Flashcards in Exam #02 - Antidepressants Deck (19):
What is the 1st line Tx for major depressive disorder?
SSRI + cognitive behavioral therapy
How long is the minimum amount of recommended treatment duration for acute treatment phase? Continuation phase? Maintenance phase?
Acute: 6-12 wks
Continuation: 4-9 months
Maintenance greater than or equal to 1 year
All of the following are true about depression except:
A. depression is heterogenous
B. low rate of relapse
C. drugs have delayed onset of action
D. monoamine hypothesis involves a deficiency of serotonin, NE, and/or DA
E. Decreasing tryptophan concentration will cause depressive relapse
(B) there is a HIGH rate of relapse in treatment of depression
Since tryptophan is involved in the production of serotonin, it is implicated in having an effect on the concentration of serotonin
True or False - reserpine produces depressive symptoms?
True - it depletes stores of NT's and low [NT's] (specifically DA, NE, and serotonin) is what causes depression
How long might antidepressant drugs take before a therapeutic effect is seen in the patient?
1 - 6 weeks
Which of the following statements about depression is false?
A. Antidepressant treatment increases BDNF expression
B. depression is caused by up regulation of neurotransmitter receptors
C. antidepressant effects is related to down regulation of receptors
D. Glucocorticoid hypothesis is related to chronic cortisol in the hippocampus
E. none of above
(E) all of them are correct
Antidepressant treatment increases BDNF (brain derived neutrotrophic factor) expression which increases neurogenesis activity
All of the following are SSRIs used in the Tx of depression except:
(D) venlafaxine is a SNRI
What is the basic MOA of buproprion (wellbutrin ®)?
What are the most common SE of SSRIs?
2. loss of appetite
5. sexual dysfunction
Which SSRI is considered the best tolerated drug for depression b/c it has the fewest CYP450 interactions?
Escitalopram (Lexapro ®)
True or False - it is not necessary to be tapered off SSRIs?
False - when D/C SSRIs patient should be tapered off and should NOT stop abruptly
True or False - SNRIs are used for patients who only have a partial response with initial SSRI Tx?
Venlafaxine (Effexor ®)
Desvenlafaxine (Pristiq ®)
Duloxetine (Cymbalta ®)
Milnacipran (Ixel ®, Toledomin ®)
What SE might you see with Venlafaxine or other SNRIs based on their MOA?
increased HR and BP
Which antidepressant drug is also prescribed for smoking cessation?
bupropion (Wellbutrin ®)
Which of the following statements is false?
A. Neurotrophic hypothesis of major depression states that chronic stress results in decrease BDNF and therefore decreased neurogenesis
B. Fluoxetine and sertraline have active metabolites
C. sexual dysfunction is a common AE of SSRIs
D. Trazadone is an atypical antidepressant
E. Long term effect of SSRIs is 5HT receptor upregulation
(E) Long term effect of SSRIs is 5HT receptor DOWNREGULATION
Depression is CAUSED by up regulation of NT receptors
All of the following are SNRIs except:
A. Venlafaxine (Effexor ®)
B. Duloxetine (Cymbalta ®)
C. Bupropion (Wellbutrin ®)
E. all are SNRIs
(C) Bupropion is a DNRI not an SNRI
Which antidepressant was the first drug approved for seasonal affective disorder?
Which antidepressant produces fewer sexual SE than other antidepressants?