NR668 SCRIPT 2026 FULL CORRECT
ANSWER SET
◉Antidepressant medications: SSRI's. Answer: -Class side effects:
sexual dysfunction, weight gain, nausea, withdrawal symptoms and
potential increased suicidality especially amongst adolescents &
young adults
• Fluoxetine
• Paroxetine
• Sertraline
• Fluvoxamine
• Citalopram
• Escitalopram
◉Fluoxetine. Answer: -CYP2D6 Metabolism
-More P450 interactions that most antidepressants
-5HT2C Antagonism results in the release of Dopamine & NE which
explains why it can be activating
-Half life of 5 days - 2 weeks!
• This is a concern when starting another agent
◉Paroxetine. Answer: -CYP2D6 Metabolism
, -More P450 interactions that most antidepressants
-Notable effect on anxiety thought related to muscarinic,
anticholinergic action
• Hence, it is less activating
-Short half life contributes to horrible withdrawal
◉Sertraline. Answer: -SSRI with some dopamine reuptake inhibition
-Often the cardiologist SSRI of choice given its record of
cardiovascular safety
-Weight neutral although known to cause transient diarrhea
-Thought relatively safe for breast feeding & pregnancy
◉Fluvoxamine. Answer: -Not FDA approved for depression
-Approved for OCD
-Known side effect of hyponatremia
◉Citalopram. Answer: -Supposedly less tolerated than escitalopram
-Persons age 60+ are limited to a QD dose of 20mg given the known
risk of QT prolongation
• associated with Torsade de pointes which can lead to sudden death
◉Escitalopram. Answer: -The S - stereoisomer of Citalopram
ANSWER SET
◉Antidepressant medications: SSRI's. Answer: -Class side effects:
sexual dysfunction, weight gain, nausea, withdrawal symptoms and
potential increased suicidality especially amongst adolescents &
young adults
• Fluoxetine
• Paroxetine
• Sertraline
• Fluvoxamine
• Citalopram
• Escitalopram
◉Fluoxetine. Answer: -CYP2D6 Metabolism
-More P450 interactions that most antidepressants
-5HT2C Antagonism results in the release of Dopamine & NE which
explains why it can be activating
-Half life of 5 days - 2 weeks!
• This is a concern when starting another agent
◉Paroxetine. Answer: -CYP2D6 Metabolism
, -More P450 interactions that most antidepressants
-Notable effect on anxiety thought related to muscarinic,
anticholinergic action
• Hence, it is less activating
-Short half life contributes to horrible withdrawal
◉Sertraline. Answer: -SSRI with some dopamine reuptake inhibition
-Often the cardiologist SSRI of choice given its record of
cardiovascular safety
-Weight neutral although known to cause transient diarrhea
-Thought relatively safe for breast feeding & pregnancy
◉Fluvoxamine. Answer: -Not FDA approved for depression
-Approved for OCD
-Known side effect of hyponatremia
◉Citalopram. Answer: -Supposedly less tolerated than escitalopram
-Persons age 60+ are limited to a QD dose of 20mg given the known
risk of QT prolongation
• associated with Torsade de pointes which can lead to sudden death
◉Escitalopram. Answer: -The S - stereoisomer of Citalopram
