Antidepressants

Question 1

Name the main classes of antidepressants

Answer 1

SSRIs, TCAs, serotonin-NA reuptake inhibitors, MAO inhibitors and others

Question 2

Name 2 SSRIs and their SE

Answer 2

SE= sexual dysfunction

Fluoxetine, Citalopram

Question 3

Name 1 Serotonin-NA reuptake inhibitor

Answer 3

Venlafaxine

Question 4

Name 2 TCAs

Answer 4

Amitriptyline, clomipramine

Question 5

Name a MAO inhibitor

Answer 5

Phenelzine

Question 6

Problems with TCAs?

Answer 6

Also blocks muscarinic, histamine and alpha-1 receptors-> SE and unsafe in overdose

Question 7

Problems with MAOi?

Answer 7

SE of weight gain and hypotension

Risk of hypertension after tyramine rich foods

Question 8

Name 3 other anti-depressants

Answer 8

Mirtazapine
agomelatine
bupropion

Question 9

What does mirtazapine do?

Answer 9

NA and serotonin receptor antagonist (5HT2&3 antagonist)

Question 10

How does agomelatine work?

Answer 10

Melatonin MT1&2 agonist, 5HT2c antagonist

DA and NA released in prefrontal cortex

Question 11

How does bupropion work?

Answer 11

DA and N reuptake inhibitor and releaser

Question 12

What psychological therapy is recommended for depression?

Answer 12

CBT, interpersonal therapy, problem solving therapy, structured group physical activity programme

Question 13

What is ECT and when is it used?

Answer 13

Electro-convulsive therapy, used in life threatening depression or if all other therapies have failed

Question 14

What is the first line treatment for severe depression?

Answer 14

SSRI, if no response try other drugs, continue for 6 months after response
Include other management techniques