Antidepressants

Question 1

Depression is due to

Answer 1

Decreased NE, 5-HT, and/or dopamine

Question 2

Monoamine oxidase inhibitors

Answer 2

3rd line treatment for depression after SSRI/TCA

Increase all 3 amines: NE, 5-HT and DA

Question 3

Phenelzine

Answer 3

Nonselective MAO inhibitor

Question 4

Tranylcypromine

Answer 4

Nonselective MAO inhibitor

Question 5

Food and dru interaction with MAO

Answer 5

Tyramine rich food
Can cause hypertensive crisis when combined with drugs that increase NE
Can cause serotonin crisis when combined with drugs that increase serotonin

Question 6

TCA

Answer 6

2nd line agent for tx of depression
Block NE and 5-HT
Also block H1, a1 and M receptors
Used for resistant depression

Question 7

Blocking of M receptors with TCA causes

Answer 7

Classic anticholinergic activity: cardiotoxicity, convulsions, coma

Question 8

Imipramine

Answer 8

TCA used for enuresis

Question 9

Clomipramine

Answer 9

TCA used for OCD

SSRI is better for OCD though

Question 10

Amitriptyline

Answer 10

TCA used for neuropathic pain and migraine

Question 11

SSRI

Answer 11

First line agent for tx of depression, panic, GAD, bulimia, OCD, PTSD
Fewer autonomic side effects

Question 12

6 SSRI’s

Answer 12

Fluoxetine
Fluvoxamine
Paroxetine
Sertraline
Citalopram
Escitalopram

Question 13

Adverse affects of SSRI

Answer 13

GI upset, anorgasmia, stimulant effect (insomnia, headache, anxiety, agitation), bleeding, weight gain, increased ADH leading to hyponatremia

Question 14

What should you give initially when prescribing an SSRI

Answer 14

Benzodiazepine due to anxiety and agitation

Question 15

Serotonin syndrome

Answer 15

Rigidity, hyperthermia, hypertension, autonomic instability, myoclonus, confusion, coma, death

Question 16

Treat serotonin syndrome with

Answer 16

Benzos, intubation and 5-HT antagonist (Cyproheptadine)

Question 17

SNRI

Answer 17

No autonomic side effects

No H1 blockade

Question 18

Trazadone

Answer 18

Serotonin 2A antagonist and reuptake inhibitors
Also block a1 receptors: cause decreased BP, arrhythmias, and priapism
Can also act as a sedative

Question 19

Mirtazapine

Answer 19

a2 antagonist
Increases NE release
Blocks H1 causing sedation
Associated with weight gain–good for anorexia

Question 20

SSRI used to treat

Answer 20

GAD, PTSD, Depression, OCD

Question 21

SNRI can specifically treat

Answer 21

Pain disorder such as diabetic neuropathic pain or fibromyalgia

Question 22

Withdrawal of SSRI abruptly can cause

Answer 22

Flu like symptoms

Question 23

Side effects of TCAs

Answer 23

anticholinergic, cardiotoxicity, coma, convulsions, weight gain and increased appetite, decreased libido and anorgasmia

Question 24

Selegiline

Answer 24

MAO-B inhibitor causing breakdown of dopamine–can be used for treatment of parkinson’s