Drugs: SSRIs Overview

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Questions and Answers

Which SSRI is known for having the highest withdrawal risk and should be avoided in children?

Sertraline

Fluoxetine

Paroxetine (correct)

Escitalopram

What is the primary mechanism of action of Mirtazapine?

α2 receptor antagonism (correct)

Dopamine reuptake inhibition

5-HT2C antagonism

SERT blockade

Which drug is indicated for the treatment of premature ejaculation?

Desvenlafaxine

Fluoxetine

Agomelatine

Dapoxetine (correct)

Which SNRI is preferred for treating neuropathic pain?

Duloxetine Signup and view all the answers

What is a significant side effect associated with Agomelatine?

Hepatotoxicity Signup and view all the answers

Which TCA has more potent SERT blockade and carries a risk of cardiotoxicity?

Clomipramine Signup and view all the answers

Which drug acts as a CYP inhibitor and can reduce the efficacy of Tamoxifen?

Fluoxetine Signup and view all the answers

What are the main concerns with the use of Lithium in patients?

Narrow therapeutic index and potential financial toxicity Signup and view all the answers

Which antidepressant is associated with less sexual dysfunction and rare angioedema?

Vortioxetine Signup and view all the answers

Which medication is noted for having anticholinergic properties, leading to a risk of sexual dysfunction?

Paroxetine Signup and view all the answers

What is the primary role of L-carnitine in the context of valproate use?

It is used to treat valproate-induced hyperammonemic encephalopathy. Signup and view all the answers

Which of the following is true regarding lamotrigine and its use in patients?

It can lead to severe skin reactions, including SJS-TEN. Signup and view all the answers

What is a noted adverse reaction associated with carbamazepine use?

Bone marrow suppression and hepatotoxicity. Signup and view all the answers

In which scenario can benzodiazepines be considered particularly harmful?

In individuals with respiratory disorders. Signup and view all the answers

Which class of medications is known for a black box warning concerning dependence and addiction?

Stimulants for ADHD. Signup and view all the answers

What mechanism does memantine utilize to help treat cognitive impairment in Alzheimer's disease?

It is a low-affinity uncompetitive NMDA receptor antagonist. Signup and view all the answers

What is a common risk associated with the use of topiramate?

Hyperammonemia, though rare. Signup and view all the answers

How does psychotherapy contribute to bipolar disorder management?

It helps in improving interpersonal relationships and managing prodromes. Signup and view all the answers

What is a significant contraindication for the use of benzodiazepines?

Narrow-angle glaucoma. Signup and view all the answers

Study Notes

Drugs

Escitalopram: An anti-depressant SSRI, a pure SSRI, prolongs QT intervals, Omeprazole/Esomeprazole (CYP2C19 inhibitor) increases its concentration. It is a 5-HT2C antagonist and slightly inhibits NE reuptake. It is best taken in the morning. It has a low risk of withdrawal symptoms and inhibits Tamoxifen's CYP enzyme.
Fluoxetine: An anti-depressant SSRI, a pure SSRI, prolongs QT interval. It slightly inhibits NE reuptake and is a 5-HT2C antagonist. It is best taken in the AM. It has higher withdrawal risk and is not recommended for children. Increased sexual dysfunction and anticholinergic effects are potential side effects. It inhibits Tamoxifen's CYP enzyme and increases the risk of sexual dysfunction.
Paroxetine: An SSRI with M1 antagonism, NET blockade, and NO2 Synthase inhibition. It has a higher risk of withdrawal, especially in children (lower half-life). Potentially increases sexual dysfunction due to anticholinergic properties and inhibits Tamoxifen's CYP enzyme.
Sertraline: An SSRI that slightly inhibits dopamine (DA) reuptake, binding to a1 receptors, used for coronary heart disease. Taken in the morning, with a low withdrawal risk.
Fluvoxamine: An SSRI with sigma-1 (σ1) receptor agonism and CYP inhibition (increases Clozapine and Melatonin). Smoking can decrease its concentration. This drug is used for OCD and has a possible risk for smoking.
Dapoxetine: An SSRI used for premature ejaculation, it is rapidly absorbed and has a fast onset of action.
Venlafaxine: An SNRI (Serotonin-Norepinephrine Reuptake Inhibitor) used for neuropathic pain. Not recommended for use in children due to its lower half-life and a higher risk of withdrawal. It shows a possible association with uncontrolled glaucoma.
Desvenlafaxine: An SNRI. It shows a potential association with uncontrolled glaucoma, has a higher rate of withdrawal symptoms and is considered financially toxic.
Duloxetine: An SNRI, preferred for neuropathic pain; rare liver side effects.
Vortioxetine: A multimodal antidepressant associated with MDD (major depressive disorder), rare angioedema, and less sexual dysfunction.
Mirtazapine: A NaSSA (Noradrenergic and Specific Serotonergic Antidepressant) with common side effects including sedation, weight gain, and anticholinergic effects. It slightly increases cholesterol. It is less likely to cause sexual dysfunction.
Agomelatine: A melatonergic antidepressant used for generalized anxiety disorder (GAD) with caution in liver impairment. Side effects include less SERT side effects, gastrointestinal problems, and hepatic toxicity.
Esketamine: A glutamatergic antidepressant with a slow onset (22 days), potentially dangerous side effects like lethargy, sedation, dissociation, and addiction potential.

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Description

This quiz covers important information on selective serotonin reuptake inhibitors (SSRIs) including Escitalopram, Fluoxetine, and Paroxetine. You'll learn about their pharmacological effects, side effects, and recommended usage. Test your knowledge on these common antidepressants.