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% (D)</p> Signup and view all the answers

Which SNRI has the longest half-life?

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

Which SNRI has the highest protein binding?

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

Which SNRI is metabolized by both CYP2D6 and CYP1A2?

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

What is the typical bioavailability of orally administered levomilnacipran?

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

Which SNRI is excreted mostly unchanged in the urine?

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

Which SNRI has been found in breast milk?

<p>All of the above (D)</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 (B)</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 (D)</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. (A)</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. (D)</p> Signup and view all the answers

What is the primary indication for milnacipran?

<p>Fibromyalgia (C)</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. (A)</p> Signup and view all the answers

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

<p>Nausea (D)</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 (A)</p> Signup and view all the answers

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

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

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

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

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

<p>Triptans (D)</p> Signup and view all the answers

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

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

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

<p>Fluoxetine (C)</p> Signup and view all the answers

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

<p>Hyperhidrosis (A)</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 (D)</p> Signup and view all the answers

Which SNRI was approved by the FDA to treat fibromyalgia?

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

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

<p>Nefazodone (C)</p> Signup and view all the answers

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

<p>2013 (D)</p> Signup and view all the answers

Which SNRI predominantly affects serotonin reuptake at lower doses?

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

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