B7-069 Drugs for Mood Disorders

Question 1

depression is treated with

Answer 1

antidepressants

Question 2

periods of mania or hypomania alternating with periods of depression or euthymia

Answer 2

bipolar disorder

Question 3

bipolar disorder is treated with

Answer 3

mood stabilizing agents

Question 4

the mechanism of all […] involves increasing synaptic availability of NE and/or serotonin

Answer 4

antidepressants

Question 5

antidepressants requires […] of treatment before maximal effects are achieved

Answer 5

several weeks

(delayed effect of antipsychotics is much longer)

Question 6

ultimate effect of antidepressants may be related to [3]

Answer 6

secondary changes in receptors
increases in brain derived neurotrophic factor
cognitive changes

Question 7

MOA of MAOIs

Answer 7

irreversibly inhibit MAO-a (NE and 5-HT) and MAO-b (DA)

Question 8

MAOIs [2]

Answer 8

phenelzine
tranycypromine

Question 9

side effects of MAOIs [3]

Answer 9

postural hypotension
weight gain
sexual dysfunction

(due to effects at many receptors, not used often anymore)

Question 10

taking MAOIs in conjunction with tyramine-containing foods can cause

Answer 10

hypertensive crisis

Question 11

MAOIs have numerous drug interactions that can lead to potentially fatal […] if administered with other drugs that increase 5-HT availability

Answer 11

serotonin syndrome

Question 12

tremor, muscle rigidity, hyperthermia, hypertension, tachycardia, myoclonus are symptoms of […]

Answer 12

serotonin syndrome

HAHA= Hyperthermia, Autonomic dysfunction, Hyperreflexia, Altered mental status

serotonin syndrome is no joke, HAHA

Question 13

wait […] after stopping MAOIs before starting serotonergic drugs or stopping dietary restrictions

Answer 13

two weeks

Question 14

-iptyline
-ipramine

are what class?

Answer 14

tricyclic antidepressants

Question 15

tricyclic antidepressants she said to know [3]

Answer 15

amitriptyline
nortriptyline
clomipramine (newer)

Question 16

inhibit the reuptake of NE or serotonin at the NE and 5-HT transporters

Answer 16

TCAs

Question 17

potent antagonists at cholinergic, histaminergic, and a-adrenergic receptors

Answer 17

TCAs

Question 18

minor side effects of TCAs [4]

Answer 18

anticholinergic effects (dry mouth, constipation, dementia, blurry vision)
orthostatic hypotension
weight gain
sexual dysfunction

Question 19

present a major suicide risk

Answer 19

TCAs

Question 20

overdose/interactions of TCAs [4]

Answer 20

Coma
Arrhythmias
Seizures
Cardiac Effects

Tri-CyCliCs (3 Cs): Convulsions, Coma, Cardiotoxicity

Question 21

-etine
-prams

what class are these?

Answer 21

Selective Serotonin Reuptake Inhibitors (SSRIs)

Question 22

SSRIs she said to know [5]

Answer 22

fluoxetine
sertraline
paroxetine
citalopram
escitalopram

Question 23

inhibit 5-HT reuptake

Answer 23

SSRIs

Question 24

minor side effects of SSRIs [3]

Answer 24

GI symptoms
decrease libido
sexual dysfunction

Question 25

what SSRI is particularly known to cause GI effects?

Answer 25

fluoxetine

Question 26

SSRIs that are CYP2D6 inhibitors [2]

Answer 26

fluoxetine paroxetine

Question 27

SSRI with active metabolites and have really long half life

Answer 27

fluoxetine

Question 28

5-HT and NE uptake inhibitors

Answer 28

SNRIs

Question 29

SNRIs she said to know [3]

Answer 29

duloxetine venlafaxine milnacipran

Question 30

NRI (NE uptake inhibitor) [1]

Answer 30

maprotiline

Question 31

increases 5-HT and NE release by blocking a-2 receptors on nerve terminals

Answer 31

mirtazapine (mirtAzApine = 2 a-s, a2 receptors)

Question 32

inhibits dopamine reuptake

Answer 32

bupropion

Question 33

what atypical antipsychotic has a lower incidence of sexual dysfunction compared to SSRIs?

Answer 33

bupropion

Question 34

sedating at sub-antidepressant doses primarily used hypnotic and pre-anesthetic

Answer 34

trazodone

Question 35

can cause priapism

Answer 35

trazodone

Question 36

dopamine antagonist causes EPS and tardive dyskinesia

Answer 36

amoxapine | TCA

Question 37

non-competitive NMDA receptor antagonist

Answer 37

esketamine

Question 38

nasal spray used for treatment-resistant depression

Answer 38

esketamine

Question 39

neuroactive steroid GABA-a receptor positive modulator but mechanism not fully understood

Answer 39

brexanolone

Question 40

approved for postpartum depression

Answer 40

brexanolone

Question 41

antidepressants increase the risk of suicidal thinking and behavior in [...]

Answer 41

children

Question 42

what classes can be used to treat generalized anxiety and panic disorder? [3]

Answer 42

SSRIs TCAs MAOIs

Question 43

can be used to treat OCD [2]

Answer 43

SSRIs clomipramine (TCA)

Question 44

mood stabilizers to prevent mood swings in bipolar disorder [4]

Answer 44

lithium carbonate valproic acid carbamazepine lamotrigine

Question 45

may affect the arachidonic acid signaling

Answer 45

lithium

Question 46

therapeutic levels of lithium are reached in [...] days

Answer 46

6-10 days

Question 47

more than [...]% of lithium is excreted in urine

Answer 47

95%

Question 48

side effects of lithium [3]

Answer 48

tremor acne polydipsia/polyuria (DI)

Question 49

is lithium safe in pregnancy?

Answer 49

no-cardiac abnormalities

Question 50

antidepressant most likely to cause arrhythmias

Answer 50

amitriptyline

Question 51

inhibits dopamine uptake and has notable side effects including anxiety, agitation, and increased risk of seizures

Answer 51

bupropion

Question 52

newest TCA with much improved side effect profile

Answer 52

clomipramine

Question 53

inhibits the reuptake of both serotonin and NE does not have a TCA structure low risk of fatal overdose

Answer 53

duloxetine | SNRI

Question 54

the tyramine in certain wines and cheeses can cause sympathetic crisis if consumed with

Answer 54

MAOIs

Question 55

taking SSRIs with [...] can greatly increase the risk of serotonin syndrome

Answer 55

MAOIs

Question 56

antidepressants safe for older people with orthostatic hypotension

Answer 56

SSRI

Question 57

common adverse effects of lithium

Answer 57

nausea/vomiting polydipsia tremor acne

Question 58

anticonvulsants that are also effective mood stabilizers in bipolar disorder [2]

Answer 58

carbamazepine valproic acid

Question 59

antipsychotic used in the treatment of acute mania

Answer 59

haloperidol

Question 60

is lithium a teratogen?

Answer 60

yes