Pharmacology in Psychiatry

Question 1

how much of a delay (after given dose til symptoms improve) is seen when taking anti depressants?

Answer 1

3-6 weeks

Question 2

what antidepressant is lethal when taken as an overdose?

Answer 2

Tricyclic antidepressants (TCAs)

Question 3

basic physiology of a Monoamine oxidase inhibitors

Answer 3

bind to monoamine oxidase to prevent the inactivation of amines such as:

norepinephrine
dopamine
serotonin

(leading to increased synaptic levels)

Question 4

side effects of TCAs

Answer 4

antihistamine (sedation and weight gain)

anticholinergic (dry mouth and eyes)

Question 5

basic physiology of SSRIs

Answer 5

block the presynaptic serotonin reuptake

Question 6

SSRIs treat what?

Answer 6

anxiety and depressive disorders

Question 7

common side effects of SSRIs

Answer 7

GI upset

insomnia

fatigue

anxiety

sexual dysfunction

Question 8

common SSRIs:

pharmacological names

Answer 8

fluoxetine (prozac)

Paroxetine

Sertaline

Citalopram

Question 9

basic SNRI physiology:

Answer 9

inhibit both serotonin and noradrenergic reuptake like the TCAS

(but without antihistamine, anticholinergic or anti-adrenergic side effects)

Question 10

what are SNRIs used in?

Answer 10

depression

anxiety

neuropathic pain

Question 11

what is unipolar depression?

Answer 11

persistent/ constant depression

Question 12

3 classes of mood stabilisers:

Answer 12

lithium

anticonvulsant

antipsychotics

Question 13

who would you give a mood stabiliser to?

Answer 13

bipolar

cyclothymia

schizoaffective

Question 14

what is the only medication that officially reduces suicide rates?

Answer 14

lithium

Question 15

what is the first line mania prophylaxis?

Answer 15

carbamexapine

Question 16

when would you use anti psychotics?

Answer 16

bipolar

schizophrenia

schizoaffective disorder

Question 17

antipsychotic basic physiology

Answer 17

D2 dopamine receptor antagonists

Question 18

when would you use benzodiazepines?

Answer 18

insomnia

parasomnia

anxiety disorders

management of alcohol withdrawal

Question 19

what would you use to treat Korsakoff syndrome?

Answer 19

thiamine

Question 20

what is Korsakoff syndrome?

Answer 20

chronic memory disorder caused by a lack of thiamine

usually alcohol misuse

Question 21

Korsakoff psychosis:

Answer 21

impairment of recent and remote memory, no general cognitive impairment, impaired learning and disorientation

Question 22

what medication can be given in the management of alcohol withdrawal?

Answer 22

benzodiazepines

normally chlordiazepoxide

Question 23

what medication should be used as deterrent/ aversion to alcohol?

Answer 23

Antabuse (disulfiram)

‘gives effects of hangover immediately after consumption’

Question 24

how would you treat post natal depression?

Answer 24

just like depression

SSRI, TCA, MOI, SNRI, CBT, IPT, ECT

Question 25

how do you treat mania? 1st, 2nd, 3rd line

Answer 25

antipsychotics mood stabilisers lithium

Question 26

how do you treat obsessive compulsive disorder?

Answer 26

1st line: CBT incuding exposure and response prevention (asking people to resist their urges/ compulsions) 2nd line: SSRIs (fluoxetine, citalopram)

Question 27

how do you treat obsessive compulsive disorder?

Answer 27

1st line: CBT including exposure and response prevention (asking people to resist their urges/ compulsions) 2nd line: SSRIs (fluoxetine, citalopram) 3rd lines: TCA (clomipramine)

Question 28

what kind of drug is sodium valproate?

Answer 28

mood stabiliser