Depression - Core Drugs

Question 1

List core drugs for depression.

Answer 1

Sertraline
Citalopram
Fluoxetine
Venlafaxine
Mirtazapine

Question 2

What is the primary mechanism of action of sertraline?

Answer 2

Inhibition of serotonin reuptake results in an accumulation of serotonin

Question 3

What is the drug target of sertraline?

Answer 3

serotonin transporter

Question 4

What are the side effects of sertraline?

Answer 4

GI effects (nausea, diarrhoea), sexual dysfunction, anxiety, insomnia

Question 5

At high doses, sertraline causes partial inhibition of?

Answer 5

CYP2D6

Question 6

Sertraline has mild inhibitory effects on what transporter?

Answer 6

dopamine

Question 7

On discontinuation of sertraline, what must happen?

Answer 7

must be gradually decreased

Question 8

What is the drug target of citalopram?

Answer 8

serotonin transporter

Question 9

Outline the drug action of citalopram.

Answer 9

Inhibition of serotonin reuptake results in an accumulation of serotonin

Question 10

What are the main side effects of citalopram?

Answer 10

GI effects (nausea, diarrhoea), sexual dysfunction, anxiety, insomnia

Question 11

Citalopram causes mild antagonism of what receptors?

Answer 11

muscarinic and histamine (H1)

Question 12

On discontinuation of Citalopram, what must happen?

Answer 12

must be gradually decreased

Question 13

Citalopram is metabolised by?

Answer 13

CYP2C19

Question 14

What is the drug target

of Fluoxetine?

Answer 14

serotonin transporter

Question 15

Outline the mechanism of action for Fluoxetine.

Answer 15

Inhibition of serotonin reuptake results in an accumulation of serotonin

Question 16

What are the main side effects of fluoxetine?

Answer 16

GI effects (nausea, diarrhoea), sexual dysfunction, anxiety, insomnia

Question 17

Fluoxetine causes mild antagonism of what receptors?

Answer 17

5HT2A

5HT2C

Question 18

Fluoxetine causes complete inhibition of what receptor?

Answer 18

CYP2D6

Question 19

Fluoxetine causes significant inhibition of what receptor?

Answer 19

CYP2C19

Question 20

What are the drug targets of Venlafaxine?

Answer 20

serotonin transporter

noradrenaline transporter

Question 21

Outline the mechanism of action of venlafaxine.

Answer 21

Venlafaxine is a more potent inhibitor of serotonin reuptake than norepinephrine reuptake

Question 22

What are the main side effects of venlafaxine?

Answer 22

GI effects (nausea, diarrhoea), sexual dysfunction, anxiety, insomnia, hypertension (at higher doses)

Question 23

On discontinuation of venlafaxine, what must happen?

Answer 23

Must be gradually decreased

Question 24

What is the drug target of Mirtazapine?

Answer 24

Alpha-2 receptor

5-HT2 receptor

Question 25

Outline the mechanism of action of Mirtazapine on alpha 2 receptors.

Answer 25

Antagonises central presynaptic alpha-2-adrenergic receptors, which causes an increased release of serotonin and norepinephrine

Question 26

Outline the mechanism of action of Mirtazapine on 5HT2 receptors.

Answer 26

Antagonises central 5HT2 receptors, which leaves 5HT1 receptors unopposed causing anti-depressant effects.

Question 27

What are the main side effects of Mirtazapine?

Answer 27

weight gain

sedation

Question 28

Use of Mirtazapine has a low probability of causing?

Answer 28

sexual dysfunction

Question 29

Use of Mirtazapine may exacerbate?

Answer 29

REM sleep behaviour disorder