Antidepressants and Mood Stabilisers

Question 1

1. What does SSRI stand for?
2. Give 5 examples
3. What are the most common adverse effects?
4. What adverse effect may occur in adolescents in particular?
5. What adverse effect may occur in the elderly in particular?
6. What is the danger of rapid stoppage of these medications?

Answer 1

1. Selective Serotonin Reuptake Inhibitor
2. Citalopram, Fluoxetine, Escitalopram, Paroxetine, Sertraline
3. Nausea/vomiting/headache/diarrhoea
4. Suicidal ideation
5. Hyponatraemia
6. Discontinuation syndrome

Question 2

1. Name four Tricyclic antidepressants
2. How do TCAs act?
3. Identify 5 symptoms of ‘Anticholinergic syndrome’ which can be side effects of TCAs

Answer 2

1. Amitriptyline, nortriptyline, imipramine, dosulepin
2. Potentiate the action of noradrenaline and serotonin by inhibiting their reuptake into nerve terminals
3. Dry mouth/constipation/blurred vision/ urinary retention/tremor

Question 3

What are antidepressants designed to do?

Answer 3

Cause an acute increase in monoamine activity thus elevating mood over time.

Question 4

What are antidepressants designed to do?

Answer 4

Cause an acute increase in monoamine activity thus elevating mood over time.

Question 5

1. What does MAOI stand for?
2. name one irreversible MAOI and one reversible
3. Describe their mode of action
4. What is their most significant side effect?

Answer 5

1. Monoamine Oxidase Inhibitor
2. Phenelzine and Moclobemide
3. Inhibit the intracellular enzymes monoamine oxidase A and B, leading to an increase in Serotonin, dopamine and noradrenaline in the brain.
4. Hypertensive reaction with foods containing dopamine/Tyramine e.g. cheese.

Question 6

1. What does SNRI stand for?
2. Name two examples and their most common side effect.
3. What is their mode of action?

Answer 6

1. Serotonin and Noradrenaline Reuptake Inhibitors.
2. Duloxetine and Venlafaxine, Nausea
3. Block reuptake of monoamines at presynaptic terminals

Question 7

1. What is Lithium used for?
2. Identify two considerations with the monitoring of lithium.
3. Under what two circumstances is lithium toxicity more likely?

Answer 7

1. Mood stabilising in people with mania and depression.
2. Monitored weekly, blood taken 12 hours after dose and should be within therapeutic range (0.5mmol-1.0mmol)
3. Dehydration and with NSAIDs/Diuretics

Question 8

1. Identify the three main drugs or drug types used to treat manic episodes

Answer 8

1. Atypical antipsychotics, Lithium or Valproic acid.