64 Questions
Which type of neuronal cell bodies are involved in serotonergic neurotransmission?
Cell bodies in raphe nuclei or midline regions of pons + upper brain stem
Where do the descending pathways of serotonergic neurons innervate?
Spinal cord
Which receptor subtype of serotonin is a ligand-gated ion channel?
5-HT2
What are the actions of serotonergic neurotransmission on CNS neurons?
Both inhibition and excitation depending on the receptor subtype present
What is the primary indication for SSRIs?
Depression
What is the most common side effect of SSRIs?
Insomnia
Which neurotransmitter's reuptake is blocked by SSRIs?
Serotonin
Which disorder is NOT a therapeutic use of SSRIs?
Bipolar disorder
Which adverse effect is associated with Citalopram overdose?
Seizures
Which symptom is NOT associated with Serotonin Syndrome?
Hypotension
Which drug is known for its long half-life and minimal risk of causing discontinuation syndrome?
Fluoxetine
Which condition is NOT a reported use of SSRIs in children and teenagers?
Schizophrenia
Which side effect is common with Paroxetine and Fluvoxamine?
Insomnia
What is the mechanism of action of SSRIs?
Block the reuptake of serotonin only
Which condition is NOT a therapeutic use of SSRIs?
Schizophrenia
What is a common side effect of SSRIs?
Headache
Which neurotransmitter is primarily targeted by older typical antipsychotics?
Dopamine D2 receptors
What is the defining feature in disorders such as schizophrenia, schizophreniform disorder, and schizoaffective disorder?
Psychosis
Which symptom is characterized by social withdrawal, apathy, and emotionless responses in schizophrenia?
Negative symptoms
What is the primary target of newer atypical antipsychotics like risperidone and olanzapine?
Serotonin 5-HT2A receptors
Which hypothesis suggests that decreased dopaminergic activity in the hippocampus may contribute to negative symptoms and cognitive impairment in schizophrenia?
Extended hypothesis
How does the serotonin hypothesis suggest hallucinogenic drugs like LSD and mescaline cause hallucinations?
Through the stimulation of serotonin 5-HT2A receptors
What is the primary use of aripiprazole?
To treat schizophrenia and other psychoses
What is pimavanserin indicated for?
Treatment of psychosis associated with Parkinson's disease
What is the primary use of Selegiline?
To treat CNS disorders including schizophrenia
Which class of antidepressants inhibits the reuptake of both serotonin and norepinephrine?
Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)
Which antidepressant is known for its weak dopamine and norepinephrine reuptake inhibition, decreasing nicotine cravings and attenuating withdrawal symptoms?
Bupropion
What symptom is characterized by abnormally elevated mood, increased activity, and decreased need for sleep?
Mania
Which drug is used to manage bipolar disorder with acute and prophylactic uses and undefined mechanisms of action?
Lithium
Which drug may decrease thyroid function when used as a mood-stabilizing agent?
Carbamazepine
Which combination of drugs is approved for bipolar depression?
Olanzapine and Fluoxetine
Which age group might benefit from Mirtazapine when managing depression?
55-year-old teacher with improved symptoms but sexual dysfunction
Which drug should be avoided in a patient with angle-closure glaucoma?
Amitriptyline
Which drug is known for enhancing serotonin and noradrenergic transmission, having antihistaminic activity, and being sedating?
Mirtazapine
Which receptors are blocked by tricyclic antidepressants (TCAs)?
Serotonergic, α-adrenergic, histaminic, and muscarinic
Which of the following is the most potent inhibitor of norepinephrine reuptake among the examples of TCAs provided?
Desipramine
What adverse effect is commonly associated with TCAs due to their anticholinergic action?
Dry mouth
What type of dietary restrictions are associated with MAOIs?
High tyramine diet
Which type of antidepressant is specifically known for its inhibition of serotonin reuptake?
Selective serotonin reuptake inhibitors (SSRIs)
What is a potential advantage of selective serotonin reuptake inhibitors (SSRIs) in overdose situations compared to TCAs and MAOIs?
Safer profile in overdose situations
Which neurotransmitter transporters do SSRIs have greater selectivity for?
Serotonin transporter only
What is a potential consequence of accidental or deliberate overdoses of tricyclic antidepressants (TCAs)?
Respiratory depression
Which receptor is implicated in the control of mood, cognition, and memory?
5-HT1A receptor
What is the role of 5-HT2A receptor?
Memory and learning
Which system of the brain is affected by blocking D2 receptors to reduce hallucinations and delusions?
Mesolimbic system
Which symptoms are considered as 'positive' symptoms of schizophrenia?
Hallucinations and delusions
Which type of antipsychotic drugs can reduce the 'negative' symptoms of schizophrenia?
Second-generation agents (Clozapine)
What do extrapyramidal effects of antipsychotic drugs include?
Parkinson-like symptoms
Which antipsychotic effect assists in reducing the risk of extrapyramidal symptoms (EPS)?
Anticholinergic effects
Which antipsychotics are used as antiemetics due to their action on D2 receptors in the CTZ?
Thioridazine, Chlorpromazine, Clozapine, and Olanzapine
What is the route of administration for most antipsychotic drugs?
p.o. or i.m.
How is the clearance of antipsychotic drugs primarily achieved?
Hepatic transformation via oxidative and conjugative reactions
What is the primary precursor for serotonin synthesis?
Tryptophan
Which receptor subtype is responsible for vasoconstriction via serotonin?
5-HT2B
How is serotonin released from the presynaptic neuron?
Ca2+-dependent vesicular release
Which neurotransmitter is believed to be deficient in key brain areas of individuals with depression?
Serotonin
What class of drugs are used to treat depression by potentiating the actions of norepinephrine and/or serotonin in the brain?
Antidepressants
Which class of antidepressants inhibits the reuptake of norepinephrine and serotonin into presynaptic neurons?
Tricyclic antidepressants
Which receptor subtype is responsible for inhibition of neurotransmitter release?
5-HT1B
What is the role of serotonin in the GI tract?
Motility via 5-HT4 receptors
What is the mechanism of action of Monoamine Oxidase Inhibitors (MAOIs) in treating depression?
Inhibition of serotonin breakdown by monoamine oxidase enzymes
What is the main similarity between serotonin, dopamine, and norepinephrine?
The involvement in various neurological and psychiatric conditions
What is the primary effect of Selective Serotonin Reuptake Inhibitors (SSRIs) on serotonin?
Increasing serotonin levels by blocking reuptake into presynaptic neurons
What is the effect of Tricyclic antidepressants on neurotransmitter levels in the brain?
Increase both norepinephrine and serotonin levels
Study Notes
- Serotonin has multiple roles in the body, including vasoconstriction via 5-HT2 receptors and vasodilation via activation of 5-HT2B receptors in the vascular endothelium.
- In the GI tract, serotonin plays a role in motility via 5-HT4 receptors and vasodilation through vasorelaxant mediators released from the vascular endothelium due to activation of 5-HT2B.
- Serotonin is synthesized from the amino acid tryptophan in the presence of various enzymes such as tryptophan hydroxylase and aromatic L-amino acid decarboxylase.
- Serotonin is stored in vesicles in the presynaptic neuron and released via Ca2+-dependent vesicular release.
- Serotonin acts on both presynaptic and postsynaptic receptors, with some receptors leading to inhibition of neurotransmitter release (5-HT1B) and others leading to excitation (5-HT3).
- Serotonin and other monoamines, including dopamine and norepinephrine, share similarities in their synthesis, action via G-protein coupled receptors, and involvement in various neurological and psychiatric conditions.
- Depression is a mood disorder characterized by persistent feelings of sadness, loss of interest, low self-esteem, and other emotional and biological symptoms. It is believed that depression may be due to a deficiency of serotonin and/or norepinephrine in key brain areas.
- The monoamine hypothesis, which suggests that depression is due to a deficiency in NE and 5-HT, is not a complete explanation for depression, as treatment with drugs that increase NE and 5-HT levels can take weeks to provide relief.
- Antidepressant drugs, including Monoamine Receptor Antagonists, Selective Serotonin Reuptake Inhibitors (SSRIs), Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs), and Monoamine Oxidase Inhibitors (MAOIs), are used to treat depression by potentiating the actions of norepinephrine and/or serotonin in the brain.
- Tricyclic antidepressants, a class of Monoamine Receptor Antagonists, inhibit the reuptake of norepinephrine and serotonin into presynaptic neurons and interact with other receptor types, leading to both therapeutic benefits and side effects.
Test your knowledge of antipsychotic medications and drugs acting in the central nervous system. Learn about their uses in treating psychosis, schizophrenia, mania, and other related disorders.
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