Depression and Bipolar Disorder

Question 1

Antidepressant onset

Answer 1

Typically can take weeks to see clinical effects

Question 2

Criteria for diagnosis of MDD

Answer 2

Depressed mood and/or diminished interest or pleasure and at least 4 of the other symptoms of MDD in the same 2 week period

Question 3

Most important outcome of depression treatment

Answer 3

Prevention of suicide attempts

Question 4

Neuroleptic malignant syndrome (NMS)

Answer 4

Caused by: dopamine antagonists
Initiation of symptoms: days to weeks
Duration of symptoms: days to 2 weeks

Question 5

Serotonin syndrome (SS)

Answer 5

Caused by: serotonin agonists
Initiation of symptoms: Hours
Duration of symptoms: usually 24 hours

Question 6

Tricyclic Antidepressants (TCAs) Indication

Answer 6

Depression

Question 7

TCA MOA

Answer 7

Serotonin and norepinephrine reuptake inhibitors

Question 8

TCA adverse effects

Answer 8

Anticholinergic effects: dry mouth, constipation, confusion, urinary retention, dry eye
Orthostatic hypotenstion, drowsiness/dizziness
Arrhythmia
Withdrawal can have cholinergic rebound
Serotonin syndrome
Sexual dysfunction

Question 9

Triazolopyridine Indication

Answer 9

MDD, sleep aid

Question 10

Triazolopyridine MOA

Answer 10

Selective serotonin reuptake inhibitor, blocks alpha-1 and histamine receptors

Question 11

Triazolopyridine Adverse Effects

Answer 11

Dizziness
Sedation
Cognitive slowing
Serotonin syndrome

Question 12

SSRI indication

Answer 12

MDD, OCD, panic disorder, PTSD, PMDD, anxiety

Question 13

SSRI MOA

Answer 13

Blocks serotonin reuptake

Question 14

SSRI Adverse Effects

Answer 14

Nausea, Diarrhea, Sexual dysfunction, Weight gain, Serotonin syndrome

Question 15

Aminoketone indication

Answer 15

MDD, adjunct in smoking cessation

Question 16

Aminoketone MOA

Answer 16

Norepinephrine and dopamine reuptake inhibitor

Question 17

Aminoketone Adverse effects

Answer 17

Tremor 
Insomnia 
Minimal sexual dysfunction
Weight loss or weight neutral 
Seizures

Question 18

Tetracyclic antidepressants indication

Answer 18

MDD

Question 19

Tetracyclic antidepressants MOA

Answer 19

SNRI

anticholinergic and antihistamine

Question 20

Tetracyclic antidepressants Adverse effects

Answer 20

Sedation
Weight gain
Dry mouth 
Constipation 
Serotonin syndrome

Question 21

Bipolar I

Answer 21

One or more manic or mixed episodes

Equally common in men and women

Question 22

Bipolar II

Answer 22

Depressive episodes with hypomanic episodes

More common in women

Question 23

Mania

Answer 23

Elevated, expansive, or irritable mood lasting at least 1 week and causes impairment in functioning

Question 24

Hypomania

Answer 24

Elevated, expansive, or irritable mood that lasts at least 4 days but does not cause marked impairment in functioning

Question 25

Euthymia

Answer 25

Normal mood

Question 26

Lithium carbonate indication

Answer 26

Mania in bipolar disorder

Question 27

Lithium carbonate MOA

Answer 27

Alters cation transport in neurons and muscle and influences reuptake of serotonin and/or norepinephrine

Question 28

Lithium carbonate Adverse Effects

Answer 28

``` Nausea Vomiting Diarrhea Muscle weakness Tremor Nephrotoxicity, polyuria, polydipsia, nocturia ```

Question 29

Diavlproex sodium/Valproic acid indication

Answer 29

mania associated with bipolar disorder

Question 30

Diavlproex sodium/Valproic acid MOA

Answer 30

Increases availability of GABA or enhances action of GABA or mimics its action

Question 31

Diavlproex sodium/Valproic acid adverse effects

Answer 31

Nausea Flatulence Find hand tremor Sedation

Question 32

Second Generation Antipsychotics (SGA) Indication

Answer 32

Manic episodes associated with Bipolar disorder I often in combination with lithium or divalproex

Question 33

Second Generation Antipsychotics (SGA) MOA

Answer 33

Antagonism of serotonin, dopamine, histamine, and alpha-adrenergic receptors

Question 34

Second Generation Antipsychotics (SGA) Adverse Effects

Answer 34

``` Somnolence Extrapyramidal symptoms, dopamine related, head held forward, drooping eyelids, open mouth, drooling, hand tremors, slow shuffling gate Dizziness Weight gain Neuroleptic malignant syndrome ```

Question 35

Lamotrigine indication

Answer 35

Bipolar I disorder

Question 36

Lamotrigine MOA

Answer 36

Inhibits release of glutamate and inhibits voltage gated sodium channels

Question 37

Lamotrigine Adverse Effects

Answer 37

``` Headache Nausea Drowsiness Tremor Rash Maculopapular rash, especially with valproic acid treatment ```