depression 1

Question 1

what black box warning is on all anti-derpressants

Answer 1

increase risk of suicidal ideation (due to increase of energy)

Question 2

what are the monoamines

Answer 2

serotonin
dopamine
norepinephrine

Question 3

what are 3 forms of non-pharm therapy for depression

Answer 3

1. psychotherapy
2. ECT
3. bright light therapy

Question 4

what are the contraindications for use of SSRIs

Answer 4

1. use of an MAOI or use of MAOI within 14 days
2. 5 week washout for fluoxetine
3. concurrent use with linezolid or IV methylene blue

Question 5

why are SSRI’s first line for depression

Answer 5

safety and tolerability

Question 6

what are some side effects of SSRI’s

Answer 6

sexual dysfunction, nausea, and vomiting

Question 7

what SSRI’s have the largest risk for QTc prolongation risk

Answer 7

1. citalopram
2. escitalopram
3. paroxetine

Question 8

what SSRI is a pregnancy category D drug

Answer 8

paroxetine

Question 9

list 3 CYP 2D6 inhibiting SSRI’s

Answer 9

1. paroxetine
2. fluoxetine
3. sertraline

Question 10

what is an SSRI with a major side effect of diarrhea

Answer 10

sertraline (Zoloft)

Question 11

what SSRI is indicated primarily for OCD disorder (not MDD)

Answer 11

fluvoxamine (Luvox)

Question 12

what should be counseled for all SSRI’s

Answer 12

1. GI distrubances (n/v/d)
2. CNS effects (anxiety, headache, insomnia, depression)
3. sexual dysfunction

Question 13

What SNRI side effect is not seen in SSRIs

Answer 13

dose dependent increase in blood pressure

Question 14

doses of venlafaxine greater than 150 mg have what effect

Answer 14

blocks norepinephrine causing hypertension

Question 15

True/ False:

desvenlafaxine shows no benefit over venlafaxine

Answer 15

True

Question 16

what SNRIs are indicated for fibromyalgia

Answer 16

duloxetine

milnacipran

Question 17

why should SNRI’s not be d/c’d abruptly

Answer 17

withdrawal syndrome of flu like symptoms

Question 18

what are the indications of bupropion

Answer 18

1. MDD (first line)
2. social anxiety disorder
3. smoking cessation

Question 19

what is the MOA of bupropion

Answer 19

metabolite that acts as a norepinephrine and dopamine reuptake inhibitor

Question 20

what antidepressant can not cause serotonin syndrome

Answer 20

bupropion (no effect on serotonin)

Question 21

what are the contraindications of bupropion

Answer 21

1. history of seizures
2. eating disorder
3. electrolyte imbalance

Question 22

who should use caution when using bupropion

Answer 22

alcoholics, and patients with a history of mania or psychosis

Question 23

what are the adverse effects of bupropion

Answer 23

1. seizure
2. dry mouth
3. constipation
4. weight loss