CMN 548 Module 5 Psychopharmacology Exam
Latest Updates, EXAM - 2026 (Questions +
Answers) Study Guide, Practice Questions,
Solutions, Answers
What are the two basic mechanisms for studying receptors? - CORRECT ANSWERS - 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? - CORRECT ANSWERS - There are
hundreds to thousands of axons connecting to one dendrite
- A single transmitter can evoke multiple pathways
Pharmacokinetic drug interactions are... - CORRECT ANSWERS the effects of drugs on the PLASMA concentrations of
each other
Pharmacokinetic concepts describe and predict... - CORRECT ANSWERS - the time course of drug concentration in
different parts of the body
- onset, duration, absorption, distribution, metabolism, excretion
Remission - CORRECT ANSWERS - 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... - CORRECT ANSWERS 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? - CORRECT ANSWERS -
38% full remission
- 65% partial remission
Withdrawal symptoms are worse with drugs that have this pharmacokinetic property. - CORRECT ANSWERS Short
elimination half life
,Which medications are most often associated with mentally and physically distressing discontinuation reactions? - CORRECT ANSWERS
- 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? - CORRECT ANSWERS
Alprazolam (Xanax)
Which SSRI produces more intense withdrawal symptoms that it's counterparts? - CORRECT ANSWERS Paroxetine
(Paxil)
Medications with this pharmacokinetic property have delayed discontinuation symptoms. - CORRECT ANSWERS Long
elimination half life
- Fluoxetine (Prozac, SSRI) has a long elimination half life of its active metabolite
What is autoinhibition? - CORRECT ANSWERS 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. - CORRECT
ANSWERS 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? - CORRECT ANSWERS
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... - CORRECT ANSWERS
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.... - CORRECT ANSWERS
The effect sizes are not large
, What is expectation bias? - CORRECT ANSWERS 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? - CORRECT ANSWERS 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. - CORRECT ANSWERS 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.... - CORRECT ANSWERS 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? - CORRECT ANSWERS 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? - CORRECT ANSWERS 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? - CORRECT ANSWERS 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? - CORRECT ANSWERS Evaluate the overall risk-to-
benefit relationship of the drug and to provide an adequate basis for product labeling.
- Generally has broader inclusion and exclusion criteria than phase 2 for a more accurately representative population of people taking the
medication
What does phase 4 of a nonclinical study entail and what is the goal? - CORRECT ANSWERS - Drug has been approved,
post marketing activities
- Elucidate specific issues about a drug, which are considered important for optimal use but not essential to know before drug approval
Latest Updates, EXAM - 2026 (Questions +
Answers) Study Guide, Practice Questions,
Solutions, Answers
What are the two basic mechanisms for studying receptors? - CORRECT ANSWERS - 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? - CORRECT ANSWERS - There are
hundreds to thousands of axons connecting to one dendrite
- A single transmitter can evoke multiple pathways
Pharmacokinetic drug interactions are... - CORRECT ANSWERS the effects of drugs on the PLASMA concentrations of
each other
Pharmacokinetic concepts describe and predict... - CORRECT ANSWERS - the time course of drug concentration in
different parts of the body
- onset, duration, absorption, distribution, metabolism, excretion
Remission - CORRECT ANSWERS - 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... - CORRECT ANSWERS 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? - CORRECT ANSWERS -
38% full remission
- 65% partial remission
Withdrawal symptoms are worse with drugs that have this pharmacokinetic property. - CORRECT ANSWERS Short
elimination half life
,Which medications are most often associated with mentally and physically distressing discontinuation reactions? - CORRECT ANSWERS
- 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? - CORRECT ANSWERS
Alprazolam (Xanax)
Which SSRI produces more intense withdrawal symptoms that it's counterparts? - CORRECT ANSWERS Paroxetine
(Paxil)
Medications with this pharmacokinetic property have delayed discontinuation symptoms. - CORRECT ANSWERS Long
elimination half life
- Fluoxetine (Prozac, SSRI) has a long elimination half life of its active metabolite
What is autoinhibition? - CORRECT ANSWERS 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. - CORRECT
ANSWERS 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? - CORRECT ANSWERS
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... - CORRECT ANSWERS
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.... - CORRECT ANSWERS
The effect sizes are not large
, What is expectation bias? - CORRECT ANSWERS 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? - CORRECT ANSWERS 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. - CORRECT ANSWERS 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.... - CORRECT ANSWERS 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? - CORRECT ANSWERS 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? - CORRECT ANSWERS 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? - CORRECT ANSWERS 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? - CORRECT ANSWERS Evaluate the overall risk-to-
benefit relationship of the drug and to provide an adequate basis for product labeling.
- Generally has broader inclusion and exclusion criteria than phase 2 for a more accurately representative population of people taking the
medication
What does phase 4 of a nonclinical study entail and what is the goal? - CORRECT ANSWERS - Drug has been approved,
post marketing activities
- Elucidate specific issues about a drug, which are considered important for optimal use but not essential to know before drug approval
