Antideppressants

Question 1

what is a possible cause of depression

Answer 1

reduction in serotonin receptors in the hippocampus

Question 2

what are mono amine oxadase inhibitors

Answer 2

inhibit the activity of MAO enzymes

increases levels of norepinephrine and serotonin and dopamine

Question 3

name some MAOIs

Answer 3

phenelzine
selegiline
tranylcypromine

Question 4

what are some side effects of MAOIs

Answer 4

weakness, dizziness, headache, fatigue, weight gain, impotence

Question 5

what should MAOIs not be used in combination with

Answer 5

SSRIs
tricyclic antidepressants
morphine/tramadol

due to increasing serotonin to dangerous levels

foods high in tyramine may also be probematic: cheese, some meats, alcohol, broad beans

Question 6

what is neuroleptic malignant syndrome

Answer 6

confusion, hypertension, tremor, coma

and possibly death due to high serotonin levels

Question 7

what is RIMA

Answer 7

reversible inhibition of MAO type A

less effect of tyramine
short acting

Question 8

how do tricyclic antidepressants work

Answer 8

inhibits reuptake of norepinephrine

Question 9

risperidone

Answer 9

antipsychotic with antidepressant properties

Question 10

lithium

Answer 10

antipsychotic with antidepressant properties
adverse affects on kidney and thyroid
function

Question 11

Venlafaxine:

Answer 11

serotonin-norepinephrine re-uptake
inhibitor

resistant depression and panic disorder

Question 12

Mirtazapine

Answer 12

presynaptic alpha₂-adrenoreceptor
antagonist.

can cause drowsiness

Question 13

Duloxetine

Answer 13

SNRI (serotonin norepinephrine up-take
inhibitor)

 Depression
 Neuropathic pain (diabetes, fibromyalgia)
 Stress urinary incontinence

Question 14

SSRI toxicity

Answer 14

Citalopram (QT interval)
Escitalopram
Paroxetine
Sertraline
Fluoxetine

Question 15

what are the side effects of SSRIs

Answer 15

 Suicide: possible increased risk of suicide especially in
children and adolescents
 Overdose: safer than other antidepressants
 Epilepsy: may reduce fit threshold
 Others include:
 Nausea
 Rash
 Muscle aches
 Insomnia
 Sweating

 Sexual: dysfunction and reduced libido
 Cardiac: some, especially citalopram, to be used with
caution as can cause QT interval prolongation
therefore dose dependant with citalopram
 Bleeding: affects anticoagulants (i.e. warfarin and
aspirin) and also increased risk of GI bleeds.

Question 16

how do SSRIs work

Answer 16

5-HT receptors are found in the peripheral and central nervous
systems mediating both excitatory and inhibitory
neurotransmission
 These receptors modulate the release of many neurotransmitters
 GABA
 Dopamine
 Epinephrine
 Norepinephrine
 Acetylcholine
They influence aggression, anxiety, cognition, learning memory,
mood and sleep

Question 17

Trazodone

Answer 17

sedating drug related to tricyclic

Question 18

Amitriptyline
 Clomipramine
 Imipramine
 Lofepramine
 Nortriptyline

Answer 18

common tricyclics

Question 19

side effects of tricyclics

Answer 19

 Tricyclics should be used with caution in
cardiovascular disease due to risk of arrythmias
 Tricyclics have antimuscarinic activity that blocks
activity of the muscarinic acetylcholine receptor and
so reduce intestinal mobility
 They can induce bradycardia followed by tachycardia,
reduce bronchial secretions, urinary retention, dry
mouth and confusion