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Created by Victoria Wright
over 7 years ago
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What is the Amine Hypothesis?
The following is the definition of what?
Abnormally low levels of norepinephrine and/or serotonin underlie depression
What evidence is there of the Amine Hypothesis?
What are the following evidence of?
Reserpine, an (old) antihypertensive drug depletes pre-synaptic stores of
norepinephrine (NE) and is associated with depressive symptoms,
Autopsy studies of the brains of depressed suicide victims indicate a low
level of NE and/or serotonin (5-HT) metabolism in most brain regions,
Drugs found to be beneficial act to enhance NE or 5-HT levels.
What is the major weakness of the Amine Hypothesis?
What is the Neuroendocrine Hypothesis?
Which drugs are Serotonin Selective Reuptake Inhibitors (SSRIs)?
What are the antidepressant drug classes?
What is the antidepressant drug class of the following?
Amitriptyline
What is the antidepressant drug class of the following?
Clomipramine
What is the antidepressant drug class of the following?
Imipramine
What is the antidepressant drug class of the following?
Phenylzine
What is the antidepressant drug class of the following?
Tranylcypromine
What is the antidepressant drug class of the following?
Selegiline
What is the antidepressant drug class of the following?
Fluoxetine
What is the antidepressant drug class of the following?
Paroxetine
What is the antidepressant drug class of the following?
Sertraline
What is the antidepressant drug class of the following?
Citalopram
What is the antidepressant drug class of the following?
Escitalopram
What is the antidepressant drug class of the following?
Venlafaxine
What is the antidepressant drug class of the following?
Duloxetine
What is the antidepressant drug class of the following?
Trazodone
What is the antidepressant drug class of the following?
Mirtazapine
What is the antidepressant drug class of the following?
Bupropion
What is the antidepressant drug class of the following?
Desvenlafaxine
What is the Neurotrophin Hypothesis?
What is described below?
Laboratory research indicates that antidepressants increase BDNF production in hippocampus
- This requires long term (weeks) not short term (days) treatment
BDNF increases neurogenesis and synaptic connectivity
Stress, pain and depression can reduce BDNF
Imaging studies indicate reduced hippocampal volume (size) in depression
Why do none of the depression hypotheses provide the full answer?
Inhibition of serotonin transporter (SERT) is the mechanism of action for which
antidepressant drug class?
What is the mechanism of action of Serotonin Selective Reuptake Inhibitors (SSRIs)?
Which antidepressant drug class is first line in treating depression?
Which SSRI(s) is approved for children?
Which SSRI(s) is approved in adolescents?
Which antidepressant drug class (and which drugs) are used for the following?
Depression, GAD, PTSD, OCD, panic disorder, PMDD,
bulimia
What are the SSRIs used for?
Which SSRIs are potent inhibitors of CYP 2D6?
- Interactions with tamoxifen and other CYP 2D6 substrates
Which SSRI does the following apply to?
Long half life of active metabolite; risk
of serotonin syndrome if switching to MAOI
Which antidepressant drug class has high selectivity for SERT (serotonin transporter)?
Which antidepressant drug class has a high therapeutic index?
What are the adverse effects of SSRIs?
Which SSRI is Category D?
Risk of heart defects with first trimester exposure
True or False
Discontinuation syndrome is an adverse effect of SSRIs and SNRIs
True or False
Significant weight loss is an adverse effect of SSRIs.
Which drugs are Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)?
Which antidepressant drug class have high selectivity for SERT and NET (norepinephrine transporter)?
Which antidepressant drug class (and drugs) are used for depression, neuropathic pain, GAD, stress urinary
incontinence, and vasomotor symptoms of menopause?
Venlafaxine is metabolized to what by CYP 2D6?
What are the uses of SNRIs?
What are the adverse effects of Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)?
Discontinuation syndrome is an adverse effect of which antidepressants?
The adverse effects of SNRIs are similar to SSRIs but also include what?
Which drugs are Tricyclic antidepressants (TCAs)?
The following applies to which antidepressant drug class?
Dominant class of antidepressants until ~ 1990s when SSRIs took over
What is used in depression that is unresponsive to SSRIs and SNRIs?
What are Tricyclic antidepressants (TCAs) used for?
As a class, Tricyclic antidepressants (TCAs), inhibit what?
The following applies to which antidepressant drug class?
Narrow therapeutic index and bothersome side effects explain reduced use
When are Tricyclic antidepressants (TCAs)
taken?
The following applies to which antidepressant drug class?
Metabolized by CYP 2D6, serum levels are affected by inhibitors (e.g. fluoxetine)
The following applies to which antidepressant drug class?
Potentially lethal in overdose
What are the adverse effects of tricyclic antidepressants (TCAs)?
What are the drug interactions of TCAs?
The following are drug interactions for which antidepressant drug class?
CNS depressants, e.g. antihistamines, alcohol, benzodiazepines
The following applies to which antidepressant?
Antagonist for 5-HT2A receptor
The following applies to what antidepressant?
Used for depression and anxiety
Seldom used as monotherapy
Adjunct with SSRI for patients with insomnia
What is Trazodone used for?
The following applies to which antidepressant?
Used as a hypnotic – highly sedating and not associated with tolerance or dependence
If Trazodone is used as a hypnotic, how many times a day should it be taken?
The following applies to which antidepressant?
Rapid metabolism requires multiple doses per day
What are the adverse effects of Trazodone?
The following are the adverse effects of which antidepressant?
Sedation
GI
α1-antagonism: orthostatic hypotension
Has been associated with priapism
The following applies to which antidepressant?
Has CNS stimulating effects, inhibits NE and dopamine transporters;
increases presynaptic release of NE and dopamine
What is the mechanism of action of Bupropion?
What is the mechanism of action of Trazodone?
The following applies to what antidepressant?
Not used for anxiety
Not sedating
Not associated with sexual side effects, bleeding or weight gain
The following are the adverse effects of what antidepressant?
Agitation, anxiety, headache, insomnia, nausea, anorexia
Lowers seizure threshold, problem in epilepsy, alcoholism, eating disorders
What is the pharmacology of Mirtazapine?
The following applies to what antidepressant?
Complex pharmacology; antagonist at adrenergic α2 and 5-HT2 receptor;
also H1 antagonist (sedative effects, weight gain)
The following applies to which antidepressant?
Not associated with sexual side effects
Sedating – useful for depression with insomnias
Appetite stimulating – may be useful in depression plus anorexia
True or False
Mirtazapine is useful for depression with insomnias.
True or False
Mirtazapine may be useful for depression plus anorexia.
Mirtazapine is sedating and appetite stimulating. This could be useful in treating people who have depression and what other two conditions?
The following are the adverse effects of what antidepressant?
Weight gain, dry mouth, constipation
What are the adverse effects of Mirtazapine?
What are the drug-drug interactions of Mirtazapine?
The following are the drug-drug interactions of what antidepressant?
Drug interactions with alcohol, benzodiazepines (increased sedative effects)
What drugs are Monoamine oxidase inhibitors (MAOI)?
What class of antidepressant drugs are described below?
Irreversible inhibition of MAO-A and MAO-B; long duration of effect
MAO-A: metabolizes NE, 5-HT and dopamine
MAO-B: metabolizes dopamine
True or False
Monoamine oxidase inhibitors (MAOI) lead to irreversible inhibition of MAO-A and MAO-B
True or False
MAO-A: metabolizes dopamine
MAO-B: metabolizes NE, 5-HT and dopamine
What class of antidepressant drugs are used in treatment resistant depression?
What are Monoamine oxidase inhibitors (MAOI) used for?
The following are the adverse effects of what class of antidepressant drugs?
Potentially lethal in overdose (autonomic, cardiac, seizures)
Orthostatic hypotension, weight gain
Insomnia, restlessness
Discontinuation syndrome
What are the adverse effects of Monoamine oxidase inhibitors (MAOI)?
What food interactions are possible with Monoamine oxidase inhibitors (MAOI)?
What foods should be avoided with Monoamine oxidase inhibitors?
What classes of antidepressants are approved for PTSD, OCD, social anxiety,
GAD and panic disorder?
Therapeutic use of antidepressants requires how many months for benefit?
How long is the trial period for the therapeutic use of antidepressants? What should be done if there is inadequate response?
What are the therapeutic uses of antidepressants for pain?
Which antidepressants are approved therapies for Premenstrual Dysphoric Disorder?
Which antidepressant is as effective as nicotine patches for Smoking Cessation?
True or False
Antidepressants have more success helping anorexia than bulimia.
Most antidepressants have
sexual side effects. Which do not?
Which class of antidepressant can help with premature ejaculation?
Which class of antidepressant can help with “hot flashes”?
What is Serotonin Syndrome?
St. John’s wart can cause serotonin syndrome in the presence of what?
How do you choose an antidepressant?
True or False
At the population level, efficacy is similar for all antidepressant drugs.
Another treatment is augmentation of SSRI by adding another drug. What drugs could be added?