Depression

Question 1

What are the 5 main drugs used to treat depression?

Answer 1

Sertraline
Citalopram
Fluoxetine
Venlafaxine
Mirtazapine

Question 2

What is the drug mechanism for Sertraline, Fluoxetine and Citalopram?

Answer 2

Selective Serotonin Reuptake Transporter Inhibitors, stops 5-HHT from reuptaking serotonin at the presynaptic neuron allowing for more serotonin to induce a therapeutic effect

Question 3

What is the drug mechanism for venlafaxine?

Answer 3

SSRI and noradrenaline transporter inhibitor

Question 4

What is the action mechanism of mirtazapine?

Answer 4

Antagonises the following: Alpha 2 receptor, H1 receptor, 5HT2 receptor and 5HT3 receptor
However when concerned with anti depressive effects, antagonising alpha 2 receptors increases the release of serotonin and noradrenaline and antagonising 5HT2 receptors leaves 5HT1 receptors unopposed causing anti depressive effects

Question 5

What are the side effects of Sertraline, Citalopram, fluoxetine and venlafaxine?

Answer 5

GI effects- nausea, diarrhoea
Sexual Dysfunction
Anxiety
Insomnia
Venlafaxine can give hypertension

Question 6

Can you take erythromycin and Citalopram together?

Answer 6

No as they both elongate the QT interval

Question 7

Why does increasing SSRIs past a point no longer have a therapeutic effect?

Answer 7

There are no more 5HTTs to inhibit

Question 8

Why do you need to slowly wean someone off Sertraline before beginning a new drug?

Answer 8

Serotonin syndrome
Withdrawal symptoms
Drug interactions

Question 9

What does low dose mirtazapine and high dose mirtazapine do?

Answer 9

Low dose: sedative effect- histamine receptor
Mid dose: anti-depressant effect- alpha-2 and 5HT2 receptor
High dose: anti-emetic effect- 5HT3 receptor

Question 10

What are the side effects of mirtazapine?

Answer 10

Weight gain
Sedation