Pharma - Depression

Question 1

What is the primary mechanism of action of sertraline?

Answer 1

→ Inhibition of serotonin reuptake results in an accumulation of serotonin.
→ Serotonin in the central nervous system plays a role in the regulation of mood, personality, and wakefulness.

Question 2

What is the drug target for sertraline?

Answer 2

Serotonin transporter

Question 3

What are the main side effects of the sertraline?

Answer 3

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

Question 4

What are the physiological side effects of sertraline?

Answer 4

→ mild inhibition of dopamine transporter

→ partial inhibition of CYP2D6 at high doses

Question 5

Why should sertraline be gradually decreased at discontinuation?

Answer 5

due to partial inhibition of CYP2D6 at high doses (150 mg)

Question 6

What is the primary mechanism of action of citalopram?

Answer 6

→ Inhibition of serotonin reuptake results in an accumulation of serotonin.
→ Serotonin in the central nervous system plays a role in the regulation of mood, personality, and wakefulness.

Question 7

What is the drug target for citalopram?

Answer 7

Serotonin transporter

Question 8

What are the main side effects of the citalopram?

Answer 8

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

Question 9

What are the physiological side effects of citalopram?

Answer 9

Mild antagonism of muscarinic and histamine (H1) receptors

Question 10

Why should citalopram be gradually decreased at discontinuation?

Answer 10

Must be gradually decreased on discontinuation. Metabolized by CYP2C19.

Question 11

What is the primary mechanism of action of fluoxetine?

Answer 11

→ Inhibition of serotonin reuptake results in an accumulation of serotonin.
→ Serotonin in the central nervous system plays a role in the regulation of mood, personality, and wakefulness.

Question 12

What is the drug target for fluoxetine?

Answer 12

Serotonin transporter

Question 13

What are the main side effects of the fluoxetine?

Answer 13

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

Question 14

What are the physiological side effects of fluoxetine?

Answer 14

Mild antagonism of 5HT2A and 5HT2C receptors

Question 15

Why should fluoxetine be gradually decreased at discontinuation?

Answer 15

Complete inhibition of CYP2D6 and significant inhibition of CYP2C19 (caution with warfarin).

Question 16

What is the primary mechanism of action of fluoxetine?

Answer 16

→ Inhibition of serotonin reuptake results in an accumulation of serotonin.
→ Serotonin in the central nervous system plays a role in the regulation of mood, personality, and wakefulness.

Question 17

What is the drug target for fluoxetine?

Answer 17

Serotonin transporter

Question 18

What are the main side effects of the fluoxetine?

Answer 18

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

Question 19

What are the physiological side effects of fluoxetine?

Answer 19

Mild antagonism of 5HT2A + 5HT2C receptors

Question 20

Why should fluoxetine be gradually decreased at discontinuation?

Answer 20

Complete inhibition of CYP2D6 and significant inhibition of CYP2C19 (caution with warfarin).

Question 21

What is the primary mechanism of action of Venlafaxine?

Answer 21

→ Venlafaxine is a more potent inhibitor of serotonin reuptake than norepinephrine reuptake.
→ Noradrenaline in the central nervous system is implicated in the regulation of emotions and cognition.

Question 22

What is the drug target for Venlafaxine?

Answer 22

→ Serotonin transporter

→ Noradrenaline transporter

Question 23

What are the main side effects of the Venlafaxine?

Answer 23

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

Question 24

What are the physiological side effects of Venlafaxine?

Answer 24

Must be gradually decreased on discontinuation

Question 25

What is the primary mechanism of action of Mirtazapine?

Answer 25

Antagonises central presynaptic alpha-2-adrenergic receptors, which causes an increased release of serotonin and norepinephrine. Antagonises central 5HT2 receptors, which leaves 5HT1 receptors unopposed causing anti-depressant effects.

Question 26

What is the drug target for Mirtazapine?

Answer 26

→ Alpha-2 receptor

→ 5-HT2 receptor

Question 27

What are the main side effects of the Mirtazapine?

Answer 27

→ Weight gain
→ sedation
→ Low probability of sexual dysfunction
→ May exacerbate REM sleep behaviour disorder