Pharmacology of 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 primary target of Sertraline?

Answer 2

Serotonin transporter

Question 3

What are the main side effects of Sertraline?

Answer 3

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

Question 4

What is the effect of Sertraline on the Dopamine transporter?

Answer 4

Mild inhibition of dopamine transporter



Question 5

How should you discontinue Sertraline?

Answer 5

Must be gradually decreased on discontinuation. Partial inhibition of CYP2D6 at high doses (150 mg)

Question 6

What is the 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 primary target of Citalopram?

Answer 7

Serotonin transporter

Question 8

What are the main side effects of Citalopram?

Answer 8

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

Question 9

What is the effect of Citalopram on Histamine receptors?

Answer 9

Mild antagonism of muscarinic and histamine (H1) receptors



Question 10

How should Citalopram be discontinued?

Answer 10

Must be gradually decreased on discontinuation. Metabolized by CYP2C19

Question 11

What is the mechanism of action of Fluexotine?

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 primary target of Fluexotine?

Answer 12

Serotonin transporter

Question 13

What are the main side effects of Fleuxotine?

Answer 13

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

Question 14

What is the effect of Fluexotine on 5HT2A and 5HT2C receptors?

Answer 14

Mild antagonism of 5HT2A and 5HT2C receptors



Question 15

Which drug should you be cautious of using Fluexotine with?

Answer 15

WARFARIN

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

Question 16

What is the mechanism of action of Venlafaxine?

Answer 16

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 17

What are the primary targets of Venlafaxine?

Answer 17

Serotonin transporter



Noradrenaline transporter



Question 18

What are the side effects of Venlafaxine?

Answer 18

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

Question 19

How should Venlafaxine be discontinued?

Answer 19

Gradually

Question 20

What is the primary mechanism of action of Mirtazapine?

Answer 20

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 21

What are the primary targets of Mirtazapine?

Answer 21

Alpha-2 receptor



5-HT2 receptor



Question 22

What are the main side effects of Mirtazapine?

Answer 22

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