Antidepressants

Question 1

MOA of anti-depressant medications

Answer 1

• increase amine levels (serotonin, norepi, dopamine

- down regulate number of receptor sites in response to increased neurotransmitter availability

Question 2

MAO inhibitors

Answer 2

• less common than other anti-depressants
• serious side effects
• can potentiate the effects of sympathomimentics such as norepi
• breaks down tyramine which can get into presynaptic terminals which can displace norepi

Question 3

Increased absorption of what can cause toxic elevations of catecholamines? This can lead to what?

Answer 3

intact tyramine

hypertensive emergencies and fatal accelerated hyertension

Question 4

tricyclic antidepressants

Answer 4

diminishes reuptake of monamine neruotransmitters
down regulation of postsynaptic receptors
used to treat ocd, panick attacks, chronic pain, depression, ha

Question 5

amitriptyline/elavil

Answer 5

tricyclic antidepressant
CNS modulation of serotonin, norepi - increases levels
serotonin and norepi reuptake inhibitor
major depression, bipolar, migraine, tension ha, chronic pain
SE: dizziness, drowsiness, dry mouth, constipation, blurred vision

Question 6

what dose of cyclic antidepressants can be fatal?

Answer 6

10 times the daily dose

prolonged QT leading to arrhythmias

Question 7

mirtazapine/remeron

Answer 7

tetracyclic antidepressant
antagonist at central presynaptic alpha 2, serotonin, and histamine.
depression
se: sedation, weight gain
interactions: etoh, benzo, other depressants

Question 8

trazodone

Answer 8

tetracyclic antidepressant
serotonin reuptake inhibitor and partial antagonist
antidepressant, insomnia, antianxiety
se: sedation, orthostatic hypotension, fatigue, mania

Question 9

downstream affect of SSRI

Answer 9

increased serotonin leads to production of BDNF

Question 10

fluoxetine/prozac

Answer 10

SSRI
major depressive disorder, ocd, bulimia, panic disorder
decreased serotonin reuptake increases serotonin at synapse and post-synapse
se: n/v, sexual dysfunction

Question 11

what to avoid with SSRIs

Answer 11

NSAIDs and other painkillers

Question 12

duloxetine/cymbalta

Answer 12

SNRI
pain, but not neuropathic pain
major depressive disorder, chronic ms pain, anxiety
se: ha, n/v, fatigue, insomnia, erectile dysfunction

Question 13

Desvenlafaxine/pristiq

Answer 13

?

Question 14

bupropion/wellbutrin

Answer 14

NDRI (norepi and dopamine reuptake inhibitor and nicotine receptor antagonist

• blocks norepi and dopamine reuptake
• major depression, bipolar disorder, add, smoking cessation
  se: ha, insomnia, anxiety, dizziness

Question 15

when is buproprion called zyban and not wellbutrin?

Answer 15

when it is used for smoking cessation

used for 7-12 weeks

Question 16

verenicline/chantix

Answer 16

partial nicotine agonist indicated for

SE: suicidal thoughts, depression

Question 17

folate deficiency

Answer 17

levomefolic acid (5-MTHF) deficiency can lead to depression

Question 18

what three monoamines does MTHFR act as co-enzyme for?

Answer 18

dopamine
serotonin
norepi

Question 19

SAMe

Answer 19

shares with MTHF the ability to regulate methylation

Question 20

Levomefolic acid/deplin/metafolin

Answer 20

prescription MTHF

• methylated folic acid is used for DNA replication, cysteine cycle, regulation of homocystine among many other things
• important coenzyme utilized in production of catecholamine neurotransmitters