MNG3701 COMPREHENSIVE EXAM PREP
QUESTIONS AND SOLUTIONS VERIFIED
STUDY RESOURCE
●● What are neurotransmitters involved in depression?
Answer: Monoamine neurotransmitters are responsible for depression
which are: serotonin, norepinephrine & dopamine.
●● Which neurotransmitters are associated with antipsychotics?
Answer: The FGA's block dopamine.
The SGA's block dopamine and 5HT.
Some have affinity for histamine and alpha 1 adrenergic receptors.
●● What is a common mistake leading to unsuccessful antidepressant
drug trial?
Answer: Not giving it enough time.
●● Major depression is?
Answer: 5 or more of the following symptoms in the same 2 week
period with at least 1 being depressed mood or loss of interest or
pleasure.
SIGECAPS
S: Sleep changes.
,I: interest loss.
G: Guilt or worthlessness.
E: Energy lack.
C: Concentration /cognition reduced.
A: Appetite usually declined.
P: Psychomotor retardation.
S: Suicidal or homicidal ideation.
●● Dysthymia is?
Answer: Persistent depressive symptoms lasting 2 years.
●● What role does serotonin have in the different aspect of depression?
Answer: Serotonin regulates mood, sleep, appetite, pain, sex, instincts.
Too much or too little can cause depression or apathy.
●● What is the patient education to any patient starting an
antidepressant?
Answer: * Takes 2-6 weeks to see a response
* Can increase suicidal ideation
* SE: sexual dysfunction, GI upset, activation, sedation, insomnia,
headaches
* Serotonin syndrome -
* Do not abruptly stop medication, it must be slowly titrated down
,●● What is serotonin syndrome?
Answer: Serotonin syndrome - abdominal pain, diarrhea, flushing,
diaphoresis, hyperthermia, mental status changes. renal failure,
rhabdomyolysis, cardiovascular shock, death
●● Which of the SSRIs has an indication for the treatment of bulimia to
decrease binging patterns?
Answer: Fluoxetine (Prozac)
●● Mechanism and action of SSRI:
Answer: - inhibit the reuptake of serotonin, thereby increasing serotonin
activity; have little effect on other neurotransmitters, such as dopamine
or norepinephrine
●● Mechanism and action of SNRI:
Answer: -inhibit the reuptake of the neurotransmitters serotonin and
norepinephrine, which increases extracellular concentrations of
serotonin and norepinephrine and, consequently, an increase in
neurotransmission.
●● Discontinuation syndrome: Risk factors:
Answer: * Extended therapy of SSRI
* Paroxetine bigger offender, then sertraline, citalopram, escitalopram
, * Fluoxetine less likely to occur due to long half life
* Taper over several weeks to minimize discontinuation symptoms
●● Discontinuation syndrome: symptoms
Answer: * Flu-like: Chills, body aches, nausea, headache,
lightheadedness
* Neurological symptoms : paresthesia's, insomnia, electro-shock like
phenomena
●● Sexual side effects of SSRI's and possible intervention:
Answer: Women can be anorgasmic and men have erectile dysfunction.
Bupropion (Wellbutrin) can reduce sexual side effects.
●● Which SSRI has the highest risk of drug-drug interactions due to
CYP enzymes?
Answer: Most Problematic - Paroxetine, followed by fluoxetine -
Significant effects on CYP2D6
Least Problematic - Sertraline, Citalopram, and Escitalopram
●● Mechanism of action of TCA's:
Answer: TCA's: Increase levels of NE and SE. They do this by
interfering with reuptake of them at the synapse. However they also
affect many other neurotransmitters, hence all the SE.
QUESTIONS AND SOLUTIONS VERIFIED
STUDY RESOURCE
●● What are neurotransmitters involved in depression?
Answer: Monoamine neurotransmitters are responsible for depression
which are: serotonin, norepinephrine & dopamine.
●● Which neurotransmitters are associated with antipsychotics?
Answer: The FGA's block dopamine.
The SGA's block dopamine and 5HT.
Some have affinity for histamine and alpha 1 adrenergic receptors.
●● What is a common mistake leading to unsuccessful antidepressant
drug trial?
Answer: Not giving it enough time.
●● Major depression is?
Answer: 5 or more of the following symptoms in the same 2 week
period with at least 1 being depressed mood or loss of interest or
pleasure.
SIGECAPS
S: Sleep changes.
,I: interest loss.
G: Guilt or worthlessness.
E: Energy lack.
C: Concentration /cognition reduced.
A: Appetite usually declined.
P: Psychomotor retardation.
S: Suicidal or homicidal ideation.
●● Dysthymia is?
Answer: Persistent depressive symptoms lasting 2 years.
●● What role does serotonin have in the different aspect of depression?
Answer: Serotonin regulates mood, sleep, appetite, pain, sex, instincts.
Too much or too little can cause depression or apathy.
●● What is the patient education to any patient starting an
antidepressant?
Answer: * Takes 2-6 weeks to see a response
* Can increase suicidal ideation
* SE: sexual dysfunction, GI upset, activation, sedation, insomnia,
headaches
* Serotonin syndrome -
* Do not abruptly stop medication, it must be slowly titrated down
,●● What is serotonin syndrome?
Answer: Serotonin syndrome - abdominal pain, diarrhea, flushing,
diaphoresis, hyperthermia, mental status changes. renal failure,
rhabdomyolysis, cardiovascular shock, death
●● Which of the SSRIs has an indication for the treatment of bulimia to
decrease binging patterns?
Answer: Fluoxetine (Prozac)
●● Mechanism and action of SSRI:
Answer: - inhibit the reuptake of serotonin, thereby increasing serotonin
activity; have little effect on other neurotransmitters, such as dopamine
or norepinephrine
●● Mechanism and action of SNRI:
Answer: -inhibit the reuptake of the neurotransmitters serotonin and
norepinephrine, which increases extracellular concentrations of
serotonin and norepinephrine and, consequently, an increase in
neurotransmission.
●● Discontinuation syndrome: Risk factors:
Answer: * Extended therapy of SSRI
* Paroxetine bigger offender, then sertraline, citalopram, escitalopram
, * Fluoxetine less likely to occur due to long half life
* Taper over several weeks to minimize discontinuation symptoms
●● Discontinuation syndrome: symptoms
Answer: * Flu-like: Chills, body aches, nausea, headache,
lightheadedness
* Neurological symptoms : paresthesia's, insomnia, electro-shock like
phenomena
●● Sexual side effects of SSRI's and possible intervention:
Answer: Women can be anorgasmic and men have erectile dysfunction.
Bupropion (Wellbutrin) can reduce sexual side effects.
●● Which SSRI has the highest risk of drug-drug interactions due to
CYP enzymes?
Answer: Most Problematic - Paroxetine, followed by fluoxetine -
Significant effects on CYP2D6
Least Problematic - Sertraline, Citalopram, and Escitalopram
●● Mechanism of action of TCA's:
Answer: TCA's: Increase levels of NE and SE. They do this by
interfering with reuptake of them at the synapse. However they also
affect many other neurotransmitters, hence all the SE.
