Antidepressants

Question 1

What are the first generation antidepressants?

Answer 1

-Tricyclics which were created in the late 1950s and named for their common molecular structure
-Monoamine oxidase inhibitors (MAOIs) which reduce enzymatic deactivation of monoamines

Question 2

What the kinds of tricyclic drugs?

Answer 2

-Imipramine (Tofranil)
-Desipramine (Norpramin)
-Trimipramine (Surmontil)
-Protripyline (Vivactil)
-Anitriptyline (Elavil)
-Nortriptyline (Pamelor, Aventil)
-Doxepin (Adapin, Sinequan)
-Clomipramine (Anafranil)

Question 3

What is the severe side effect of tricyclics?

Answer 3

-In large doses, they can be cardio toxic - meaning they can cause heart damage

Question 4

What are the side effects of SSRIs?

Answer 4

-Withdrawal syndrome
-Sexual dysfunction
-Serotonin syndrome

Question 5

What is fluozetine?

Answer 5

-SSRI
-Brand name Prozac
-It is the 1st released SSRI*
-Efficacy is comparable to TCAs without AChM or H side-effects
-Active metabolite is norfluozetine

Question 6

What is sertraline?

Answer 6

-SSRI
-Brand name Zoloft
-As efficacious as TCAs
-Has a higher risk for serotonin syndrome and withdrawal syndrome*

Question 7

What is fluvoxamine?

Answer 7

-Brand name Luvox
-Shortest half-life of all SSRIs (16 hrs)
-Inhibits CYP1A2 which is increased by elements of tobacco smoke; smokers may require a higher dose to experience therapeutic effects

Question 8

What are SSNRIs?

Answer 8

-Selective serotonin norepinephrine reuptake inhibitors
-Dual-action antidepressants, similar to TCAs
-Highly selective for NT and 5-HT
-Analgesic; can relieve pain

Question 9

What is nefazodone?

Answer 9

-SSNRI
-Brand name: Serzone
-5-HT antagonist, also blocks reuptake of 5-HT and NE
-Has increased risk for severe liver damage*

Question 10

What is milnacipran?

Answer 10

-SSNRI
-Brand name: Savella
-Comparable to TCAs but better tolerated
-Comparable to SSRIs, no difference in tolerability
-Approved for treatment of fibromyalgia*

Question 11

What is duloxetine?

Answer 11

-Duloxetine is an SSNRI
-The brand name is Cymbalta
-Duloxetine has a half life of 12 hours
-It reduces depressions, anxiety, pain
-It is not recommended for bipolar patients because it may induce mania*

Question 12

What is mirtazepine?

Answer 12

-Mirtazepine is a tetracyclic
-It’s brand name is Remeron
-It has a half life of 10-20 hours
-It does not block reuptake transporters, it increases the release of 5-ht and NE
-It has side effects of increased appetite/weight gain and very few sexual side effects*

Question 13

What is maprotiline?

Answer 13

-Maprotiline is a second generation antidepressant that is a modified TCA
-It’s brand name is Ludiomil
-It is similar to imipramine
-One of the side effects is that it is an epileptogenic (increased seizure susceptibility)

Question 14

What is amozapine?

Answer 14

-Amozapine is a second generation antidepressant who is a NET antagonist
-It’s brand name is Ascendin
-Amozapine is better than TCAs at relieving anxiety and behavioral agittion
-It blocks DA receptors and can induce Parkinsonian-like EPS*

Question 15

What is trazodone?

Answer 15

-Trazodone is a second generation antidepressant
-It’s brand name is Desyrel
-Trazodone is a weak NET, SERT antagonist and blocks 5-HT2A
-It has heavy sedative effects and is primarily used as a hypnotic*

Question 16

What is clomipramine?

Answer 16

-Clomipramine is a second generation antidepressant that is a NET and SERT antagonist with a higher affinity for SERT
-It’s brand name is Anafranil
-It is used to treat anxiety and pain as well as depression, particularly OCD and panic disorder*

Question 17

What is the wine and cheese effect?

Answer 17

-When taking MAOIs it is problematic to consume foods containing high levels of tyramine because it can increase blood pressure
-Products of fermentation

Question 18

Impairment of memory is a side effect clearly associated with the use of

Answer 18

TCAs

Question 19

Compared to SSRIs, TCAs are:

Answer 19

Equally effective, but have different side effects

Question 20

The tricyclic antidepressants differ from Prozac and Zoloft in that they also have major effects on ________________.

Answer 20

Norepinephrine

Question 21

An SNRI would be a good treatment choice for someone

Answer 21

With MDD and pain

Question 22

The neurogenic theory of depression stems from recent findings that in the mature brain

Answer 22

Neurons are capable of being repaired and produces

Question 23

What type of antidepressant is amitriptyline?

Answer 23

TCAs

Question 24

OF the following classes of antidepressant drugs, the one associated with the highest incidence of sexual dysfunction is

Answer 24

SSRIs

Question 25

If an SSRI is taken in conjunction with an MAOI, the levels of 5-HT can become dangerously high leading to ___________________.

Answer 25

Serotonin syndrome

Question 26

First-generation tricyclic antidepressants are defined by a commonality in basic

Answer 26

Molecular structure

Question 27

What is the pharmacodynamic mechanism of bupropion?

Answer 27

It blocks DA and NE reuptake

Question 28

Orthostatic hypotension is a common side effect of

Answer 28

TCAs and MAOIs

Question 29

Which statement below best describes the pharmacodynamics of Escitalopram

Answer 29

It primarily effects 5-HT systems with minimal effects on NE/DA/ACh systems

Question 30

Venalfaxine is a/an

Answer 30

SNRI

Question 31

Which neurotransmitters are effected by amitriptyline

Answer 31

NE, ACh, 5HT