NR 546 Final Study Guide
1. Prefrontal Cortex Symptoms of MDD: Concentration
Mental Fatigue
Mood
2. PFC & Amygdala Symptoms of MDD: Guilt
Suicidality
Worthlessness
3. Striatum Symptoms of MDD: Physical fatigue
4. Nucleus Accumbens Symptoms of MDD: Pleasure interests
5. Hypothalamus Symptoms of MDD: Sleep
Appetite
,6. Prefrontal cortex (PFC) Symptoms of Mania: Risk-taking
Talkative/pressured speech
7. Nucleus Accumbens & PFC Symptoms of Mania: Racing thoughts, grandiosity
8. PFC & Amygdala Symptoms of Mania: Mood
9. Medication Management: SSRI-Selective Serotonin Reuptake Inhibitors
*Inhibit 5 HT reuptake
SNRI-Serotonin Norepinephrine Reuptake Inhibitors
*inhibit 5-HT reuptake
*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
,10. Selective Serotonin Reuptake Inhibitors (SSRIs): Most adverse effects will
subside after 4-5 days once the body adjusts to increased serotonin levels.: -
diarrhea
headache
weight gain
sexual side effects
11. Serotonin Norepinephrine Reuptake Inhibitors (SNRIs): Medications
should not be abruptly stopped to avoid discontinuation symptoms. NE ef-
fects of the medication may increase anxiety in some clients. Report worsen-
ing anxiety to the provider.: elevated blood pressure
anxiety
insomnia
constipation
, 12. Norepinephrine Dopamine Reuptake Inhibitors (NDRI): Take medication in
the morning. Stop taking medication if seizures occur. Stop taking medication
if anxiety is noted.: agitation
headache
dry mouth
constipation
weight loss
13. escitalopram (Lexapro) SSRI: no known drug interactions
best tolerated SSRI
27-32 hour half-life good for forgetful prone clients
least CYP reactions
Substrate for 3A4
14. citalopram (Celexa) SSRI: mild antihistamine effects; Half-Life: 23-45 hours
Weak Inhibitor of 2D6
15. fluoxetine (Prozac) SSRI: longest half-life
Use caution in patients with comorbid anxiety due to risk for activation and panic
1. Prefrontal Cortex Symptoms of MDD: Concentration
Mental Fatigue
Mood
2. PFC & Amygdala Symptoms of MDD: Guilt
Suicidality
Worthlessness
3. Striatum Symptoms of MDD: Physical fatigue
4. Nucleus Accumbens Symptoms of MDD: Pleasure interests
5. Hypothalamus Symptoms of MDD: Sleep
Appetite
,6. Prefrontal cortex (PFC) Symptoms of Mania: Risk-taking
Talkative/pressured speech
7. Nucleus Accumbens & PFC Symptoms of Mania: Racing thoughts, grandiosity
8. PFC & Amygdala Symptoms of Mania: Mood
9. Medication Management: SSRI-Selective Serotonin Reuptake Inhibitors
*Inhibit 5 HT reuptake
SNRI-Serotonin Norepinephrine Reuptake Inhibitors
*inhibit 5-HT reuptake
*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
,10. Selective Serotonin Reuptake Inhibitors (SSRIs): Most adverse effects will
subside after 4-5 days once the body adjusts to increased serotonin levels.: -
diarrhea
headache
weight gain
sexual side effects
11. Serotonin Norepinephrine Reuptake Inhibitors (SNRIs): Medications
should not be abruptly stopped to avoid discontinuation symptoms. NE ef-
fects of the medication may increase anxiety in some clients. Report worsen-
ing anxiety to the provider.: elevated blood pressure
anxiety
insomnia
constipation
, 12. Norepinephrine Dopamine Reuptake Inhibitors (NDRI): Take medication in
the morning. Stop taking medication if seizures occur. Stop taking medication
if anxiety is noted.: agitation
headache
dry mouth
constipation
weight loss
13. escitalopram (Lexapro) SSRI: no known drug interactions
best tolerated SSRI
27-32 hour half-life good for forgetful prone clients
least CYP reactions
Substrate for 3A4
14. citalopram (Celexa) SSRI: mild antihistamine effects; Half-Life: 23-45 hours
Weak Inhibitor of 2D6
15. fluoxetine (Prozac) SSRI: longest half-life
Use caution in patients with comorbid anxiety due to risk for activation and panic
