Antidepressants / Anxiolytics

Question 1

Best antidepressants

Answer 1

Prozac (fluoxetine)

Question 2

SSRIs

Answer 2

Prozac

Paxil

Celexa

Lexapro

Zoloft

Luvox

Question 3

SNRIs

Answer 3

Effexor

Pristiq

Cymbalta

Savella

Fetzima

Question 4

Tricyclic

Answer 4

Amitriptyline (Elavil)

Imipramine (Tofranil)

Desipramine

Doxepin (Sinequaan)

Question 5

MAOIs

Answer 5

Nardil

Marplan

Parnate

Selegiline (Eldepryl)

Question 6

Serotonin / 5HT Modulators

Answer 6

Trazodone

Vilazodone

Question 7

Atypicals

Answer 7

Wellbutrin (Buproprion)

Remeron (Mirtazapine)

Question 8

Which antidepressants have an increased bleeding risk

Answer 8

SSRI

Prozac
Paxil
Celexa
Lexapro
Zoloft
Luvox

interferes with platelet activation / aggregation

Question 9

Which SSRIs are 2D6 2C9 inhibitors?

Answer 9

Zoloft and Paxil

watch out for Rifampicin and Warfarin

Question 10

SSRI’s and pregnancy

Prozac
Paxil
Celexa
Lexapro
Zoloft
Luvox

Answer 10

Not Great

1st trimester - cardiac defects

3rd trimester - low birth weight, premature, withdrawal

Question 11

SSRI least associated with weight gain

Answer 11

Prozac

Question 12

SSRII general indications

Answer 12

MDD
OCD
PD
Bulimia 
GAD
SAD

Question 13

SSRI with highest risk of drug interactions

Answer 13

Paxil

Question 14

SSRI that is most sedating, most weight gain, most sexual dysfunction

Answer 14

Paxil

Question 15

Which SSRI is also indicated for PTSD, PMDD

Answer 15

Zoloft

Question 16

SSRI with few drug interactions and lowest sexual side effects

Answer 16

Celexa

for dep

Question 17

Limits of using Celexa

Answer 17

Only really indicated for depression, no other psych probe

risk of QT prolongation

Question 18

Which SSRI would be most appropriate for a patient who has depression and CV

Answer 18

Zoloft

Question 19

Which SSRI is indicated also for PD

Answer 19

Zoloft

Prozac

Question 20

Which SSRIs are not indicated for anxiety

Answer 20

Prozac

Celexa

Question 21

SSRI with widest scope of indications

Answer 21

Zoloft

Question 22

SNRI MOA

Effexor
Pristiq
Cymbalta
Savella
Fetzima

Answer 22

Binds 5-HT and NE receptor transporters

Question 23

In addition to depression and anxiety disorders, what can SNRI’s be used for?

Effexor
Pristiq
Cymbalta
Savella
Fetzima

Answer 23

Neuropathic pain, chronic pain
(Cymbalta, Effexor)

Fibromyalgia
(Savella)

Question 24

2 ADRs of SNRIs which are not found in SSRI

Answer 24

Hypertension

Hyperlipidemia

Question 25

SNRI drug interactions ``` Effexor Cymbakta Savella Fetzima Pristiq ```

Answer 25

Platelet inhibitors MAOIs

Question 26

Which SNRIs is a strong 3A4 inhibitor

Answer 26

Levomilnacipram (Fetzima) Watch ``` Benzo's CCB's Macrolides HIV antivirals Statins ```

Question 27

Which SNRIs are strong 2D6 inhibitors

Answer 27

Cymbalta

Question 28

Which SNRI is really only indicated for MDD

Answer 28

Pristiq

Question 29

Effexor used for

Answer 29

PTSD, neuropathic pain, hot flashes

Question 30

Avoid using Cymbalta with these patients

Answer 30

Renal, hepatic impairment

Question 31

Savella is only really indicated for

Answer 31

FIBROMYALGIA

Question 32

MOA of Remeron vs MOA of Wellbutrin

Answer 32

Remeron increase 5HT and NE centrally Wellbutrin is a WEAK NE reuptake inhibitor, does not effect 5HT

Question 33

Indications of Remeron vs Wellbutrin

Answer 33

Remeron - MDD Wellbutrin - MDD and Smoking Cessation

Question 34

Wellbutrin UP ADRs

Answer 34

more UP Anxiety, Insomnia, Psychosis Weight loss Hypertension Dry Mouth

Question 35

Remeron DOWN ADRs

Answer 35

more DOWN Sedation Dizzy Weight gain High cholesterol, High LFTs

Question 36

What even is a Tricyclic ?? Amitriptyline (Elavil) Imipramine (Tofranil) Desipramine Doxepin (Sinequaan)

Answer 36

SNRI with alpha adrenergic block

Question 37

Tricyclic effect on the heart? Amitriptyline (Elavil) Imipramine (Tofranil) Desipramine Doxepin (Sinequaan)

Answer 37

Membrane stabilizing effect - blocks sodium channels anti arrhythmic?

Question 38

In addition to depression, anxiety, ocd, what can tricylic be used for?

Answer 38

Neuropathic pain Migraine Bipolar

Question 39

Tricyclic interactions Amitriptyline (Elavil) Imipramine (Tofranil) Desipramine Doxepin (Sinequaan)

Answer 39

Cimetidine MAOIs, Sympathomimetics, Antocholinergics, SSRIs 2D6

Question 40

Tricyclic ADR Amitryptyline Imipramine Desipramine Doxepin

Answer 40

Anticholinergic Arrhythmia Sexual disfunction Diaphoresis

Question 41

Tricyclics OD risk Amitryptaline Imipramine Desipramine Doxepin

Answer 41

HIGH RISK - 70% mortality, 10 days supply taken at once can be fatal

Question 42

5HT modulators ADRs Trazodone Vilazodone

Answer 42

Sedation, somnolence HA, Dizziness, dry mouth ARRYTHMIA, LONG QT, ORTHOSTASIS

Question 43

Vilazodone indication

Answer 43

Depression

Question 44

Trazodone indication

Answer 44

Depression Low doses for sleep

Question 45

WATCH OUT VILAZODONE IS A

Answer 45

P450 3A4 SUBSTRATE

Question 46

WEIRD VILAZODONE ADR

Answer 46

PRIAPSISM

Question 47

MAOI contraindication

Answer 47

HTN / CV disease Amphetamines, Sympathomimetics CNS depressants (alcohol, narcotics) Antihypertensive, Diuretic, Antihistaminic, Sedative, Anesthetic drugs Buproprion, Dextromethorphan CHEESE

Question 48

APA guidelines for treating depression 1st line

Answer 48

1st line: SSRI, SNRI, | Buproprion (Wellbutrin) Mirtazepine (Remeron)

Question 49

1st line for GAD

Answer 49

Paxil Lexapro Effexor Cymbalta

Question 50

2nd line for GAD

Answer 50

Buspirone - partial agonist of 5HT receptors - no dependency - no sedation - slow onset - not effective for depression ADRs - dizzy, HA, nausea

Question 51

1st line OCD

Answer 51

SSRIs ``` Prozac Paxil Celexa Lexapro Zoloft ```

Question 52

1st line for SAD

Answer 52

Effexor ``` SSRIs Prozac Paxil Celexa Lexapro Zoloft ```

Question 53

1st line for PTSD

Answer 53

Prozac Zoloft Effector