CMN 548 Module 5
Psychopharmacology (2025-2026)
WITH Correct Verified and Well
Analyzed Answers Graded A+
What are the two basic mechanisms for studying receptors?
- Measure the binding of a ligand (radioactively traced)
- Measure the physiologic consequences of agonist binding (and
effects of the antagonist)
How do didactic depictions of neurotransmitter signaling differ from
real life?
- There are hundreds to thousands of axons connecting to one
dendrite
- A single transmitter can evoke multiple pathways
Pharmacokinetic drug interactions are...
the effects of drugs on the PLASMA concentrations of each other
Pharmacokinetic concepts describe and predict...
- the time course of drug concentration in different parts of the body
- onset, duration, absorption, distribution, metabolism, excretion
Remission
- Preferred outcome of treatment
- Absolute score of 7 or less on the HAMD (Hamilton depression)
scale
- <10 on the MADRS (Montgomery-Asberg Depression Rating Scale)
Responders are patients who...
improve but do not experience full resolution of symptoms
- 50% of greater decrease from baseline on HAMD and MADRS
depression ratings
What is the probability of remission from OCD with SSRI treatment
over 3 years of treatment?
,- 38% full remission
- 65% partial remission
Withdrawal symptoms are worse with drugs that have this
pharmacokinetic property.
Short elimination half life
Which medications are most often associated with mentally and
physically distressing discontinuation reactions?
- Sedative hypnotics and opiates
- Barbiturate (part of the sedative hypnotic class) withdrawal can be
fatal
Which benzodiazepine produces more intense withdrawal symptoms
that it's counterparts?
Alprazolam (Xanax)
Which SSRI produces more intense withdrawal symptoms that it's
counterparts?
Paroxetine (Paxil)
Medications with this pharmacokinetic property have delayed
discontinuation symptoms.
Long elimination half-life
- Fluoxetine (Prozac, SSRI) has a long elimination half-life of its active
metabolite
What is autoinhibition?
Dose dependent inhibition of a medication's own metabolism
- Paroxetine (Paxil, SSRI) inhibits P450 CYP 2D6 which is what
metabolizes the medication
Bupropion (Wellbutrin, atypical antidepressant) inhibits this enzyme
system and paroxetine (Paxil, SSRI) is metabolized by it.
CYP 2D6
- Discontinuing bupropion would result in a rapid increase in
metabolism of Paroxetine and drop in plasma concentrations
- Paroxetine would need to be increased
What effect have sustained release alprazolam, paroxetine, and
venlafaxine had on withdrawal reactions?
None.
- They do not reduce severity of withdrawal because the long half-life
is due to delayed absorption not prolonged elimination
- Only benefit is the in reduced dosing frequency
Withdrawal symptoms present after hours or days of dose reduction
or discontinuation and resolve within...
, A few weeks
- Persistent symptoms would indicate something besides withdrawal
- Psychotic and mood symptoms DO NOT usually reappear abruptly
after discontinuing long term treatment
Signal detection is more challenging for compounds developed for
psychiatric disorders because....
The effect sizes are not large
What is expectation bias?
A situation where either the staff conducting the trial or subjects in
the trial or both groups expect that the test drug will confer a benefit
or that it is unlikely to do so.
What effect does expectation bias play on drug trials?
Staff may have an unconscious bias toward rating more beneficial
effects than are actually present.
- A larger trial may subsequently prove that there is no difference
from the placebo.
Explain the regression to mean phenomenon in drug trials.
As many trials enroll patients during an exacerbation of their illness,
the phenomenon would tend to mean that future measurements
would be less extreme even if the subject is on a placebo.
CYP 450 testing to predict drug dosing and responsiveness is one
example of....
Personalized Medicine
- Measuring patient 2D6 metabolism can also help determine dosing
of fluoxetine (Prozac, SSRI), a 2D6 inhibitor when combined with
medications metabolized by the same pathway
What is the ethical argument again whole genome sequencing?
Finding variants that indicate only susceptibility and not definite
disease can alter the way a person lives their life (eg. schizophrenia)
What does phase 1 of a nonclinical study entail and what is the goal?
Initial introduction of the new drug to humans, usually in healthy
volunteers.
- Goal of obtaining pharmacokinetic and pharmacologic effects of the
drug in order to design a valid phase 2 study.
What does phase 2 of a nonclinical study entail and what is the goal?
Initial controlled efficacy studies in patients with the disease or
condition.
- Determine optimal doses of the drug, common short term side
effects and risks
What does phase 3 of a nonclinical study entail and what is the goal?
Psychopharmacology (2025-2026)
WITH Correct Verified and Well
Analyzed Answers Graded A+
What are the two basic mechanisms for studying receptors?
- Measure the binding of a ligand (radioactively traced)
- Measure the physiologic consequences of agonist binding (and
effects of the antagonist)
How do didactic depictions of neurotransmitter signaling differ from
real life?
- There are hundreds to thousands of axons connecting to one
dendrite
- A single transmitter can evoke multiple pathways
Pharmacokinetic drug interactions are...
the effects of drugs on the PLASMA concentrations of each other
Pharmacokinetic concepts describe and predict...
- the time course of drug concentration in different parts of the body
- onset, duration, absorption, distribution, metabolism, excretion
Remission
- Preferred outcome of treatment
- Absolute score of 7 or less on the HAMD (Hamilton depression)
scale
- <10 on the MADRS (Montgomery-Asberg Depression Rating Scale)
Responders are patients who...
improve but do not experience full resolution of symptoms
- 50% of greater decrease from baseline on HAMD and MADRS
depression ratings
What is the probability of remission from OCD with SSRI treatment
over 3 years of treatment?
,- 38% full remission
- 65% partial remission
Withdrawal symptoms are worse with drugs that have this
pharmacokinetic property.
Short elimination half life
Which medications are most often associated with mentally and
physically distressing discontinuation reactions?
- Sedative hypnotics and opiates
- Barbiturate (part of the sedative hypnotic class) withdrawal can be
fatal
Which benzodiazepine produces more intense withdrawal symptoms
that it's counterparts?
Alprazolam (Xanax)
Which SSRI produces more intense withdrawal symptoms that it's
counterparts?
Paroxetine (Paxil)
Medications with this pharmacokinetic property have delayed
discontinuation symptoms.
Long elimination half-life
- Fluoxetine (Prozac, SSRI) has a long elimination half-life of its active
metabolite
What is autoinhibition?
Dose dependent inhibition of a medication's own metabolism
- Paroxetine (Paxil, SSRI) inhibits P450 CYP 2D6 which is what
metabolizes the medication
Bupropion (Wellbutrin, atypical antidepressant) inhibits this enzyme
system and paroxetine (Paxil, SSRI) is metabolized by it.
CYP 2D6
- Discontinuing bupropion would result in a rapid increase in
metabolism of Paroxetine and drop in plasma concentrations
- Paroxetine would need to be increased
What effect have sustained release alprazolam, paroxetine, and
venlafaxine had on withdrawal reactions?
None.
- They do not reduce severity of withdrawal because the long half-life
is due to delayed absorption not prolonged elimination
- Only benefit is the in reduced dosing frequency
Withdrawal symptoms present after hours or days of dose reduction
or discontinuation and resolve within...
, A few weeks
- Persistent symptoms would indicate something besides withdrawal
- Psychotic and mood symptoms DO NOT usually reappear abruptly
after discontinuing long term treatment
Signal detection is more challenging for compounds developed for
psychiatric disorders because....
The effect sizes are not large
What is expectation bias?
A situation where either the staff conducting the trial or subjects in
the trial or both groups expect that the test drug will confer a benefit
or that it is unlikely to do so.
What effect does expectation bias play on drug trials?
Staff may have an unconscious bias toward rating more beneficial
effects than are actually present.
- A larger trial may subsequently prove that there is no difference
from the placebo.
Explain the regression to mean phenomenon in drug trials.
As many trials enroll patients during an exacerbation of their illness,
the phenomenon would tend to mean that future measurements
would be less extreme even if the subject is on a placebo.
CYP 450 testing to predict drug dosing and responsiveness is one
example of....
Personalized Medicine
- Measuring patient 2D6 metabolism can also help determine dosing
of fluoxetine (Prozac, SSRI), a 2D6 inhibitor when combined with
medications metabolized by the same pathway
What is the ethical argument again whole genome sequencing?
Finding variants that indicate only susceptibility and not definite
disease can alter the way a person lives their life (eg. schizophrenia)
What does phase 1 of a nonclinical study entail and what is the goal?
Initial introduction of the new drug to humans, usually in healthy
volunteers.
- Goal of obtaining pharmacokinetic and pharmacologic effects of the
drug in order to design a valid phase 2 study.
What does phase 2 of a nonclinical study entail and what is the goal?
Initial controlled efficacy studies in patients with the disease or
condition.
- Determine optimal doses of the drug, common short term side
effects and risks
What does phase 3 of a nonclinical study entail and what is the goal?
