depression

Question 1

What is the primary mechanism of action of sertraline?

Answer 1

• Inhibition of serotonin reuptake results in serotonin accumulation
• Serotonin affects mood, personality and wakefulness

Question 2

What is the drug target of sertraline?

Answer 2

Serotonin transporter

Question 3

What is the main side effect of sertraline?

Answer 3

• GI effects (nausea, diarrhoea)
• Sexual dysfunction
• Anxiety
• Insomnia

Question 4

How does sertraline affect dopamine?

Answer 4

Mild inhibition of dopamine transporter

Question 5

What must be considered when discontinuing sertraline?

Answer 5

Must be gradually decreased

Question 6

What is the primary mechanism of action of citalopram?

Answer 6

Inhibition of serotonin reuptake results in accumulation of serotonin

Question 7

What is the drug target of citalopram?

Answer 7

Serotonin transporter

Question 8

What are the main side effects of citalopram?

Answer 8

• GI effects (nausea, diarrhoea)
• Sexual dysfunction
• Anxiety
• Insomnia
• QT prolongation

Question 9

What else can citalopram act as?

Answer 9

Mild antagonist of muscarinic and histamine (H1) receptors

Question 10

What must be considered when discontinuing citalopram?

Answer 10

Must be gradually decreased

Question 11

What is citalopram metabolised by?

Answer 11

CYP2C19

Question 12

What is the primary mechanism of action of fluoxetine?

Answer 12

Inhibition of serotonin reuptake results in serotonin accumulation

Question 13

What is the drug target of fluoxetine?

Answer 13

Serotonin transporter

Question 14

What are the ain side effects of fluoxetine?

Answer 14

• GI effects (nausea, diarrhoea)
• Sexual dysfunction
• Anxiety
• Insomnia

Question 15

What else does fluoxetine act as?

Answer 15

• Mild antagonist of 5HT2A and 5HT2C receptors
• Complete inhibition of CYP2D6 and significant inhibition of CYP2C19 (caution with warfarin)

Question 16

What is the primary mechanism of action of venlafaxine?

Answer 16

• More potent inhibitor of serotonin reuptake than noradrenaline reuptake
• Noradrenaline is involved in regulation of emotion and cognition

Question 17

What are the drug targets of venlafaxine?

Answer 17

• Serotonin transporter
• Noradrenaline transporter

Question 18

What are the main side effects of venlafaxine?

Answer 18

• GI effects (nausea, diarrhoea)
• Sexual dysfunction
• Anxiety
• Insomnia
• Hypertension (at higher doses)

Question 19

What must be considered when discontinuing venlafaxine?

Answer 19

Must be gradually decreased

Question 20

What is the primary mechanism of action of mirtazapine?

Answer 20

• Antagonises central presynaptic alpha-2-adrenergic receptors
  
  • Causes an increased release of serotonin and noradrenaline
• Antagonises central 5HT2 receptors, leaving 5HT1 receptors unopposed causing anti-depressant effects

Question 21

What are the drug targets of mirtazapine?

Answer 21

• Alpha-2 receptor
• 5HT2 receptor

Question 22

What are the main side effects of mirtazapine?

Answer 22

• Weight gain
• Sedation

Question 23

What less common side effects are there of mirtazapine?

Answer 23

• Low probability of sexual dysfunction
• May exacerbate REM sleep behaviour disorder