NR547 Final Exam
Study online at https://quizlet.com/_dx15sg
SSRIs
SNRIs
Medications for depression SDRIs
TCAs
MAOIs
-Action: inhibit 5-HT reuptake
-Examples: citalopram, escitalopram, flu-
oxetine, paroxetine, sertraline
-Adverse effects:
• nausea
SSRIs
• agitation
• diarrhea
• headache
• weight gain
• sexual side effects
-inhibit 5-HT reuptake
-inhibit NE reuptake (‘ energy, focus)
-increase DA in prefrontal cortex (‘ cogni-
tion)
-Examples: desvenlafaxine, duloxetine,
levomilnacipran, venlafaxine
-Adverse effects:
• elevated blood pressure
SNRIs
• nausea
• sweating
• tremors
• anxiety
• insomnia
• constipation
• anorexia
• sexual dysfunction
-inhibit DA reuptake (‘alertness, motiva-
tion)
-inhibit NE reuptake (‘energy)
SDRIs -Adverse effects:
• agitation
• headache
• dry mouth
, NR547 Final Exam
Study online at https://quizlet.com/_dx15sg
• constipation
• weight loss
-Action: inhibits the reuptake of serotonin
and norepinephrine; blocks norepineph-
rine, histamine, and acetylcholine recep-
tors
-Examples: amitriptyline, clomipramine,
desipramine, doxepin
-Common Side Effects:
• dry mouth
TCAs
• constipation
• blurred vision
• urinary retention
• sedation
• weight gain
• hypotension
• tachycardia
• sexual dysfunction
-Action: increases norepinephrine and
serotonin by inhibiting the enzyme that
inactivates it
-Examples: isocarboxazid, phenelzine,
tranylcypromine
MAOIs
-Common Side Effects:
• sedation
• dizziness
• sexual dysfunction
• hypertensive crisis
Prescribing pearls: citalopram (Celexa) mild antihistamine effects
Prescribing pearls: escitalopram
no known drug interactions
(Lexapro)
Prescribing pearls: fluoxetine (Prozac) longest half-life
Prescribing pearls: paroxetine (Paxil) also treats social anxiety and insomnia
treats anxious depression smokers re-
Prescribing pearls: fluvoxamine (Luvox)
quire increased dose
Prescribing pearls: sertraline (Zoloft)
, NR547 Final Exam
Study online at https://quizlet.com/_dx15sg
also treats social anxiety and hypersom-
nolence
NDRI may improve energy, alertness,
Prescribing pearls: bupropion (Well- and motivation; not first line treatment for
butrin) anxiety; contraindicated in clients with a
history of seizures
effective for atypical pain at higher doses;
appropriate for clients who present with
Prescribing pearls: duloxetine (Cymbal-
somatic symptoms of depression; effec-
ta)
tive for atypical pain, such as fibromyal-
gia and diabetic neuropathy
treats both depression and anxiety disor-
Prescribing pearls: venlafaxine (Effexor) ders, ensure trial of higher dose before
switching to a different medication
Prescribing pearls: desvenlafaxine (Pris- effective for perimenopausal vasomotor
tiq) symptoms
-Client preference
-Prior treatment response
-Anticipated adverse effects
considered when selecting a medication:
-Comorbidities
-Half-life and interactions
-Cost
-Increase dose gradually
-Switch to a different drug within the
if a medication is not achieving efficacy: same class
-Switch to drug in a different class
-Add a second medication
Use to protect against suicide lithium
genetic factors contribute 31-42% of the
MDD and BPD genetics
disease risk in MDD and 59-85% in BPD
-posits that depression occurs as a re-
sult of a deficiency of one or all three
monoamine transmitters
• serotonin, norepinephrine, and
dopamine
-while mania may result from an excess
, NR547 Final Exam
Study online at https://quizlet.com/_dx15sg
*Emphasis is now shifted from the
monoamines to their receptors and oth-
monoamine hypothesis of depression er downstream events such as the reg-
ulation of gene expression, growth fac-
tors, environmental factors, and epige-
netic changes
Three principal neurotransmitters
-norepinephrine (NE), dopamine (DA),
and serotonin 5HT
• comprise the monoamine neurotrans-
mitter 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
-Many of the symptoms of mood dis-
orders are hypothesized to involve dys-
function of various combinations of the
monoamine neurotransmitters
Mood disorders in-
depressive disorders and bipolar disor-
clude ____________________ and
ders
___________________
one of the most prevalent psychiatric dis-
orders
-estimated that more than 300 million
people suffer from
-leading cause of disability worldwide
-7.1% of adults and 13.3% of adoles-
cents in the U.S. had at least one major
Major depressive disorder (MDD)
depressive episode
-An imbalance of specific neurotransmit-
ters, including dopamine, serotonin, and
norepinephrine, can influence brain ac-
tivity and result in depression
-decreased neurotransmitter activity in
the prefrontal cortex (PFC)
MDD dx
Study online at https://quizlet.com/_dx15sg
SSRIs
SNRIs
Medications for depression SDRIs
TCAs
MAOIs
-Action: inhibit 5-HT reuptake
-Examples: citalopram, escitalopram, flu-
oxetine, paroxetine, sertraline
-Adverse effects:
• nausea
SSRIs
• agitation
• diarrhea
• headache
• weight gain
• sexual side effects
-inhibit 5-HT reuptake
-inhibit NE reuptake (‘ energy, focus)
-increase DA in prefrontal cortex (‘ cogni-
tion)
-Examples: desvenlafaxine, duloxetine,
levomilnacipran, venlafaxine
-Adverse effects:
• elevated blood pressure
SNRIs
• nausea
• sweating
• tremors
• anxiety
• insomnia
• constipation
• anorexia
• sexual dysfunction
-inhibit DA reuptake (‘alertness, motiva-
tion)
-inhibit NE reuptake (‘energy)
SDRIs -Adverse effects:
• agitation
• headache
• dry mouth
, NR547 Final Exam
Study online at https://quizlet.com/_dx15sg
• constipation
• weight loss
-Action: inhibits the reuptake of serotonin
and norepinephrine; blocks norepineph-
rine, histamine, and acetylcholine recep-
tors
-Examples: amitriptyline, clomipramine,
desipramine, doxepin
-Common Side Effects:
• dry mouth
TCAs
• constipation
• blurred vision
• urinary retention
• sedation
• weight gain
• hypotension
• tachycardia
• sexual dysfunction
-Action: increases norepinephrine and
serotonin by inhibiting the enzyme that
inactivates it
-Examples: isocarboxazid, phenelzine,
tranylcypromine
MAOIs
-Common Side Effects:
• sedation
• dizziness
• sexual dysfunction
• hypertensive crisis
Prescribing pearls: citalopram (Celexa) mild antihistamine effects
Prescribing pearls: escitalopram
no known drug interactions
(Lexapro)
Prescribing pearls: fluoxetine (Prozac) longest half-life
Prescribing pearls: paroxetine (Paxil) also treats social anxiety and insomnia
treats anxious depression smokers re-
Prescribing pearls: fluvoxamine (Luvox)
quire increased dose
Prescribing pearls: sertraline (Zoloft)
, NR547 Final Exam
Study online at https://quizlet.com/_dx15sg
also treats social anxiety and hypersom-
nolence
NDRI may improve energy, alertness,
Prescribing pearls: bupropion (Well- and motivation; not first line treatment for
butrin) anxiety; contraindicated in clients with a
history of seizures
effective for atypical pain at higher doses;
appropriate for clients who present with
Prescribing pearls: duloxetine (Cymbal-
somatic symptoms of depression; effec-
ta)
tive for atypical pain, such as fibromyal-
gia and diabetic neuropathy
treats both depression and anxiety disor-
Prescribing pearls: venlafaxine (Effexor) ders, ensure trial of higher dose before
switching to a different medication
Prescribing pearls: desvenlafaxine (Pris- effective for perimenopausal vasomotor
tiq) symptoms
-Client preference
-Prior treatment response
-Anticipated adverse effects
considered when selecting a medication:
-Comorbidities
-Half-life and interactions
-Cost
-Increase dose gradually
-Switch to a different drug within the
if a medication is not achieving efficacy: same class
-Switch to drug in a different class
-Add a second medication
Use to protect against suicide lithium
genetic factors contribute 31-42% of the
MDD and BPD genetics
disease risk in MDD and 59-85% in BPD
-posits that depression occurs as a re-
sult of a deficiency of one or all three
monoamine transmitters
• serotonin, norepinephrine, and
dopamine
-while mania may result from an excess
, NR547 Final Exam
Study online at https://quizlet.com/_dx15sg
*Emphasis is now shifted from the
monoamines to their receptors and oth-
monoamine hypothesis of depression er downstream events such as the reg-
ulation of gene expression, growth fac-
tors, environmental factors, and epige-
netic changes
Three principal neurotransmitters
-norepinephrine (NE), dopamine (DA),
and serotonin 5HT
• comprise the monoamine neurotrans-
mitter 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
-Many of the symptoms of mood dis-
orders are hypothesized to involve dys-
function of various combinations of the
monoamine neurotransmitters
Mood disorders in-
depressive disorders and bipolar disor-
clude ____________________ and
ders
___________________
one of the most prevalent psychiatric dis-
orders
-estimated that more than 300 million
people suffer from
-leading cause of disability worldwide
-7.1% of adults and 13.3% of adoles-
cents in the U.S. had at least one major
Major depressive disorder (MDD)
depressive episode
-An imbalance of specific neurotransmit-
ters, including dopamine, serotonin, and
norepinephrine, can influence brain ac-
tivity and result in depression
-decreased neurotransmitter activity in
the prefrontal cortex (PFC)
MDD dx
