Antidepressants and Mood Stabilizers

Question 1

what are the 3 phases of Tx in mood disoreders

Answer 1

• Acute (0-3 months); ~50% may stop treatment
• Continuation (4-9 months); 65-75% may stop treatment
• Maintenance (years)

Question 2

ALL current treatments for depression have a _______ week delay before achieving antidepressant effect

Answer 2

4-16

Question 3

________ is the only approved treatment for depression that produces more rapid response than meds

Answer 3

Electroconvulsive Therapy (ECT)

Question 4

Overall response rate (decrease in symptoms by 50%) to antidepressants in the first 8 weeks of treatment is approximately ______

Answer 4

67%.

Question 5

Antidepressants are generally divided into 5 broad categories: _____

Answer 5

Selective serotonin reuptake inhibitors (SSRIs), Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs), Tricyclic antidepressants (TCAs),
Monoamine Oxidase Inhibitors (MAOIs)
Other (mixed actions)

Question 6

Mirtazapine (other category): blocks which receptors

Answer 6

5-HT2A,
5-HT2C,
5-HT3,
a-2-adrenergic

Question 7

Buproprion (other) increases whole-body ____, and weakly blocks reuptake of _______

Answer 7

NE,

DA

Question 8

Trazodone and nefazodone: most potent action is blockade of post-synaptic ________. Block reuptake of _____& ________.

Answer 8

5-HT2,

5-HT and NE

Question 9

MAOIs: irreversibly inhibit MAO-A and MAO-B, increasing levels of _________

Answer 9

5-HT and NE

Question 10

Vilazodone, a new antidepressant, it is an ______+ 5HT1A partial agonist

Answer 10

SSRI

Question 11

what are the side effects of Tricyclics

Answer 11

Hypotension, 
orthostasis, 
anticholinergic side effects, 
weight gain, 
sexual side effects, 
dangerous in overdose

Question 12

what are the side effects of SSRI’s

Answer 12

Diarrhea, 
nausea, 
jitteriness/anxiety, 
sexual side effects, 
drug interactions: P450 inhibition

Question 13

which class of drugs can give you withdrawal syndrome (flu-like, “electric shocks”)

Answer 13

SNRIs

Question 14

which drug has a higher seizure risk (contraindicated in eating disorder patients and those with seizure disorder)

Answer 14

Bupropion

Question 15

which drug has No sexual side effects, weight neutral

Answer 15

Bupropion

Question 16

_________continues to be the most effective treatment we have for treating depression, though it is expensive, causes memory loss, and still has a strong stigma associated with it that limits its use

Answer 16

Electroconvulsive Therapy (ECT)

Question 17

what is the most effective anti-manic drug

Answer 17

Lithium

Question 18

drugs for Prevention of Future Episodes in bipolar disorder

Answer 18

Lithium has best established evidence.
Lithium + divalproex is also good preventative combination, though higher side effect burden

Other: aripiprazole, olanzapine, lamotrigine

Question 19

Treatment of bipolar disorder is more complex than treatment of unipolar depression. Different phases of the illness must be considered and medications selected appropriately. An ideal drug would be ______

Answer 19

anti-manic, anti-depressive and prevent future episodes

Question 20

what are the major drawbacks of lithium

Answer 20

narrow therapeutic window (0.6-1.2 mEq/l),
toxic/lethal in overdose,
Can cause diabetes insipidus,
hypothyroidism can develop 5-10%.

Question 21

Divalproex Sodium is a proven anti-manic but is not

a proven _________

Answer 21

preventative agent (mood stabilizer)

Question 22

which drug class can show an Increased diastolic blood pressure

Answer 22

SNRIs

Question 23

which antidepressant drug is good for insomnia, has rapid anti-anxiety effect and Low incidence of sexual side effects ?

Answer 23

Mirtazapine