Last 2 week mental health medications on Final exam

Question 1

Class: Selective serotonin reuptake inhibitor (SSRI).
Indications:

Major depressive disorder (MDD).
Generalized anxiety disorder (GAD).
Obsessive-compulsive disorder (OCD).
Panic disorder, social anxiety disorder, and post-traumatic stress disorder (PTSD).

Mechanism of Action:

Inhibits the reuptake of serotonin (5-HT) in the brain, increasing serotonin levels in the synaptic cleft and improving mood and anxiety symptoms.

Side Effects:

Common: Nausea, diarrhea, insomnia, sexual dysfunction (e.g., reduced libido, delayed orgasm), and headache.
Serious: Increased risk of suicidal thoughts in young adults, serotonin syndrome (when combined with other serotonergic agents), and withdrawal symptoms if abruptly discontinued.

Answer 1

Sertraline (Zoloft)

Question 2

Class: Norepinephrine-dopamine reuptake inhibitor (NDRI).
Indications:

Major depressive disorder (MDD).
Seasonal affective disorder (SAD).
Smoking cessation (as Zyban®).

Mechanism of Action:

Inhibits the reuptake of norepinephrine and dopamine, enhancing neurotransmission in areas of the brain associated with mood and reward.

Side Effects:

Common: Insomnia, dry mouth, weight loss, and headache.
Serious: Seizure risk (especially at high doses), contraindicated in individuals with a history of seizures or eating disorders. Unlike SSRIs, it has a lower risk of sexual side effects and weight gain.

Answer 2

Bupropion (wellbutrin)

Question 3

Class: Serotonin antagonist and reuptake inhibitor (SARI).
Indications:

Major depressive disorder (MDD).
Often used in patients who cannot tolerate the sexual side effects associated with SSRIs.

Mechanism of Action:

Blocks serotonin 5-HT2 receptors while also inhibiting the reuptake of serotonin and norepinephrine, leading to mood improvement without the pronounced sexual dysfunction common with SSRIs.

Side Effects:

Common: Sedation, dry mouth, dizziness, and blurred vision.
Serious: Black box warning for hepatotoxicity (risk of liver failure). Nefazodone has been largely discontinued in many countries due to this risk, though it remains available in some regions.

Answer 3

Nefazodone (Serzone)

Question 4

Class: Serotonin-norepinephrine reuptake inhibitor (SNRI).
Indications:

Major depressive disorder (MDD).
Generalized anxiety disorder (GAD).
Chronic pain conditions like fibromyalgia, diabetic peripheral neuropathy, and chronic musculoskeletal pain.

Mechanism of Action:

Inhibits the reuptake of both serotonin and norepinephrine, increasing their levels in the brain and providing both antidepressant and analgesic effects.

Side Effects:

Common: Nausea, dry mouth, dizziness, fatigue, and constipation.
Serious: Hypertension, liver toxicity, and increased risk of suicidal thoughts in young adults. Sudden discontinuation can lead to withdrawal symptoms.

Answer 4

Duloxetine (Cymbalta)

Question 5

Class: Noradrenergic and specific serotonergic antidepressant (NaSSA).
Indications:

Major depressive disorder (MDD), particularly in individuals with insomnia or significant weight loss.
Also used off-label for anxiety disorders and sleep disturbances.

Mechanism of Action:

Blocks presynaptic alpha-2 adrenergic receptors, enhancing the release of norepinephrine and serotonin. It also antagonizes specific serotonin receptors (5-HT2 and 5-HT3) while stimulating 5-HT1A receptors, leading to both antidepressant and anxiolytic effects.

Side Effects:

Common: Sedation (especially at lower doses), increased appetite, and significant weight gain.
Serious: Less risk of sexual dysfunction compared to SSRIs and SNRIs, but weight gain and sedation can be problematic for some patients. Rare risk of agranulocytosis (low white blood cell count).

Answer 5

Mirtazapine (Remeron)

Question 6

What are some foods high in tyramine

Answer 6

Bananas, Oranges, limes, lemons, processed meat, aged cheese, pickled vegatables, raisins