Antidepressants and Mood Stabilizers -Schneck

Question 1

SSRI

Answer 1

block 5HT pre synaptic reuptake pumps

Question 2

SNRI

Answer 2

block NE and 5HT reuptake pumps

Question 3

Mirtazapine

Answer 3

block 5HT2A, 5HT2C, 5HT3 and alpha 2 adrenergic receptors

Question 4

buproprion

Answer 4

increases whole body NE

weakly blocks repute of DA

Question 5

Trazadone and Nefazodone

Answer 5

potent blockade postsynaptic 5HT2

block repute of 5HT and NE

Question 6

tricyclics

Answer 6

block reuptake 5HT, and NE (and a little bit for DA)

block H1, muscarinic cholinergic receptors, and alpha 1

Question 7

MAOIs

Answer 7

irreversably inhibit MAO-A and MAO-B

increase levels of 5HT and NE

Question 8

Vilazodone (SSRI)

Answer 8

SSRI

5HT1A partial agonist

Question 9

TCA SE

Answer 9

dangerous in overdose (10 day supply)

anticholinergic SE

Hypotension, orthostasis
weight gain, sexual

Question 10

MAOI SE

Answer 10

Hypertensive Crisis- Tyramine RXN

dry mouth
constipation, urinary retention

hypotension, orthostasis
weight gain, sexual

Question 11

SSRI SE

Answer 11

Sexual, P450 Inhibition

diarrhea, nausea
jitteriness/anxiety

Question 12

SNRIs

Answer 12

withdrawal syndrome (flu like with electric shocks)

sweating
increased diastolic BP
Sexual

Question 13

Buproprion SE

Answer 13

Seizure risk (contraindicated in eating disorder and seizure disorder pts)

Increased anxiety, jitteriness, insomnia

Does not work in panic disorder
NO: Sexual, Weight, Activating

Question 14

Mirtazapine SE

Answer 14

Weight gain
daytime somnolence

helpful with insomnia, rapid anti-anxiety
low sexual se

Question 15

Primary ME of VNS, DBS, TMS in mood disorders

Answer 15

alter monoamines

efficacy and cost/benefit ratio unclear

Question 16

Divalproex Sodium

Answer 16

rapid loading

not proven as preventative agent

weight gain, sedation, not effective in bipolar depression

Question 17

2 FDA approved treatments for bipolar depression

Answer 17

quetiapine

olanzapine+fluoxetine

Question 18

Lithium

Answer 18

best studies, best proven

minuses: narrow therapeutic window, diabetes insidious, hypothyroidism

tremor, nausea, diarrhea, taste, thirst, cognitive dulling, renal, decreased urine concentration

Question 19

atypical antipsychotics

Answer 19

all anti manic

weight gain, risk of metabolic effects/ diabetes, risk of increased cholesterol/ lipids, expensive

Question 20

antidepressants for bipolar depressants

Answer 20

not proven, sometimes make worse

Question 21

best treatments for bipolar depression in descending order

Answer 21

quetiapine
lamotrigine
olanzapine/fluoxetine
lithium

Question 22

prevention of future episodes

Answer 22

lithium
lithium+divalproex (higher SE burden_

aripiprazole
olanzapine
lamotrigine