Watts Antidepressants

Question 1

what was the first antidepressant and what class?

Answer 1

imipramine

Question 2

types of depression with percentages

Answer 2

reactive - 60%
major depressive disorder - 25%
bipolar affective - 15%

Question 3

drug induced depression classes

Answer 3

antihypertensive
sedative hypnotics
anti-inflammatory/analgesics
steroids

Question 4

biogenic amine hypothesis

Answer 4

reserpine depletes NE and 5HT

Question 5

neuroendocrine hypothesis

Answer 5

overactive HPA and CRF
stress causes hypothalamus to release cortisol

Question 6

antidepressants do what to CRF

Answer 6

reduce levels

Question 7

CRF1 does what

Answer 7

arousal
anxiety
sexual dysfunction
sleep problems
activation of HPA axis

Question 8

CRF2 does what

Answer 8

appetite suppression

Question 9

neurotrophic hypothesis

Answer 9

depressed ppl have reduced BDNF and volume of hippocampus

Question 10

antidepressants to what to BDNF

Answer 10

increase

Question 11

increase in BDNF does what to dendritic sprouts

Answer 11

increase

Question 12

MAO inhibitors mechanism of action

Answer 12

prevents degradation of NE and 5HT by mao
- increased amount of NE and 5HT packaged in vescicles

Question 13

non selective MAO inhibitors

Answer 13

phenelzine
tranylcypromine

Question 14

non selective MAO inhibitors are _________

Answer 14

irreversible

Question 15

MAO B selective inhibitor

Answer 15

selegiline (reversible)

Question 16

MAO A selective inhibitor

Answer 16

moclobemide

Question 17

MAO side effects

Answer 17

headache
drowsiness
dry mouth
weight gain
orthostatic hypotension
sexual dysfunction

Question 18

avoid what kind of foods with MAO

Answer 18

tyramine containing

Question 19

orthosteric site is where what binds?

Answer 19

serotonin

Question 20

indications for TCAs

Answer 20

depression, pain, panic, enuresis

Question 21

patients more likely suicidal with what class

Answer 21

TCAs (2 weeks into treatment)

Question 22

tertiary amines inhibit what

Answer 22

NE and 5HT via NET and SERT

Question 23

tertiary amines also are antagonists at what

Answer 23

antihistamine
antimuscarinic
antiadrenergic

Question 24

side effects of tertiary amines

Answer 24

weight gain
sedation
autonomic
(very strong)
also conduction of heart

Question 25

tertiary amine drugs

Answer 25

imipramine amitriptyline clomipramine doxepin

Question 26

imipramine metabolized to what

Answer 26

desipramine (secondary amine)

Question 27

amitriptyline metabolized to what

Answer 27

nortriptyline (secondary amine)

Question 28

imipramine uses

Answer 28

ADHD enuresis

Question 29

clomipramine use

Answer 29

OCD (orgasm while yawning)

Question 30

secondary amine drugs

Answer 30

desipramine nortriptyline maprotiline

Question 31

secondary amines inhibit what mainly

Answer 31

NET

Question 32

secondary amines side effects

Answer 32

less sedation less weight gain less CV less anticholinergic

Question 33

SSRI moa

Answer 33

serotonin transporters blocked increased 5HT in synapse

Question 34

side effects of SSRIs

Answer 34

N/V headache sexual dysfunction anxiety insomnia

Question 35

SSRI discontinuation syndrome symptoms

Answer 35

brain zaps dizzy sweating

Question 36

what can occur if SSRIs are given with MAOis or TCAs

Answer 36

serotonin syndrome: restless, shiver, hyperthermia

Question 37

treatment of serotonin syndrome

Answer 37

administration of serotonin antagonists (cyptoheptadine) benzos to control movements

Question 38

vilazodone MOA

Answer 38

SSRI + 5HT1A partial agonist

Question 39

vartioxetine MOA

Answer 39

SSRI + 5HT1A partial agonist

Question 40

vilazodone side effect profile

Answer 40

reduced sexual dysfunction compared to SSRIs

Question 41

tetracyclic antidepressants

Answer 41

maprotiline mirtazapine

Question 42

maprotiline is a ____ inhibitor

Answer 42

NET

Question 43

D2 antagonists will have what side effects

Answer 43

motor side effects

Question 44

mirtazapine targets whwat

Answer 44

alpha 2 receptor antagonist 5HT antagonist H1 antagonist

Question 45

bupropiron is a _____

Answer 45

unicyclic antidepressant

Question 46

bupropion inhibits what

Answer 46

DAT NET SERT

Question 47

trazodone MOA

Answer 47

5HT2 antagonist SERT inhibitor (off label alpha 1, H1, 5HT2)

Question 48

venlafxine use

Answer 48

GAD and panic disordewr

Question 49

SNRIs

Answer 49

desvenlafaxine venlafaxine duloxetine milnacipran levomilnacipran

Question 50

duloxetine treats what

Answer 50

peripheral neuropathy

Question 51

milnacipran treats what

Answer 51

fibromyalgia

Question 52

NSRI meds

Answer 52

reboxetine atomoxetine

Question 53

triple blockers block what

Answer 53

serotonin norepinephrine dopamine SDNRIs

Question 54

what is a triple blocker example

Answer 54

cocaine

Question 55

NMDA antagonist drug

Answer 55

ketamine esketamine

Question 56

ketamine useful at what doses

Answer 56

subanesthetic

Question 57

esketamine approved with what

Answer 57

oral antidepressant

Question 58

post partum depression treatment

Answer 58

SSRI: fluoxetine/paroxetine brexanolone

Question 59

brexanolone MOA

Answer 59

resensitizes GABA-A receptors

Question 60

what happens during pregnancy

Answer 60

increase in allopregnanolone GABA-A receptors desensitize

Question 61

non pharm options for depression

Answer 61

electroconvulsive psychotherapy hospitalization

Question 62

fibanserin use

Answer 62

female sexual desire stimulate originally developed as antidepressant

Question 63

filbanserin targets

Answer 63

5HT1A agonist 5HT2A/C antagonist (polypharmacology)

Question 64

mania features

Answer 64

euphoria high risk behavior decrease sleep and appetite aggressive

Question 65

lithium mechanism

Answer 65

depletes PIP2 and IP3 so less Gq activation and recycling of PIP2

Question 66

effectiveness of lithium

Answer 66

lag time- takes awhile bc we need to burn out the PIP2

Question 67

valproic acid and valproate mechanism

Answer 67

increase GABA block Na channels block Ca channels inhibit histone deacetylase

Question 68

drugs that block Na inactive state

Answer 68

carbamazepine/oxcarbazepine lamotrigine topiramate