Advanced Psychopharmacology Actual
Study Guide – Weeks 1–8 Notes
Bundle – NR 546 – Chamberlain
University (2025/2026)
Instructions: Select the best answer from the four options provided for each of the 120 multiple-
choice questions. Answers are provided in red, followed by a rationale.
1. Which neurotransmitter is primarily associated with mood regulation and sleep?
a) Dopamine
b) Serotonin
c) Norepinephrine
d) Glutamate
Answer: b) Serotonin
Rationale: Serotonin (5-HT) regulates mood, sleep, and appetite. Imbalances are linked
to depression and anxiety disorders. Dopamine influences reward and motivation,
norepinephrine affects arousal and attention, and glutamate is excitatory, involved in
learning and memory (Stahl, 2021).
2. What is a key pharmacokinetic factor affecting psychotropic drugs?
a) Blood-brain barrier permeability
b) Peripheral vasodilation
c) Bone marrow suppression
d) Insulin release
Answer: a) Blood-brain barrier permeability
Rationale: Psychotropic drugs must cross the blood-brain barrier to act on the central
nervous system. This depends on lipophilicity and metabolism via CYP450 enzymes.
Peripheral vasodilation, bone marrow suppression, and insulin release are not primary
pharmacokinetic factors for psychotropics (Stahl, 2021).
3. Which enzyme system primarily metabolizes SSRIs?
a) CYP450
, b) MAO
c) COMT
d) Acetylcholinesterase
Answer: a) CYP450
Rationale: SSRIs are metabolized by the cytochrome P450 system (e.g., CYP2D6,
CYP3A4), affecting drug interactions and clearance. MAO metabolizes monoamines,
COMT degrades catecholamines, and acetylcholinesterase breaks down acetylcholine,
not relevant to SSRI metabolism (Stahl, 2021).
4. What is the primary role of GABA in the brain?
a) Excitatory signaling
b) Inhibitory signaling
c) Reward processing
d) Memory consolidation
Answer: b) Inhibitory signaling
Rationale: GABA is the primary inhibitory neurotransmitter, reducing neuronal
excitability and calming brain activity. It is implicated in anxiety and seizure disorders.
Glutamate is excitatory, dopamine drives reward, and acetylcholine aids memory (Stahl,
2021).
5. Which ethical issue is critical in psychopharmacology prescribing?
a) Off-label use without consent
b) Overprescribing antibiotics
c) Ignoring patient allergies
d) Routine lab monitoring
Answer: a) Off-label use without consent
Rationale: Off-label use of psychotropics requires informed consent to ensure ethical
practice and patient autonomy. Overprescribing antibiotics or ignoring allergies is
unrelated, and lab monitoring is standard care, not an ethical issue (Stahl, 2021).
6. Which neurotransmitter’s dysregulation is most associated with schizophrenia?
a) Serotonin
b) Dopamine
c) Acetylcholine
d) GABA
Answer: b) Dopamine
Rationale: Dopamine dysregulation, particularly in the mesolimbic pathway, is linked to
schizophrenia’s positive symptoms (e.g., hallucinations). Serotonin, GABA, and
acetylcholine play roles but are less central to schizophrenia’s pathophysiology (Stahl,
2021).
,7. What is a key pharmacodynamic principle of psychotropic drugs?
a) Receptor binding affinity
b) Blood glucose regulation
c) Bone density increase
d) Platelet activation
Answer: a) Receptor binding affinity
Rationale: Pharmacodynamics involves drug-receptor interactions, such as agonist or
antagonist binding affinity, determining therapeutic effects. Glucose regulation, bone
density, and platelet activation are not primary pharmacodynamic mechanisms for
psychotropics (Stahl, 2021).
8. Which drug class increases serotonin availability in the synaptic cleft?
a) SSRIs
b) Antipsychotics
c) Benzodiazepines
d) Stimulants
Answer: a) SSRIs
Rationale: SSRIs block serotonin reuptake, increasing synaptic serotonin for mood
regulation. Antipsychotics target dopamine/serotonin receptors, benzodiazepines enhance
GABA, and stimulants increase dopamine/norepinephrine (Stahl, 2021).
9. Which SSRI has the longest half-life, reducing discontinuation syndrome risk?
a) Sertraline
b) Fluoxetine
c) Paroxetine
d) Citalopram
Answer: b) Fluoxetine
Rationale: Fluoxetine has a half-life of 4–6 days (norfluoxetine up to 12 days),
minimizing withdrawal symptoms compared to sertraline (26 hours), paroxetine (21
hours), or citalopram (35 hours). This ensures gradual clearance (Stahl, 2021).
10. What is a Black Box Warning for SSRIs in young adults?
a) Hepatotoxicity
b) Increased suicidality
c) Hypertensive crisis
d) Cardiotoxicity
Answer: b) Increased suicidality
Rationale: SSRIs carry a Black Box Warning for increased suicidal ideation in patients
, under 25, requiring close monitoring during initiation. Hepatotoxicity, hypertensive
crisis, and cardiotoxicity are not primary concerns for SSRIs (Burch et al., 2021).
11. Which SSRI is least likely to cause drug interactions?
a) Paroxetine
b) Fluoxetine
c) Escitalopram
d) Fluvoxamine
Answer: c) Escitalopram
Rationale: Escitalopram has minimal CYP450 inhibition, reducing drug interactions
compared to paroxetine and fluoxetine (strong CYP2D6 inhibitors) or fluvoxamine
(CYP1A2 inhibitor). This makes it safer in polypharmacy (Stahl, 2021).
12. What is a common side effect of SNRIs?
a) Agranulocytosis
b) Hypertension
c) Myoclonus
d) Rash
Answer: b) Hypertension
Rationale: SNRIs (e.g., venlafaxine) increase norepinephrine, which can elevate blood
pressure. Agranulocytosis is linked to clozapine, myoclonus to serotonin syndrome, and
rash to lamotrigine, not SNRIs (Stahl, 2021).
13. Which TCA is commonly used for neuropathic pain?
a) Amitriptyline
b) Clomipramine
c) Imipramine
d) Desipramine
Answer: a) Amitriptyline
Rationale: Amitriptyline’s anticholinergic and monoamine reuptake inhibition properties
make it effective for neuropathic pain. Clomipramine is used for OCD, imipramine for
depression, and desipramine for depression with less sedation (Stahl, 2021).
14. What dietary restriction is required for MAOI use?
a) Gluten-free
b) Tyramine-free
c) Sugar-free
d) Low-sodium
Study Guide – Weeks 1–8 Notes
Bundle – NR 546 – Chamberlain
University (2025/2026)
Instructions: Select the best answer from the four options provided for each of the 120 multiple-
choice questions. Answers are provided in red, followed by a rationale.
1. Which neurotransmitter is primarily associated with mood regulation and sleep?
a) Dopamine
b) Serotonin
c) Norepinephrine
d) Glutamate
Answer: b) Serotonin
Rationale: Serotonin (5-HT) regulates mood, sleep, and appetite. Imbalances are linked
to depression and anxiety disorders. Dopamine influences reward and motivation,
norepinephrine affects arousal and attention, and glutamate is excitatory, involved in
learning and memory (Stahl, 2021).
2. What is a key pharmacokinetic factor affecting psychotropic drugs?
a) Blood-brain barrier permeability
b) Peripheral vasodilation
c) Bone marrow suppression
d) Insulin release
Answer: a) Blood-brain barrier permeability
Rationale: Psychotropic drugs must cross the blood-brain barrier to act on the central
nervous system. This depends on lipophilicity and metabolism via CYP450 enzymes.
Peripheral vasodilation, bone marrow suppression, and insulin release are not primary
pharmacokinetic factors for psychotropics (Stahl, 2021).
3. Which enzyme system primarily metabolizes SSRIs?
a) CYP450
, b) MAO
c) COMT
d) Acetylcholinesterase
Answer: a) CYP450
Rationale: SSRIs are metabolized by the cytochrome P450 system (e.g., CYP2D6,
CYP3A4), affecting drug interactions and clearance. MAO metabolizes monoamines,
COMT degrades catecholamines, and acetylcholinesterase breaks down acetylcholine,
not relevant to SSRI metabolism (Stahl, 2021).
4. What is the primary role of GABA in the brain?
a) Excitatory signaling
b) Inhibitory signaling
c) Reward processing
d) Memory consolidation
Answer: b) Inhibitory signaling
Rationale: GABA is the primary inhibitory neurotransmitter, reducing neuronal
excitability and calming brain activity. It is implicated in anxiety and seizure disorders.
Glutamate is excitatory, dopamine drives reward, and acetylcholine aids memory (Stahl,
2021).
5. Which ethical issue is critical in psychopharmacology prescribing?
a) Off-label use without consent
b) Overprescribing antibiotics
c) Ignoring patient allergies
d) Routine lab monitoring
Answer: a) Off-label use without consent
Rationale: Off-label use of psychotropics requires informed consent to ensure ethical
practice and patient autonomy. Overprescribing antibiotics or ignoring allergies is
unrelated, and lab monitoring is standard care, not an ethical issue (Stahl, 2021).
6. Which neurotransmitter’s dysregulation is most associated with schizophrenia?
a) Serotonin
b) Dopamine
c) Acetylcholine
d) GABA
Answer: b) Dopamine
Rationale: Dopamine dysregulation, particularly in the mesolimbic pathway, is linked to
schizophrenia’s positive symptoms (e.g., hallucinations). Serotonin, GABA, and
acetylcholine play roles but are less central to schizophrenia’s pathophysiology (Stahl,
2021).
,7. What is a key pharmacodynamic principle of psychotropic drugs?
a) Receptor binding affinity
b) Blood glucose regulation
c) Bone density increase
d) Platelet activation
Answer: a) Receptor binding affinity
Rationale: Pharmacodynamics involves drug-receptor interactions, such as agonist or
antagonist binding affinity, determining therapeutic effects. Glucose regulation, bone
density, and platelet activation are not primary pharmacodynamic mechanisms for
psychotropics (Stahl, 2021).
8. Which drug class increases serotonin availability in the synaptic cleft?
a) SSRIs
b) Antipsychotics
c) Benzodiazepines
d) Stimulants
Answer: a) SSRIs
Rationale: SSRIs block serotonin reuptake, increasing synaptic serotonin for mood
regulation. Antipsychotics target dopamine/serotonin receptors, benzodiazepines enhance
GABA, and stimulants increase dopamine/norepinephrine (Stahl, 2021).
9. Which SSRI has the longest half-life, reducing discontinuation syndrome risk?
a) Sertraline
b) Fluoxetine
c) Paroxetine
d) Citalopram
Answer: b) Fluoxetine
Rationale: Fluoxetine has a half-life of 4–6 days (norfluoxetine up to 12 days),
minimizing withdrawal symptoms compared to sertraline (26 hours), paroxetine (21
hours), or citalopram (35 hours). This ensures gradual clearance (Stahl, 2021).
10. What is a Black Box Warning for SSRIs in young adults?
a) Hepatotoxicity
b) Increased suicidality
c) Hypertensive crisis
d) Cardiotoxicity
Answer: b) Increased suicidality
Rationale: SSRIs carry a Black Box Warning for increased suicidal ideation in patients
, under 25, requiring close monitoring during initiation. Hepatotoxicity, hypertensive
crisis, and cardiotoxicity are not primary concerns for SSRIs (Burch et al., 2021).
11. Which SSRI is least likely to cause drug interactions?
a) Paroxetine
b) Fluoxetine
c) Escitalopram
d) Fluvoxamine
Answer: c) Escitalopram
Rationale: Escitalopram has minimal CYP450 inhibition, reducing drug interactions
compared to paroxetine and fluoxetine (strong CYP2D6 inhibitors) or fluvoxamine
(CYP1A2 inhibitor). This makes it safer in polypharmacy (Stahl, 2021).
12. What is a common side effect of SNRIs?
a) Agranulocytosis
b) Hypertension
c) Myoclonus
d) Rash
Answer: b) Hypertension
Rationale: SNRIs (e.g., venlafaxine) increase norepinephrine, which can elevate blood
pressure. Agranulocytosis is linked to clozapine, myoclonus to serotonin syndrome, and
rash to lamotrigine, not SNRIs (Stahl, 2021).
13. Which TCA is commonly used for neuropathic pain?
a) Amitriptyline
b) Clomipramine
c) Imipramine
d) Desipramine
Answer: a) Amitriptyline
Rationale: Amitriptyline’s anticholinergic and monoamine reuptake inhibition properties
make it effective for neuropathic pain. Clomipramine is used for OCD, imipramine for
depression, and desipramine for depression with less sedation (Stahl, 2021).
14. What dietary restriction is required for MAOI use?
a) Gluten-free
b) Tyramine-free
c) Sugar-free
d) Low-sodium
