Depression Case

Question 1

t/f: antidepressants are habit forming

Answer 1

f!

Question 2

SSRI’s affect what NT in the brain

Answer 2

serotonin

Question 3

SNRI’s affect what 2 hormones/NT in the brain

Answer 3

serotonin
NE

Question 4

2 first line meds for dpn

Answer 4

SSRI
SNRI

Question 5

name 5 SSRIs

Answer 5

citalopram (celexa)
escitalopram (lexapro)
fluoxetine (prozac)
paroxetine (paxil)
sertraline (zoloft)

Question 6

name 3 SNRI’s

Answer 6

desvenlafaxine (pristiq)
duloxetine (cymbalta)
venlafaxine (effexor)

Question 7

TCA’s are useful for what type of depression

Answer 7

melancholic (profoundly sad)

Question 8

which 2 antidepressants carries a risk of lethal overdose

Answer 8

TCA
MAOI

Question 9

name 1 TCA

Answer 9

amitriptyline (Elavil)

Question 10

name 1 tetracyclic antidepressant

Answer 10

buproprion (wellbutrin)

Question 11

name 2 MAOI’s

Answer 11

isocarbozid (marplan)
penelzine (nardil)

Question 12

what 2 antidepressants can be helpful for concurrent insomnia/anxiety

Answer 12

mirtazapine (remeron)
penelzine (desyrel)

Question 13

what 2 antidepressants can be helpful for resistant depression

Answer 13

aripiprazole (abilify)
quetiapine (seroquel)

Question 14

6 clinical uses of antidepressants

Answer 14

depression
anxiety
chronic pain
premenstrual dysphoric disorder (PMDD)
smoking cessation
eating disorders

Question 15

which antidepressants are associated with deadly withdrawal

Answer 15

tick question - none!

Question 16

adverse effects of SSRI’s (6)

Answer 16

serotonic activity ->
nausea
GI upset
diarrhea
diminished sexual fxn
HA
weight gain

Question 17

2 symptoms of SSRI discontinuation syndrome

Answer 17

dizzy
paresthesias

Question 18

s.e of SNRIs

Answer 18

serotenergic effects

PLUS

noradrenergic effects:
increased BP and HR
insomnia, anxiety, agitation

Question 19

s.e of TCAs (5)

Answer 19

anticholinergic ->
dry mouth
constipation
urinary retention
blurred vision
confusion

Question 20

sx of TCA discontinuation syndrome

Answer 20

cholinergic rebound
flu like sx

Question 21

what antidepressant has the highest rates of sexual effects

Answer 21

MAOIs

Question 22

besides sexual effects, 2 other s.e of MAOI’s

Answer 22

orthostatic hypotn
weight gain

Question 23

very last line antidepressant that should only be used as a refractory option

Answer 23

MAOIs

Question 24

mc method of suicide attempts

Answer 24

drug overdose
esp TCAs

Question 25

how to manage GI s.e of antidepressants

Answer 25

take after meals

Question 26

how do you manage sedation s.e of antidepressants

Answer 26

take at HS

Question 27

least sedating antidepressant

Answer 27

SSRIs

Question 28

least sedating SSRI

Answer 28

prozac

Question 29

3 sedating antidepressants

Answer 29

remeron
celexa
effexor

Question 30

how to manage agitation s.e of antidepressants

Answer 30

switch to more sedating antidepressant

Question 31

2 antidepressants with least sexual side effects

Answer 31

wellbutrin
remeron
(also consider PDE-5)

Question 32

antidepressants that are good for anxiety/panic

Answer 32

paxil
remeron
effexor
TCAs

avoid benzos

Question 33

2 methods to manage orthostatic hypotn s.e of antidepressants

Answer 33

hydration
education on movement

Question 34

you should taper antidepressants over __ weeks

Answer 34

4
slower if symptomatic

Question 35

2 OTC options for depression

Answer 35

st. john’s wort
SAMe

Question 36

t/f: st john’s wort can be taken with a serotenergic agent

Answer 36

f!