NR547 latest update for 2025/26 Study Pack | High-Scoring Verified Quizzes and Answers | 100% guaranteed pass

NR547 latest update for 2025/26 Study Pack |
High-Scoring Verified Quizzes and Answers | 100%
guaranteed pass
Medications for depression - SSRIs

SNRIs

SDRIs

TCAs

MAOIs

SSRIs - -Action: inhibit 5-HT reuptake

-Examples: citalopram, escitalopram, fluoxetine, paroxetine, sertraline

-Adverse effects:

• nausea

• agitation

• diarrhea

• headache

• weight gain

• sexual side effects

SNRIs - -inhibit 5-HT reuptake

-inhibit NE reuptake (↑ energy, focus)

-increase DA in prefrontal cortex (↑ cognition)

-Examples: desvenlafaxine, duloxetine, levomilnacipran, venlafaxine

-Adverse effects:

• elevated blood pressure

• nausea

• sweating

, • tremors

• anxiety

• insomnia

• constipation

• anorexia

• sexual dysfunction

SDRIs - -inhibit DA reuptake (↑alertness, motivation)

-inhibit NE reuptake (↑energy)

-Adverse effects:

• agitation

• headache

• dry mouth

• constipation

• weight loss

TCAs - -Action: inhibits the reuptake of serotonin and norepinephrine; blocks
norepinephrine, histamine, and acetylcholine receptors

-Examples: amitriptyline, clomipramine, desipramine, doxepin

-Common Side Effects:

• dry mouth

• constipation

• blurred vision

• urinary retention

• sedation

• weight gain

• hypotension

• tachycardia

, • sexual dysfunction

MAOIs - -Action: increases norepinephrine and serotonin by inhibiting the
enzyme that inactivates it

-Examples: isocarboxazid, phenelzine, tranylcypromine

-Common Side Effects:

• sedation

• dizziness

• sexual dysfunction

• hypertensive crisis

Prescribing pearls: citalopram (Celexa) - mild antihistamine effects

Prescribing pearls: escitalopram (Lexapro) - no known drug interactions

Prescribing pearls: fluoxetine (Prozac) - longest half-life

Prescribing pearls: paroxetine (Paxil) - also treats social anxiety and insomnia

Prescribing pearls: fluvoxamine (Luvox) - treats anxious depression smokers
require increased dose

Prescribing pearls: sertraline (Zoloft) - also treats social anxiety and
hypersomnolence

Prescribing pearls: bupropion (Wellbutrin) - NDRI may improve energy, alertness,
and motivation; not first line treatment for anxiety; contraindicated in clients with a history of
seizures

Prescribing pearls: duloxetine (Cymbalta) - effective for atypical pain at higher
doses; appropriate for clients who present with somatic symptoms of depression; effective for
atypical pain, such as fibromyalgia and diabetic neuropathy

Prescribing pearls: venlafaxine (Effexor) - treats both depression and anxiety
disorders, ensure trial of higher dose before switching to a different medication

Prescribing pearls: desvenlafaxine (Pristiq) - effective for perimenopausal
vasomotor symptoms

considered when selecting a medication: - -Client preference

, -Prior treatment response

-Anticipated adverse effects

-Comorbidities

-Half-life and interactions

-Cost

if a medication is not achieving efficacy: - -Increase dose gradually

-Switch to a different drug within the same class

-Switch to drug in a different class

-Add a second medication

Use to protect against suicide - lithium

MDD and BPD genetics - genetic factors contribute 31-42% of the disease risk in
MDD and 59-85% in BPD

monoamine hypothesis of depression - -posits that depression occurs as a result
of a deficiency of one or all three monoamine transmitters

• serotonin, norepinephrine, and dopamine

-while mania may result from an excess



*Emphasis is now shifted from the monoamines to their receptors and other
downstream events such as the regulation of gene expression, growth factors, environmental
factors, and epigenetic changes

- Three principal neurotransmitters

-norepinephrine (NE), dopamine (DA), and serotonin 5HT

• comprise the monoamine neurotransmitter system

• implications for the pathophysiology and treatment of mood disorders

• All known pharmacologic treatments for mood disorders act upon one or more of
these three neurotransmitters