Exam #02 - Antidepressants Flashcards Preview

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Flashcards in Exam #02 - Antidepressants Deck (19):
1

What is the 1st line Tx for major depressive disorder?

SSRI + cognitive behavioral therapy

2

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

3

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

4

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

5

How long might antidepressant drugs take before a therapeutic effect is seen in the patient?

1 - 6 weeks

6

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

7

All of the following are SSRIs used in the Tx of depression except:

A. Fuoxetine
B. Sertraline
C. Fluvoxamine
D. Venlafaxine
E. Citalopram

(D) venlafaxine is a SNRI

8

What is the basic MOA of buproprion (wellbutrin ®)?

DNRI

9

What are the most common SE of SSRIs?

1. nausea
2. loss of appetite
3. insomnia
4. HA
5. sexual dysfunction

10

Which SSRI is considered the best tolerated drug for depression b/c it has the fewest CYP450 interactions?

Escitalopram (Lexapro ®)

11

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

12

True or False - SNRIs are used for patients who only have a partial response with initial SSRI Tx?

True

SNRIs
Venlafaxine (Effexor ®)
Desvenlafaxine (Pristiq ®)
Duloxetine (Cymbalta ®)
Milnacipran (Ixel ®, Toledomin ®)

13

What SE might you see with Venlafaxine or other SNRIs based on their MOA?

increased HR and BP

14

Which antidepressant drug is also prescribed for smoking cessation?

bupropion (Wellbutrin ®)

15

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

16

All of the following are SNRIs except:

A. Venlafaxine (Effexor ®)
B. Duloxetine (Cymbalta ®)
C. Bupropion (Wellbutrin ®)
D. Milnacipran
E. all are SNRIs

(C) Bupropion is a DNRI not an SNRI

17

Which antidepressant was the first drug approved for seasonal affective disorder?

Bupropion

18

Which antidepressant produces fewer sexual SE than other antidepressants?

Bupropion

19

Which antidepressant was approved by the FDA for neuropathic pain and fibromyalgia pain?

Duloxetine (Cymbalta ®)