Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs) in the United States
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Questions and Answers

What is the typical time needed to reach maximum plasma concentration for both venlafaxine and duloxetine?

  • 2 hours (correct)
  • 3 hours
  • 1 hour
  • 4 hours

    • What is the approximate bioavailability of orally administered desvenlafaxine?

  • 95%
  • 50%
  • 80% (correct)
  • 65%

    • Which of the following SNRIs is metabolized primarily by CYP3A4?

  • Venlafaxine
  • Duloxetine
  • Milnacipran
  • Levomilnacipran (correct)

    • What percentage of milnacipran is excreted unchanged in the urine?

    <p>55%</p> Signup and view all the answers

    Which SNRI has the longest half-life?

    <p>Duloxetine</p> Signup and view all the answers

    Which SNRI has the highest protein binding?

    <p>Duloxetine</p> Signup and view all the answers

    Which SNRI is metabolized by both CYP2D6 and CYP1A2?

    <p>Duloxetine</p> Signup and view all the answers

    What is the typical bioavailability of orally administered levomilnacipran?

    <p>90%</p> Signup and view all the answers

    Which SNRI is excreted mostly unchanged in the urine?

    <p>Milnacipran</p> Signup and view all the answers

    Which SNRI has been found in breast milk?

    <p>All of the above</p> Signup and view all the answers

    What is the recommended initial dosage for desvenlafaxine in the treatment of major depressive disorder (MDD)?

    <p>50 mg once daily</p> Signup and view all the answers

    If a patient does not respond to the initial dosage of desvenlafaxine after 6 weeks, what is the recommended course of action?

    <p>Increase the dose of desvenlafaxine to 100 mg per day</p> Signup and view all the answers

    Which of the following statements about duloxetine is true?

    <p>It was initially thought to be especially effective for melancholic depressions, but the results have been inconclusive.</p> Signup and view all the answers

    Which of the following statements about venlafaxine is true?

    <p>It is more activating than SSRIs and a first-line drug for sluggish types of depression.</p> Signup and view all the answers

    What is the primary indication for milnacipran?

    <p>Fibromyalgia</p> Signup and view all the answers

    Which of the following statements regarding patient education for serotonin-norepinephrine reuptake inhibitors (SNRIs) is true?

    <p>Patients should be informed about the potential withdrawal symptoms associated with abrupt discontinuation.</p> Signup and view all the answers

    What was the most common adverse effect of milnacipran reported in clinical trials?

    <p>Nausea</p> Signup and view all the answers

    Which of the following drugs may require an adjustment of levomilnacipran dosage due to a potential drug interaction?

    <p>Ketoconazole</p> Signup and view all the answers

    What is the recommended initial dose of duloxetine for treating major depressive disorder?

    <p>20 mg/day</p> Signup and view all the answers

    Which of the following adverse effects is commonly reported by male patients taking milnacipran?

    <p>Erectile dysfunction</p> Signup and view all the answers

    What is the maximum recommended daily dose of levomilnacipran for the treatment of major depressive disorder?

    <p>120 mg</p> Signup and view all the answers

    Which of the following drugs may cause serotonin syndrome if used concurrently with milnacipran?

    <p>Triptans</p> Signup and view all the answers

    What is the recommended dose of milnacipran for the treatment of fibromyalgia?

    <p>100 mg twice daily</p> Signup and view all the answers

    Which of the following drugs may interact with venlafaxine by inhibiting the CYP2D6 enzyme?

    <p>Fluoxetine</p> Signup and view all the answers

    Which of the following adverse effects is commonly associated with levomilnacipran?

    <p>Hyperhidrosis</p> Signup and view all the answers

    What is the recommended initial dose of venlafaxine XR for treating major depressive disorder?

    <p>75 mg/day</p> Signup and view all the answers

    Which SNRI was approved by the FDA to treat fibromyalgia?

    <p>Milnacipran (Savella)</p> Signup and view all the answers

    Which SNRI has a Black Box Warning related to liver toxicity?

    <p>Nefazodone</p> Signup and view all the answers

    At what year was levomilnacipran (Fetzima) approved for Major Depressive Disorder (MDD)?

    <p>2013</p> Signup and view all the answers

    Which SNRI predominantly affects serotonin reuptake at lower doses?

    <p>Venlafaxine (Effexor XR)</p> Signup and view all the answers

    What is the main mechanism of action of venlafaxine, duloxetine, and desvenlafaxine as SNRIs?

    <p>Inhibiting serotonin and norepinephrine transporters</p> Signup and view all the answers

    Which SNRI is considered a more potent and equal serotonin and norepinephrine reuptake inhibitor than venlafaxine?

    <p>Duloxetine (Cymbalta)</p> Signup and view all the answers

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