front 1 Neurotransmitters involved in depression include | back 1 Serotonin, NE, epinephrine, dopamine, glutamate, acetylcholine (serotonin may be the most important) |
front 2 Diagnosis relies on symptom assessment according to | back 2 Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) |
front 3 Most widely used depression assessment scale | back 3 The Hamilton Depression Rating Scale (Ham-D) |
front 4 DSM- 5 Criteria | back 4 M SIG E CAPS Mood: depressed Sleep: increased/decreased Interest/pleasure: diminished Guilt or feelings of worthlessness Energy: decreased Concentration: decreased Appetite: increased/decreased Psychomotor: agitation or retardation Suicidal ideation |
front 5 Drugs that cause or worsen depression | back 5 ADHD medication, indomethacin, antiretrovirals, propranolol, hormones, steroids, clonidine, isotretinoin, methyldopa, methadone |
front 6 Natural products used for treating depression | back 6 St. Johns wort, SAMe (s-adenosyl-L-methionine), valerian, 5-HTP (5-hydroxytryptophan) |
front 7 If a drug does not work after _____, treatment should be reassessed | back 7 4-8 weeks |
front 8 Mild depression should be treated with | back 8 psychotherapy (CBT) or medication |
front 9 Initial treatment for depression in pregnancy | back 9 SSRIs (except paroxetine due to cardiac effects) |
front 10 Potential risk of using SSRIs in pregnancy | back 10 Persistent pulmonary hypertension of the newborn |
front 11 Preferred treatment in breastfeeding | back 11 SSRIs or tricyclics (except doxepin) |
front 12 Brand name for brexanolone | back 12 Zulresso |
front 13 Indication for Brexanolone | back 13 postpartum depression- C-IV (given as a continuous IV infusion over 60 hours) |
front 14 Medications that are restricted to patients unresponsive to other treatments | back 14 phenelzine, tranylcypromine, isocarboxazid |
front 15 Brand name for phenelzine | back 15 Nardil |
front 16 Symptoms of serotonin syndrome | back 16 severe nausea, dizziness, headache, diarrhea, agitation, tachycardia, hallucinations or muscle rigidity |
front 17 Serotonin withdrawal symptoms include | back 17 anxiety, agitation, insomnia, dizziness and flu-like symptoms |
front 18 Which SSRI self-tapers | back 18 Fluoxetine (because of long half life) |
front 19 All antidepressants carry a boxed warning of a possible | back 19 increase in suicidal thoughts or actions in some children, teenagers or young adults within the first few months or when the dose is changed |
front 20 ______ are required for all antidepressants | back 20 MedGuides |
front 21 Physical symptoms such as low energy improve | back 21 within 1-2 weeks but psychological symptoms such as low mood may take a month or longer |
front 22 MOA of SSRIs | back 22 increase 5-HT by inhibiting its reuptake in the neuronal synapse (they weekly affect NE and DA) |
front 23 Brand name for citalopram | back 23 Celexa |
front 24 What medication is the S-enantiomer of citalopram | back 24 escitalopram |
front 25 Brand name for escitalopram | back 25 Lexapro |
front 26 Brand name for fluoxetine | back 26 Prozac |
front 27 Brand name for fluoxetine + olanzapine | back 27 Symbyax (used for treatment resistant depression) |
front 28 Brand name for paroxetine | back 28 Paxil |
front 29 What is the generic name of Brisdelle and what is it used for? | back 29 Paroxetine and used for moderate to severe vasomotor symptoms associated with menopause |
front 30 Generic name of Zoloft | back 30 sertraline |
front 31 Sertaline is preferred in patients with | back 31 cardiac risk |
front 32 Most activating SSRI | back 32 Fluoxetine (take dose in AM) |
front 33 Most sedating SSRI | back 33 Paroxetine and fluvoxamine (take dose in PM) |
front 34 Which SSRIs are approved for premenstrual dysphoric disorder (PMDD) | back 34 Fluoxetine, Paxil CR and sertraline |
front 35 Fluvoxamine is only approved for | back 35 OCD |
front 36 Warnings associated with SSRIs | back 36 QT prolongation, SIADH/hyponatremia and bleeding (additive risk) |
front 37 How many weeks is the washout period between MAO inhibitors and SSRIs | back 37 2 weeks (except fluoxetine) |
front 38 Brand name of vilazodone | back 38 Viibryd |
front 39 Drug class of Viibryd | back 39 SSRI and 5-HT1A partial agonist |
front 40 Brand name of vortioxetine | back 40 Trintellix |
front 41 Drug class of Trintellix | back 41 SSRI, 5-HT3 receptor antagonist and 5-HT1A agonist |
front 42 MOA of SNRIs | back 42 increase 5-HT by inhibiting its reuptake in the neuronal synapse, also inhibit reuptake of NE |
front 43 Brand name of venlafaxine | back 43 Effexor |
front 44 Brand name of duloxetine | back 44 Cymbalta |
front 45 Brand name of desvenlafaxine | back 45 Pristiq |
front 46 Brand name of levomilnacipran | back 46 Fetzima |
front 47 Which SNRI can leave a ghost tablet in the stool | back 47 desvenlafaxine |
front 48 MOA of tricyclic antidepressants (TCA) | back 48 Inhibit NE and 5-HT reuptake, also block ACh and histamine receptors |
front 49 Which category of TCAs are relatively selective for NE | back 49 Secondary amines |
front 50 Tertiary amines can be slightly more effective but have a | back 50 worse side effect profile |
front 51 Which medications are tertiary amines | back 51 amitriptyline, doxepin, clomipramine, imipramine, trimipramine |
front 52 Brand name for doxepin | back 52 Silenor (used for insomnia) Zonalon (cream used for pruritus) |
front 53 Brand name for clomipramine | back 53 Anafranil |
front 54 Brand name for imipramine | back 54 Tofranil |
front 55 Secondary amines | back 55 Nortriptyline, amoxapine, desipramine, maprotiline, protriptyline |
front 56 Which amine group have increased anticholinergic properties and are more likely to cause sedation and weight gain | back 56 Tertiary amines |
front 57 Brand name for nortriptyline | back 57 Pamelor |
front 58 Brand name for desipramine | back 58 Norpramin |
front 59 Drug class for bupropion | back 59 dopamine and norepinephrine reuptake inhibitors |
front 60 Brand name for bupropion | back 60 Wellbutrin Zyban (for smoking cessation) Contrave (for weight management) |
front 61 Do not exceed bupropion ___ mg/day due to seizure risk | back 61 450 mg/day |
front 62 Contraindications with bupropion | back 62 seizure disorder, history of anorexia/bulimia, abrupt discontinuation of ethanol or sedatives, MAO inhibitors, linezolid, IV methylene blue and other forms of bupropion |
front 63 MOA of MAO inhibitors | back 63 inhibit the enzyme monoamine oxidase, which breaks down catecholamines including 5-HT, NE, Epi and DA |
front 64 Brand name for isocarboxazid | back 64 Marplan |
front 65 When changing from fluoxetine to MAO inhibitor, what is required | back 65 5 week wash out |
front 66 MOA of mirtazapine in depression | back 66 has central presynaptic alpha-2 adrenergic antagonist effects which result in increased release of NE and 5-HT |
front 67 Brand name for mirtazapine | back 67 Remeron |
front 68 MOA of trazodone | back 68 Inhibits 5-HT reuptake, blocks H1 and alpha-1 adrenergic receptors (rarely used as antidepressant due to sedation) |
front 69 MOA of nefazodone | back 69 Inhibits 5-HT and NE reuptake, blocks 5-HT2 and alpha-1 adrenergic receptors |
front 70 The American Psychiatric Association (APA) guidelines state that patients should receive a | back 70 4-8 week trial of medication at a therapeutic dose before concluding that a drug is not working |
front 71 Agents approved augmentation therapy | back 71 aripiprazole, Symbyax, quetiapine ER, brexpiprazole, cariprazine, esketamine |
front 72 Brand name for aripiprazole | back 72 Abilify |
front 73 Brand name for quetiapine | back 73 Seroquel |
front 74 Brand name for brexpiprazole | back 74 Rexulti |
front 75 Brand name for cariprazine | back 75 Vraylar |
front 76 Brand name for esketamine | back 76 Spravato (C-III) |