaxine, duloxetine

Question 21

Sexual dysfxn is UNLIKELY with which anti-depressants?

Answer 21

nefazodone, mirtazapine

Question 22

Sexual dysfxn is RARE with which anti-depressant?

Answer 22

bupropion