Antidepressants

Question 1

percent of patients that improve with placebo treatment

Answer 1

30-40%

Question 2

mechanism of action of TCA

Answer 2

inhibition of monoamine reuptake (which does not correlate with its latency), desensitized receptors

Question 3

adverse effects of TCA

Answer 3

sedation, weight gain, delirium, confusion, manic (esp in bipolar patients if given without mood stabilizer)

Question 4

TCAs have this effect on alpha adrenergic receptors, and what are the side effects of this?

Answer 4

antagonist of alpha adrenergic activity

orthostatic hypotension, reflex tachycardia, arrhythmias

Question 5

treatment of acute overdose of tricyclic antidepressants

Answer 5

maintain respiration, charcoal for gastric lavage, anti-arrhythmic agents, benzos for seizures, BICARB to correct acidosis and to increase plasma protein binding!

Question 6

antidepressants that should not be combined

Answer 6

TCAs and MAOIs

SSRIs and MAOIs

Question 7

meds class for GAD and OCD

Answer 7

SSRIs

Question 8

latency time of all antidepressants

Answer 8

2 weeks

Question 9

the active compound of fluoxetine

its half life

how the active metabolite is formed

Answer 9

norfluoxetine

over a week

liver metabolism must be functioning to get the desired active metabolite

Question 10

sexual dysfunction is more frequent with..

Answer 10

SSRIs rather than tricyclics

Question 11

which drug causes prolonged QT

Answer 11

citalopram

Question 12

MAOIs may produce this potentially lethal symptom

Answer 12

serotonin syndrome (autonomic instability)

Question 13

SSRIs have this effect on metabolism of other drugs

Answer 13

reduces metabolism of other drugs

Question 14

withdrawals may occur with this class of drugs, but ____ will not cause withdrawals due to long half life

Answer 14

SSRIs

prozac

Question 15

an SSNRIs that is not as selective for serotonin

Answer 15

venlafaxine (Effexor)

Question 16

major side effect of SNRI venlafaxine

Answer 16

increased blood pressure

Question 17

the only antidepressant that works on dopamine, which helps motivation

Answer 17

bupropion (wellbutrin) - 2nd gen antidepressant

Question 18

prototypes of MAOIs

Answer 18

phenelzine and tranylcypromine

Question 19

St Johns Wart is an example of a weak

Answer 19

SSRI

Question 20

most activating SSRI

Answer 20

fluoxetine

Question 21

most anticholinergic SSRI

Answer 21

paroxetine (paxil)

Question 22

high doses of this SSRI can increase dopamine

Answer 22

sertraline

Question 23

most selective of the SSRIs

Answer 23

citalopram

Question 24

most prescribed SSRI

Answer 24

escitalopram (Lexapro)

Question 25

SSRI used for OCD and FDA approved for it

Answer 25

fluvoxamine

Question 26

what is electroconvulsive therapy ECT, and what is it used to treat?

Answer 26

inducing a seizure under anesthesia

patients whose depression was not alleviated by many other medications

Question 27

target of repetitive transcranial magnetic stimulation rTMS

Answer 27

dorsolateral PREFRONTAL CORTEX