Depression

Question 1

Depression Drugs

Answer 1

SSRI
SNRI
Aminoketones (bupropion)
Tetracyclics (mirtazapine) 
Triazolopyridines (trazodone & nefazodone) 
Tricyclic (TCAs) 
Monoamine Oxidase Inhibitors  (MAOIs)

Question 2

SSRI Contraindications

Answer 2

Use of a MAOI or use of a MAOI within 14 days.

Must have 2 week washout for most SSRIs, 5 week washout for fluoxetine

Question 3

SSRI Uses

Answer 3

Major Depression Disorder (MDD)
Obsessive Compulsive Disorder (OCD)
Panic Disorder (PD)
Generalized Anxiety Disorder (GAD)
Social Anxiety Disorder (SAD)
Eating disorders
Premenstrual Dysphoric Disorder (PMDD)

Question 4

Antidepressant DOC

Answer 4

SSRI’s

• citalopram (MDD Only)
• escitalopram
• paroxetine
• fluoxetine
• sertraline
• fluoxamine (OCD Only)

Question 5

Only SSRI not indicated for MDD

Answer 5

fluoxamine

Question 6

SSRI indicated only for OCD

Answer 6

fluoxamine

Question 7

SSRI indicated only for MDD

Answer 7

citalopram

Question 8

SSRI Pearls

Answer 8

-Counsel on GI dist (n/v/d) and 
 CNS side effects 
    (anxiety, headache, insomnia, sedation)
-Counsel about sexual dysfx
-Safer in overdose than TCAs
-Variable response to different SSRIs
-Start low and go slow
-Can impair platelet aggregation, fall risk
-Can cause SIADH

Question 9

Drug that does not have serotonin component

Answer 9

bupropion

Question 10

Good adjunctive therapy for depression if anxiety is not present

Answer 10

bupropion

Question 11

Options for depressed pt with sexual dysfxn

Answer 11

bupropion

trazodone

Question 12

Pt w/depression has not been sleeping and has sexual dysfxn should be given

Answer 12

trazodone (most commonly used for sleep)

Question 13

Antidepressants should not be used concurrently with

Answer 13

MAOIs, linezolid, methylene blue, other serotonin drugs

Question 14

Drug that increases trazodone concentrations

Answer 14

fluoxetine (can be a good thing - requires lower dose of trazodone)

Question 15

High vs low doses of trazadone

Answer 15

low - hypnotic

high - depression

Question 16

SSRI that causes QTc prolongation

Answer 16

citalopram

escitalopram

Question 17

great antidepressant for noncompliant pts

Answer 17

fluoxetine (Prozac)

-most activating SSRI

Question 18

SSRI that causes diarrhea

Answer 18

sertraline (Zoloft)

Question 19

PC for starting MAOI after SSRI or SNRI

Answer 19

Wait at least 2 wks (flush-out)

- 5 wks for fluoxetine

Question 20

Bupropion indications

Answer 20

MDD
Smoking cessation
SAD (social anxiety disorder)

Question 21

DSM-V criteria for depression

Answer 21

must have 5 and at least one of:

• depressed mood or
• loss of interest or pleasure

Question 22

Bupropion contraindications

Answer 22

seizures
eating disorder
electrolyte imbalance

Question 23

Bupropion metabolism

Answer 23

2D6

• tamoxifen
• ritonavir

Question 24

SNRI common ADE’s

Answer 24

GI complaints

Sexual dysfxn

Question 25

Bupropion has not been shown to be effective in

Answer 25

Anxiety disorders

Question 26

Bupropion dosing frequency

Answer 26

XL - QD
SR - BID
IR - TID

Question 27

Bupropion often prescribed in pts who experience:

Answer 27

sexual dysfxn with SSRIs

Question 28

Why do you need to titrate dosing for bupropion?

Answer 28

Prevent risk of seizures

Question 29

Antidepressant that has ADE of priapism

Answer 29

Trazodone

Question 30

Trazodone contraindications

Answer 30

MAOIs, methylene blue, linezolid

Question 31

MAOIs block

Answer 31

Tyramine degradation

Question 32

Serotonin Syndrome Triad

Answer 32

Mental Status Change
Autonomic Hyperactivity
Neuromuscular Abnormalities

Question 33

Antidepressants given with pt experiencing weight loss

Answer 33

Sertraline
Venlafaxine
Mirtazapine

Question 34

MAOI ADE’s

Answer 34

orthostatic hypotension
wt. gain
sexual dysfxn

Question 35

TCA contraindications

Answer 35

Pregnancy
QTc greater than 450 msec
MAOI w/in 14 days
Glaucoma

Question 36

Antidepressant with no GI ADE’s and good for elderly pt with wt. loss

Answer 36

mirtazapine