MH701 Final Assessment Questions 2025 | Full
Verified Guide | A+ Rated
How is the amygdala part of the brain involved in anxiety? - * Amygdala is in the center
of the brain near the hippocampus.
* The amygdala rates the importance of an emotional event and activates the hippocampus
accordingly.
* Determines whether there will be a fear response and initiates your flight or flight response
that helps you respond to a perceived threat.
* When this response remains switched on and there is no danger, or gets switched on too
easily, that is when it becomes an anxiety disorder. Then you can have an initiation of the
flight or fight when memories or emotions occur.
* The amygdala sends a response to the hypothalamus, which activates the pituitary and it
activates the adrenal gland which secretes hormones (adrenaline, noradrenaline and cortisol).
What are neurotransmitters involved in depression? - Monoamine neurotransmitters
are responsible for depression which are: serotonin, norepinephrine & dopamine.
Which neurotransmitters are associated with antipsychotics? - 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? - Not
giving it enough time.
Major depression is? - 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? - Persistent depressive symptoms lasting 2 years.
What role does serotonin have in the different aspect of depression? - 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? - * 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? - 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? - Fluoxetine (Prozac)
Mechanism and action of SSRI: - - 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: - -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: - * 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 - * 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: - 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? - Most
Problematic - Paroxetine, followed by fluoxetine - Significant effects on CYP2D6
Least Problematic - Sertraline, Citalopram, and Escitalopram
Mechanism of action of TCA's: - 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.
What are the most concerning side effects of TCA's? - Sedation, cardiac and
anticholinergic.
* Anticholinergic side-effects: dry mouth, constipation, blurred vision, urinary retention,
delirium
* Cardiac : tachycardia, arrhythmias, orthostatic hypotension
More lethal in overdose - cardiac arrhythmias. Monitor blood levels to prevent cardiac toxicity
* Sedation: increased SS risk
Risks with patients being on a TCA? - Cardiac arrhythmias which can be lethal
Mechanism of action of MAOIs: - Monoamine oxidase is originally responsible for
inhibiting the action of norepinephrine, dopamine, and serotonin. Therefore blocking its
action allows for more to be available in the body. These are JUST AS EFFECTIVE AS SSRI'S BUT
HAVE MORE SERIOUS ADVERSE EFFECTS AND INTERACTIONS.
Side effects you would be most concerned about with MAOIs: - Hypertensive crisis.
-Patient education that is important related to the MAOIs: - Diet that avoids tyramine
Sauerkraut, ETOH- beer and wine, cured meats, such as sausage, salami, pepperoni, hot dogs,
bologna, smoke fish, pickled foods, figs, raisins, chocolate, yeast and aged cheeses .
Verified Guide | A+ Rated
How is the amygdala part of the brain involved in anxiety? - * Amygdala is in the center
of the brain near the hippocampus.
* The amygdala rates the importance of an emotional event and activates the hippocampus
accordingly.
* Determines whether there will be a fear response and initiates your flight or flight response
that helps you respond to a perceived threat.
* When this response remains switched on and there is no danger, or gets switched on too
easily, that is when it becomes an anxiety disorder. Then you can have an initiation of the
flight or fight when memories or emotions occur.
* The amygdala sends a response to the hypothalamus, which activates the pituitary and it
activates the adrenal gland which secretes hormones (adrenaline, noradrenaline and cortisol).
What are neurotransmitters involved in depression? - Monoamine neurotransmitters
are responsible for depression which are: serotonin, norepinephrine & dopamine.
Which neurotransmitters are associated with antipsychotics? - 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? - Not
giving it enough time.
Major depression is? - 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? - Persistent depressive symptoms lasting 2 years.
What role does serotonin have in the different aspect of depression? - 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? - * 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? - 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? - Fluoxetine (Prozac)
Mechanism and action of SSRI: - - 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: - -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: - * 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 - * 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: - 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? - Most
Problematic - Paroxetine, followed by fluoxetine - Significant effects on CYP2D6
Least Problematic - Sertraline, Citalopram, and Escitalopram
Mechanism of action of TCA's: - 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.
What are the most concerning side effects of TCA's? - Sedation, cardiac and
anticholinergic.
* Anticholinergic side-effects: dry mouth, constipation, blurred vision, urinary retention,
delirium
* Cardiac : tachycardia, arrhythmias, orthostatic hypotension
More lethal in overdose - cardiac arrhythmias. Monitor blood levels to prevent cardiac toxicity
* Sedation: increased SS risk
Risks with patients being on a TCA? - Cardiac arrhythmias which can be lethal
Mechanism of action of MAOIs: - Monoamine oxidase is originally responsible for
inhibiting the action of norepinephrine, dopamine, and serotonin. Therefore blocking its
action allows for more to be available in the body. These are JUST AS EFFECTIVE AS SSRI'S BUT
HAVE MORE SERIOUS ADVERSE EFFECTS AND INTERACTIONS.
Side effects you would be most concerned about with MAOIs: - Hypertensive crisis.
-Patient education that is important related to the MAOIs: - Diet that avoids tyramine
Sauerkraut, ETOH- beer and wine, cured meats, such as sausage, salami, pepperoni, hot dogs,
bologna, smoke fish, pickled foods, figs, raisins, chocolate, yeast and aged cheeses .
