MH701 EXAM 1 2026 THERAPEUTIC
RELATIONSHIPS MODULE QUESTIONS
SOLUTIONS STRUCTURED SCRIPT
◉ Before a drug trial can be considered unsuccessful.....
Answer: Raise dosage to maximum recommended level (if side
effects allow it) and maintained at that level for at least 4-5 (4-8?)
weeks. Sometimes 4-12 weeks required for maximal improvement.
Next option: switch to different antidepressant within same or
different class.
◉ What if patient is improving on low dose of drug?
Answer: Keep dose as is (do not raise) unless clinical improvements
stop before maximum benefit obtained
◉ What if pt is not responding to drug after 2-3 weeks?
Answer: Test plasma concentrations, rule out noncompliance
◉ How long should antidepressant tx be maintained for first
depressive episode? If had multiple episodes?
Answer: 6 mo
,Might need long-term tx
◉ What would indicate a need for prophylactic antidepressant
treatment?
Answer: Episodes that involved SI or impairment of psychosocial
functioning
◉ What is the objective of pharmacologic treatment for depression?
Answer: Remission (NOT just symptom reduction) and return to
baseline function
◉ Define remission
Answer: When treatment removes essentially all symptoms
◉ Define response
Answer: At least a 50% improvement in symptoms
◉ Define recovery
Answer: Symptom-free for at least 6 months
◉ Define relapse
, Answer: When depression (or other) returns before there is a full
remission of symptoms or within first several months following
remission
◉ Define recurrence
Answer: When depressive symptoms return after pt has recovered
◉ Management of depression once patient in remission?
Answer: Continue antidepressant therapy for at least 4-9 months
(some literature says 12 months). Individuals with 2-3 past episodes
may need continuous maintenance therapy.
◉ Fluoxamine, Sertraline, Citalopram, Escitalopram, Paroxetine,
Fluvoxamine
Answer: SSRIs (in order of most energizing to most sedating)
◉ SSRIs with CYP450 interactions
Answer: Fluoxetine, Paroxetine, Fluvoxamine
◉ Serotonin Syndrome (Shits and SHIVERS)
Answer: Shits
Shivering
Hyperreflexia
RELATIONSHIPS MODULE QUESTIONS
SOLUTIONS STRUCTURED SCRIPT
◉ Before a drug trial can be considered unsuccessful.....
Answer: Raise dosage to maximum recommended level (if side
effects allow it) and maintained at that level for at least 4-5 (4-8?)
weeks. Sometimes 4-12 weeks required for maximal improvement.
Next option: switch to different antidepressant within same or
different class.
◉ What if patient is improving on low dose of drug?
Answer: Keep dose as is (do not raise) unless clinical improvements
stop before maximum benefit obtained
◉ What if pt is not responding to drug after 2-3 weeks?
Answer: Test plasma concentrations, rule out noncompliance
◉ How long should antidepressant tx be maintained for first
depressive episode? If had multiple episodes?
Answer: 6 mo
,Might need long-term tx
◉ What would indicate a need for prophylactic antidepressant
treatment?
Answer: Episodes that involved SI or impairment of psychosocial
functioning
◉ What is the objective of pharmacologic treatment for depression?
Answer: Remission (NOT just symptom reduction) and return to
baseline function
◉ Define remission
Answer: When treatment removes essentially all symptoms
◉ Define response
Answer: At least a 50% improvement in symptoms
◉ Define recovery
Answer: Symptom-free for at least 6 months
◉ Define relapse
, Answer: When depression (or other) returns before there is a full
remission of symptoms or within first several months following
remission
◉ Define recurrence
Answer: When depressive symptoms return after pt has recovered
◉ Management of depression once patient in remission?
Answer: Continue antidepressant therapy for at least 4-9 months
(some literature says 12 months). Individuals with 2-3 past episodes
may need continuous maintenance therapy.
◉ Fluoxamine, Sertraline, Citalopram, Escitalopram, Paroxetine,
Fluvoxamine
Answer: SSRIs (in order of most energizing to most sedating)
◉ SSRIs with CYP450 interactions
Answer: Fluoxetine, Paroxetine, Fluvoxamine
◉ Serotonin Syndrome (Shits and SHIVERS)
Answer: Shits
Shivering
Hyperreflexia
