NR 546
Study online at https://quizlet.com/_cw6eae
1. Prefrontal Cortex Concentration
Symptoms of MDD Mental Fatigue
Mood
2. PFC & Amygdala Guilt
Symptoms of MDD Suicidality
Worthlessness
3. Striatum Symptoms Physical fatigue
of MDD
4. Nucleus Accum- Pleasure interests
bens Symptoms of
MDD
5. Hypothalamus Sleep
Symptoms of MDD Appetite
6. Thalamus & Hy- Decreased sleep/arousal
pothalamus Symp-
toms of Mania
7. Striatum Symptoms Motor/agitation
of Mania
8. Prefrontal cortex Risk-taking
(PFC) Symptoms of Talkative/pressured speech
Mania
9. Nucleus Accum- Racing thoughts, grandiosity
bens & PFC Symp-
toms of Mania
10. PFC & Amygdala Mood
Symptoms of Mania
11. Medication Manage- SSRI-Selective Serotonin Reuptake Inhibitors
ment *Inhibit 5 HT reuptake
SNRI-Serotonin Norepinephrine Reuptake Inhibitors
*inhibit 5-HT reuptake
, NR 546
Study online at https://quizlet.com/_cw6eae
*inhibit NE reuptake (increase energy, focus)
*increase DA in prefrontal cortex (increase cognition)
NDRI-Norepinephrine Dopamine Reuptake inhibitors
*inhibit DA reuptake (increase alertness, motivation)
*inhibit NE reuptake (increase energy)
SARI-Serotonin Antagonist Reuptake Inhibitors
12. Selective Serotonin diarrhea
Reuptake Inhibitors headache
(SSRIs): Most ad- weight gain
verse effects will sexual side effects
subside after 4-5
days once the
body adjusts to in-
creased serotonin
levels.
13. Serotonin Norepi- elevated blood pressure
nephrine Reuptake anxiety
Inhibitors (SNRIs): insomnia
Medications should constipation
not be abrupt-
ly stopped to
avoid discontinua-
tion symptoms. NE
effects of the med-
ication may in-
crease anxiety in
some clients. Re-
port worsening anx-
iety to the provider.
14. Norepinephrine agitation
Dopamine headache
Reuptake Inhibitors dry mouth
(NDRI): Take constipation
medication in the weight loss
morning. Stop
taking medication if
, NR 546
Study online at https://quizlet.com/_cw6eae
seizures occur.
Stop taking
medication if
anxiety is noted.
15. escitalopram no known drug interactions
(Lexapro) SSRI best tolerated SSRI
27-32 hour half-life good for forgetful prone clients
least CYP reactions
Substrate for 3A4
16. citalopram (Celexa) mild antihistamine effects; Half-Life: 23-45 hours
SSRI Weak Inhibitor of 2D6
17. fluoxetine (Prozac) longest half-life
SSRI Use caution in patients with comorbid anxiety due to
risk for activation and panic attacks
Half-Life: 2-3 days parent, 2 week metabolite
Inhibits 2D6 and 3A4
18. paroxetine (Paxil) also treats social anxiety and insomnia
SSRI associated with weight gain
will experience withdrawal with missed dose or abrupt
stop
Half-Life: 24 hours
Inhibits 2D6
19. fluvoxamine (Lu- treats anxious depression smokers require an in-
vox) SSRI creased dose
Half-Life: 9-28 hours
Inhibits 3A4, 2C9, 1A2
20. sertraline (Zoloft) also treats social anxiety and hypersomnolence
SSRI Half-Life: 22-36 hour parent; 62-104 hour metabolite
Inhibits 2D6 and 3A4 weakly at low doses
21. venlafaxine (Effex- treats both depression and anxiety disorders, ensure
or) trial of higher dose before switching to a different med-
ication
, NR 546
Study online at https://quizlet.com/_cw6eae
Half-life: Parent drug 3-7 hour; metabolite has 9-13
hour
22. duloxetine (Cymbal- effective for atypical pain at higher doses; appropriate
ta) SNRI for clients who present with somatic symptoms of de-
pression; effective for atypical pain, such as fibromyal-
gia and diabetic neuropathy
Half-Life: 12 hours
Inhibitor of 2D6
23. bupropion (Well- NDRI may improve energy, alertness, and motivation;
butrin) not first-line treatment for anxiety; contraindicated in
clients with a history of seizures
Avoid in patients with comorbid anxiety
Half-Life: Parent 10-14 hours; Metabolite 20-27 hours
Inhibits 2D6
24. Serotonin Antago- SARIs potently block 5-HT2A and 5HT 2C receptors,
nist and Reuptake which allow more 5-HT to interact at postsynaptic
Inhibitors (SARIs) 5-HT1A sites. Serotonin blockade and reuptake inhi-
bition is present at higher doses.
25. Trazodone The most common SARI, also blocks histaminergic
and ±-
adrenergic receptors.
Half-Life: 3-6 hours
26. Serotonin Antago- Common Adverse Effects
nist and Reuptake · sedation
Inhibitors (SARIs) · drowsiness
· blurred vision
· constipation
· dry mouth
Serious Adverse Effect
priapism
27. Serotonin norepi- Mirtazapine
nephrine receptor
agonist, alpha2 re-
ceptor agonist
Study online at https://quizlet.com/_cw6eae
1. Prefrontal Cortex Concentration
Symptoms of MDD Mental Fatigue
Mood
2. PFC & Amygdala Guilt
Symptoms of MDD Suicidality
Worthlessness
3. Striatum Symptoms Physical fatigue
of MDD
4. Nucleus Accum- Pleasure interests
bens Symptoms of
MDD
5. Hypothalamus Sleep
Symptoms of MDD Appetite
6. Thalamus & Hy- Decreased sleep/arousal
pothalamus Symp-
toms of Mania
7. Striatum Symptoms Motor/agitation
of Mania
8. Prefrontal cortex Risk-taking
(PFC) Symptoms of Talkative/pressured speech
Mania
9. Nucleus Accum- Racing thoughts, grandiosity
bens & PFC Symp-
toms of Mania
10. PFC & Amygdala Mood
Symptoms of Mania
11. Medication Manage- SSRI-Selective Serotonin Reuptake Inhibitors
ment *Inhibit 5 HT reuptake
SNRI-Serotonin Norepinephrine Reuptake Inhibitors
*inhibit 5-HT reuptake
, NR 546
Study online at https://quizlet.com/_cw6eae
*inhibit NE reuptake (increase energy, focus)
*increase DA in prefrontal cortex (increase cognition)
NDRI-Norepinephrine Dopamine Reuptake inhibitors
*inhibit DA reuptake (increase alertness, motivation)
*inhibit NE reuptake (increase energy)
SARI-Serotonin Antagonist Reuptake Inhibitors
12. Selective Serotonin diarrhea
Reuptake Inhibitors headache
(SSRIs): Most ad- weight gain
verse effects will sexual side effects
subside after 4-5
days once the
body adjusts to in-
creased serotonin
levels.
13. Serotonin Norepi- elevated blood pressure
nephrine Reuptake anxiety
Inhibitors (SNRIs): insomnia
Medications should constipation
not be abrupt-
ly stopped to
avoid discontinua-
tion symptoms. NE
effects of the med-
ication may in-
crease anxiety in
some clients. Re-
port worsening anx-
iety to the provider.
14. Norepinephrine agitation
Dopamine headache
Reuptake Inhibitors dry mouth
(NDRI): Take constipation
medication in the weight loss
morning. Stop
taking medication if
, NR 546
Study online at https://quizlet.com/_cw6eae
seizures occur.
Stop taking
medication if
anxiety is noted.
15. escitalopram no known drug interactions
(Lexapro) SSRI best tolerated SSRI
27-32 hour half-life good for forgetful prone clients
least CYP reactions
Substrate for 3A4
16. citalopram (Celexa) mild antihistamine effects; Half-Life: 23-45 hours
SSRI Weak Inhibitor of 2D6
17. fluoxetine (Prozac) longest half-life
SSRI Use caution in patients with comorbid anxiety due to
risk for activation and panic attacks
Half-Life: 2-3 days parent, 2 week metabolite
Inhibits 2D6 and 3A4
18. paroxetine (Paxil) also treats social anxiety and insomnia
SSRI associated with weight gain
will experience withdrawal with missed dose or abrupt
stop
Half-Life: 24 hours
Inhibits 2D6
19. fluvoxamine (Lu- treats anxious depression smokers require an in-
vox) SSRI creased dose
Half-Life: 9-28 hours
Inhibits 3A4, 2C9, 1A2
20. sertraline (Zoloft) also treats social anxiety and hypersomnolence
SSRI Half-Life: 22-36 hour parent; 62-104 hour metabolite
Inhibits 2D6 and 3A4 weakly at low doses
21. venlafaxine (Effex- treats both depression and anxiety disorders, ensure
or) trial of higher dose before switching to a different med-
ication
, NR 546
Study online at https://quizlet.com/_cw6eae
Half-life: Parent drug 3-7 hour; metabolite has 9-13
hour
22. duloxetine (Cymbal- effective for atypical pain at higher doses; appropriate
ta) SNRI for clients who present with somatic symptoms of de-
pression; effective for atypical pain, such as fibromyal-
gia and diabetic neuropathy
Half-Life: 12 hours
Inhibitor of 2D6
23. bupropion (Well- NDRI may improve energy, alertness, and motivation;
butrin) not first-line treatment for anxiety; contraindicated in
clients with a history of seizures
Avoid in patients with comorbid anxiety
Half-Life: Parent 10-14 hours; Metabolite 20-27 hours
Inhibits 2D6
24. Serotonin Antago- SARIs potently block 5-HT2A and 5HT 2C receptors,
nist and Reuptake which allow more 5-HT to interact at postsynaptic
Inhibitors (SARIs) 5-HT1A sites. Serotonin blockade and reuptake inhi-
bition is present at higher doses.
25. Trazodone The most common SARI, also blocks histaminergic
and ±-
adrenergic receptors.
Half-Life: 3-6 hours
26. Serotonin Antago- Common Adverse Effects
nist and Reuptake · sedation
Inhibitors (SARIs) · drowsiness
· blurred vision
· constipation
· dry mouth
Serious Adverse Effect
priapism
27. Serotonin norepi- Mirtazapine
nephrine receptor
agonist, alpha2 re-
ceptor agonist
