Antidepressants Jeopardy

Question 1

The half-life of this SSRI is about one week.

Answer 1

Fluoxetine (Prozac)

Question 2

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

Answer 2

Discontinuation Syndrome

Question 3

SSRI’s and MAOI’s used in combination carry a high risk of this side effect.

Answer 3

Serotonin syndrome

Question 4

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

Answer 4

Paroxetine (Paxil)

Question 5

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

Answer 5

2 weeks

Question 6

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

Answer 6

• Paroxetine (Paxil)

- Fluvoxamine (Luvox)

Question 7

Whether the dose is very high, moderate, or low, this NT’s reuptake is blocked by venlafaxine (Effexor).

Answer 7

Serotonin

Question 8

At very high doses (>375mg/d) of venlafaxine (Effexor), this NT’s reuptake may begin to be blocked.

Answer 8

Dopamine

Question 9

This SNRI is preferred for painful sx of depression or diabetic neuropathic pain.

Answer 9

Duloxetine (Cymbalta)

Question 10

As with the SSRI’s, some pts take SNRI’s for depression have an initial response, continue taking the medication, but then experience this.

Answer 10

Poop-out syndrome (relapse)

Question 11

As with the SSRI’s, some pts take SNRI’s for depression, have an initial response, continue taking the medication
but then experience this.

Answer 11

Induced bipolar state

Question 12

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

Answer 12

Hot flashes/flushes

Question 13

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

Answer 13

Increased BP

Question 14

This medication is the most well known NDRI.

Answer 14

Buproprion (Wellbutrin)

Question 15

NDRI’s are useful in treating cravings from dependence on this substance.

Answer 15

Nicotine (smoking cessation)

Question 16

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

Answer 16

Sexual dysfunction

Question 17

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 17

Seizure

Question 18

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

Answer 18

Anxiety disorders

Question 19

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

Answer 19

Hypersomnia (>10 hours/night)

Question 20

NDRI’s commonly do this to a pt’s weight.

Answer 20

Decrease (or no change)

Question 21

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

Answer 21

ADHD

Question 22

NDRI onset of therapeutic action is usually not immediate, but is delayed until this time period.

Answer 22

2-4 weeks

Question 23

NaSSA stands for this.

Answer 23

Noradrenergic and Specific Serotonergic Agent.

Question 24

NaSSA’s novel MoA by which norepinephrine and serotonin system activity is increased is this.

Answer 24

Pre-synaptic alpha-2 adrenergic antagonist

Question 25

The medication that is in the NaSSA class is this.

Answer 25

Mirtazepine (Remeron)

Question 26

SSRIs or venlafaxine (Effexor) may cause these common side effects which NaSSA’s 5HT-3 antagonism may help reduce or remove.

Answer 26

GI side effects (nausea, diarrhea, stomach cramps)

Question 27

This mirtazapine (remeron) side effect is more likely in F than M, before menopause than after, and is unlikely to be a problem if it has not occurred w/in the first 6 weeks of tx.

Answer 27

Weight gain

Question 28

Pts 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 28

Serotonin syndrome

Question 29

Mirtazapine (remeron) is an antagonist of: a presynaptic adrenergic alpha2-autoreceptors, serotonin post synaptic receptors, and this post synaptic receptor.:

Answer 29

Histamine (H1)

Question 30

Onset of therapeutic effect of mirtazapine on insomnia and anxiety is typically in this time period.

Answer 30

Almost immediately

Question 31

Cytochrome P450 enzyme system that is significantly effected by mirtazepine (Remeron) is?

Answer 31

None

Question 32

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

Answer 32

Nortriptyline (Pamelor)

Question 33

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

Answer 33

Anticholinergic activity

Question 34

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

Answer 34

Desipramine (Norpramin)

Question 35

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

Answer 35

Men

Question 36

Fluoxetine (Prozac), paroxetine (Paxil), bupropion (Wellbutrin), duloxetine (Cymbalta) and other medications may increase all TCA’s concentration by inhibiting this p450 enzyme.

Answer 36

CYP450 2D6

Question 37

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

Answer 37

Alpha-1 adrenergic receptor

Question 38

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

Answer 38

Histamine (H1)

Question 39

TCA’s mechanism of action for treating depression is this.

Answer 39

Serotonin and norepinephrine reuptake inhibition

Question 40

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

Answer 40

Na+ channels