DRUGS USED FOR DEPRESSION
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Questions and Answers

What is the minimum duration for symptoms to be present in order to diagnose depression?

  • 1 week
  • 2 weeks (correct)
  • 4 weeks
  • 6 weeks
  • Which of the following is considered a core symptom of depression?

  • Suicidal thoughts
  • Sleep disturbance
  • Anhedonia (correct)
  • Guilt
  • For a diagnosis of mild depression, how many symptoms in total must be detectable, and how many of these should be core symptoms?

  • Four symptoms in total, with two core symptoms (correct)
  • Six symptoms in total, with two core symptoms
  • Seven symptoms in total, with three core symptoms
  • Five symptoms in total, with two core symptoms
  • Which of the following symptoms is NOT a core symptom of depression?

    <p>Suicidal thoughts</p> Signup and view all the answers

    For the classification of severe depression, how many core symptoms and total symptoms must be present?

    <p>Three core symptoms, seven total symptoms</p> Signup and view all the answers

    In cases of mild depression, which of the following treatments is generally recommended before considering pharmacological options?

    <p>Cognitive behavioral therapy</p> Signup and view all the answers

    Which treatment is generally reserved for severe or treatment-resistant depression?

    <p>Electroconvulsive therapy</p> Signup and view all the answers

    Which treatment is generally reserved for severe or treatment-resistant depression?

    <p>Electroconvulsive therapy</p> Signup and view all the answers

    According to the monoamine hypothesis, which neurotransmitter deficiency is NOT directly associated with major depression?

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

    Which class of medications is typically considered the first-line pharmacological treatment for moderate to severe depression?

    <p>Selective serotonin reuptake inhibitors (SSRIs)</p> Signup and view all the answers

    How long does it generally take for SSRIs to produce a noticeable antidepressant effect?

    <p>2 weeks</p> Signup and view all the answers

    Which neurotransmitter is NOT enhanced by antidepressants according to the monoamine hypothesis?

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

    Reserpine, a drug used for hypertension, was observed to cause depression because it depletes the brain of which neurotransmitters?

    <p>Serotonin, dopamine, and norepinephrine</p> Signup and view all the answers

    Reserpine inhibits the ability of presynaptic neurons to transport monoamines into which structures?

    <p>Synaptic vesicles</p> Signup and view all the answers

    Which of the following is an argument against the monoamine hypothesis as a complete explanation for depression?

    <p>Monoamine-enhancing drugs take several weeks to show antidepressant effects</p> Signup and view all the answers

    Which of the following is a mechanism of action of tricyclic antidepressants (TCAs) like imipramine and amitriptyline?

    <p>Blocking the reuptake of serotonin and norepinephrine</p> Signup and view all the answers

    What is the effect of tricyclic antidepressants on serotonin and norepinephrine in the synaptic cleft?

    <p>Keeps them in the synaptic cleft longer</p> Signup and view all the answers

    Which receptor, when affected by tricyclic antidepressants, is primarily responsible for drowsiness and sedation as a side effect?

    <p>Histamine-H1 receptors</p> Signup and view all the answers

    Postural hypotension and dizziness, common side effects of tricyclic antidepressants, are attributed to their action on which receptors?

    <p>Adrenergic receptors</p> Signup and view all the answers

    Side effects such as dry mouth, blurred vision, confusion, and memory impairment from tricyclic antidepressants are due to their action on which receptors?

    <p>Muscarinic (cholinergic) receptors</p> Signup and view all the answers

    Mipramine is classified as which type of antidepressant?

    <p>Tricyclic antidepressant (TCA)</p> Signup and view all the answers

    What is the primary mechanism of action for selective serotonin reuptake inhibitors (SSRIs)?

    <p>Blocking serotonin transporter to increase serotonin levels</p> Signup and view all the answers

    Which of the following is a selective serotonin reuptake inhibitor (SSRI)?

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

    Compared to tricyclic antidepressants (TCAs), SSRIs are generally better tolerated because they have minimal effects on which receptors?

    <p>Adrenergic and cholinergic receptors</p> Signup and view all the answers

    Which of the following side effects is common with SSRIs like fluoxetine?

    <p>GI disturbances and nausea</p> Signup and view all the answers

    Which serious, though less common, condition may develop due to excess serotonin levels from SSRIs?

    <p>Serotonin Syndrome</p> Signup and view all the answers

    The FDA has advised that SSRIs may increase the risk of suicide in which age group?

    <p>Adolescents and young adults (18 to 24 years)</p> Signup and view all the answers

    SSRIs are preferred over TCAs in overdose situations primarily because:

    <p>They have lower toxicity in overdose</p> Signup and view all the answers

    What is the primary mechanism of action for serotonin-norepinephrine reuptake inhibitors (SNRIs)?

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

    In which patients are SNRIs generally considered as a treatment option for depression?

    <p>Patients who do not respond to SSRIs</p> Signup and view all the answers

    Which of the following medications is classified as an SNRI?

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

    Which of the following is a common side effect associated with SNRIs? A) Hyponatremia B) Dose-related hypertension C) Cardiotoxicity D) Hypokalemia

    <p>Dose-related hypertension</p> Signup and view all the answers

    Which of the following is NOT typically a side effect of SNRIs?

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

    In addition to depression, SNRIs like duloxetine are sometimes prescribed to treat which of the following conditions?

    <p>Chronic pain conditions</p> Signup and view all the answers

    Monoamine oxidase inhibitors (MAOIs) are primarily used in the treatment of:

    <p>Resistant depression</p> Signup and view all the answers

    What is the main reason MAOIs are now rarely used in clinical practice?

    <p>High toxicity and risk of lethal food and drug interactions</p> Signup and view all the answers

    How do MAOIs increase the concentration of neurotransmitters like serotonin and norepinephrine?

    <p>By inhibiting the enzymes responsible for their degradation</p> Signup and view all the answers

    Which of the following foods should be avoided in patients taking MAOIs due to the risk of acute hypertension?

    <p>Cheese and wine</p> Signup and view all the answers

    What is the potential consequence of consuming tyramine-rich foods while on MAOIs?

    <p>Acute hypertension and severe headache</p> Signup and view all the answers

    Which of the following is a common side effect of MAOIs? A) Diarrhea B) Hypotension C) Rash D) Insomnia

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

    Which class of antidepressants is generally better tolerated and has a lower toxicity in overdose compared to tricyclic antidepressants (TCAs)?

    <p>Selective serotonin reuptake inhibitors (SSRIs)</p> Signup and view all the answers

    Which antidepressant class primarily blocks both serotonin and norepinephrine reuptake transporters, making it effective in patients who do not respond to SSRIs?

    <p>Serotonin-norepinephrine reuptake inhibitors (SNRIs)</p> Signup and view all the answers

    Which of the following is a serious dietary concern for patients taking monoamine oxidase inhibitors (MAOIs) due to the risk of hypertensive crisis?

    <p>Tyramine-rich foods (e.g., cheese, wine)</p> Signup and view all the answers

    Which antidepressant class works by inhibiting the enzyme that degrades monoamines, thereby increasing levels of serotonin and norepinephrine within the presynaptic neuron?

    <p>Monoamine oxidase inhibitors (MAOIs)</p> Signup and view all the answers

    Which side effect is more commonly associated with tricyclic antidepressants (TCAs) compared to SSRIs and is related to the drug's action on histamine receptors?

    <p>Sedation and drowsiness</p> Signup and view all the answers

    SSRIs have fewer cardiovascular side effects compared to TCAs because they have minimal effect on which type of receptor?

    <p>Adrenergic receptors</p> Signup and view all the answers

    For which class of antidepressants does the FDA warn of an increased risk of suicide in young adults (ages 18–24)?

    <p>Selective serotonin reuptake inhibitors (SSRIs)</p> Signup and view all the answers

    A patient with resistant depression is being considered for a class of drugs that block neurotransmitter degradation in the presynaptic terminal. Which class of drugs fits this description?

    <p>Monoamine oxidase inhibitors (MAOIs)</p> Signup and view all the answers

    Which of the following antidepressant classes is associated with dose-related hypertension as a potential side effect?

    <p>Serotonin-norepinephrine reuptake inhibitors (SNRIs)</p> Signup and view all the answers

    Which drug class has a significant interaction with NSAIDs, increasing the risk of gastrointestinal bleeding?

    <p>Selective serotonin reuptake inhibitors (SSRIs)</p> Signup and view all the answers

    Which of the following best describes the mechanism of action of cognitive-behavioral therapy (CBT) in treating depression?

    <p>Correcting distorted interpretations and automatic negative thinking</p> Signup and view all the answers

    What is the primary neurotransmitter system targeted by ketamine in the treatment of depression?

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

    Which treatment option is known as the most effective intervention for acute, serious major depression, particularly when other treatments fail?

    <p>Electroconvulsive therapy (ECT)</p> Signup and view all the answers

    St John's Wort, a herbal treatment for mild depression, affects neurotransmitters primarily by:

    <p>Inhibiting reuptake of serotonin, norepinephrine, and dopamine</p> Signup and view all the answers

    Esketamine, an FDA-approved treatment for depression, is administered as a: A) Tablet B) Intravenous infusion C) Nasal spray D) Oral liquid

    <p>Nasal spray</p> Signup and view all the answers

    The antidepressant effect of ketamine is primarily due to its action on which receptor type?

    <p>NMDA receptors</p> Signup and view all the answers

    Which of the following alternative treatments for depression is associated with enzyme induction in the liver, potentially affecting the metabolism of other drugs?

    <p>St John's Wort</p> Signup and view all the answers

    What is a primary focus of current ketamine research in the treatment of depression?

    <p>Testing ketamine analogues for resistant depression</p> Signup and view all the answers

    Which of the following is a primary side effect concern for patients using St John's Wort due to its enzyme-inducing properties?

    <p>Decreased effectiveness of co-administered drugs</p> Signup and view all the answers

    Which of the following is considered a natural and self-limiting condition, but can become abnormal when anxiety is disproportionate to the stressful situation or persists without a stressful trigger?

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

    Which neurotransmitter is primarily implicated in the pathophysiology of anxiety through abnormal activity in the locus coeruleus and its influence on the amygdala?

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

    Which of the following symptoms is NOT typically associated with somatic manifestations of anxiety?

    <p>Increased libido</p> Signup and view all the answers

    A patient reports experiencing an irrational fear of being in crowded places and is unable to control their feelings of dread in such situations. Which of the following anxiety disorders best describes this patient's condition?

    <p>Phobic disorder</p> Signup and view all the answers

    Which anxiety disorder is characterized by time-consuming obsessions and compulsions that significantly interfere with daily functioning?

    <p>Obsessive-compulsive disorder (OCD)</p> Signup and view all the answers

    In the context of anxiety, which neurotransmitter's malfunction, specifically its decreased response to stress, is believed to contribute to the development of anxiety disorders?

    <p>Gamma-aminobutyric acid (GABA)</p> Signup and view all the answers

    What anxiety disorder is characterized by apprehension lasting for more than 6 months without a specific cause?

    <p>Generalised anxiety disorder (GAD)</p> Signup and view all the answers

    Which neurotransmitter's abnormal activity in the locus coeruleus is linked to anxiety, and can be triggered by stimulants like caffeine?

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

    The role of serotonin in anxiety is mainly supported by its effects on which two areas of the brain?

    <p>Locus coeruleus and amygdala</p> Signup and view all the answers

    Which of the following pharmacological treatments for anxiety is considered first-line therapy for Generalized Anxiety Disorder (GAD) and is suitable for long-term use?

    <p>Selective serotonin reuptake inhibitors (SSRIs)</p> Signup and view all the answers

    Which drug class is often co-prescribed with SSRIs for short-term relief of anxiety symptoms due to its immediate anxiolytic effects, despite having a potential for dependence?

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

    Which of the following is a common side effect concern when prescribing SSRIs for anxiety disorders?

    <p>Lag phase of 2-3 weeks before therapeutic effects are felt</p> Signup and view all the answers

    Which of the following is an effective treatment option for anxiety, especially in cases of morbid anxiety or panic symptoms, and can be used in resistant cases?

    <p>Monoamine oxidase inhibitors (MAOIs)</p> Signup and view all the answers

    Which tricyclic antidepressant (TCA) is licensed for the treatment of obsessional and phobic states, although it is not typically used in GAD or panic disorder?

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

    During the initial 2-3 weeks of treatment with SSRIs or TCAs, which of the following is a common concern for patients with anxiety disorders?

    <p>Worsening of anxiety symptoms before improvement</p> Signup and view all the answers

    Which of the following medications is commonly used to treat somatic symptoms of anxiety, such as palpitations and tremors, but is not an anxiolytic?

    <p>Beta-blockers</p> Signup and view all the answers

    Which of the following is recommended as the first-line treatment for Generalized Anxiety Disorder (GAD) according to NICE guidelines?

    <p>Cognitive Behavioral Therapy (CBT)</p> Signup and view all the answers

    When starting an SSRI like sertraline for Generalized Anxiety Disorder (GAD), what is a common initial effect that requires careful monitoring?

    <p>Initial increase in anxiety</p> Signup and view all the answers

    If there is no improvement in anxiety symptoms after 2 months of SSRI treatment for GAD, what is the recommended next step according to NICE guidelines?

    <p>Increase the dose or switch to an alternative SSRI or SNRI (such as duloxetine or venlafaxine MR)</p> Signup and view all the answers

    For severe and disabling anxiety causing significant distress, what is the recommended short-term treatment option according to current guidelines?

    <p>Short-term use of benzodiazepines (2-4 weeks) with regular review</p> Signup and view all the answers

    Barbiturates and benzodiazepines treat anxiety by increasing the opening of which channel in the brain?

    <p>Chloride channels (GABA-A receptor)</p> Signup and view all the answers

    Activation of the GABA system by drugs like benzodiazepines and barbiturates can result in which of the following effects?

    <p>Sleep and drowsiness</p> Signup and view all the answers

    Which of the following is a key difference between the sites of action of barbiturates and benzodiazepines on the GABA-A receptor?

    <p>Barbiturates act as inverse agonists, whereas benzodiazepines act as agonists</p> Signup and view all the answers

    Which of the following substances is known to be an excitant that can counteract the inhibitory effects of GABA, potentially leading to anxiety?

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

    Which medication class is most appropriate for patients with comorbid depression and anxiety or when SSRIs are ineffective?

    <p>Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)</p> Signup and view all the answers

    Which of the following is true regarding the use of benzodiazepines in anxiety treatment? A) They are used for long-term management of anxiety. B) They are recommended for the first-line treatment of panic disorder. C) They are used for short-term relief of acute anxiety. D) They have no risk of dependence.

    <p>They are used for short-term relief of acute anxiety.</p> Signup and view all the answers

    Which medication is typically used in the treatment of panic disorder or obsessive-compulsive disorder (OCD) when other treatments have not been effective, but it carries more side effects?

    <p>Tricyclic Antidepressants (TCAs)</p> Signup and view all the answers

    Which class of medications for anxiety is associated with serious food and drug interactions, including hypertensive crises when combined with certain foods?

    <p>Monoamine Oxidase Inhibitors (MAOIs)</p> Signup and view all the answers

    Which of the following is a common side effect of SSRIs in the treatment of anxiety disorders?

    <p>Increased anxiety during the initial weeks of treatment</p> Signup and view all the answers

    Which of the following benzodiazepines has the shortest half-life and is used for acute anti-anxiety effects?

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

    What is the primary mechanism of action of benzodiazepines in the treatment of anxiety?

    <p>Enhance GABA-A-mediated transmission</p> Signup and view all the answers

    Which of the following is NOT a side effect commonly associated with benzodiazepines? A) Drowsiness B) Confusion C) Impaired coordination D) Increased serotonin production

    <p>Increased serotonin production</p> Signup and view all the answers

    Which benzodiazepine has the longest half-life and is known for a potential "hangover" effect?

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

    Which of the following is NOT a recommended use for benzodiazepines in the treatment of anxiety and sleep disturbance? A) Long-term use for chronic anxiety B) Short-term treatment for acute anxiety C) Treatment for transient insomnia D) Treatment for short-term insomnia due to emotional stress

    <p>Long-term use for chronic anxiety</p> Signup and view all the answers

    What is a potential dangerous effect of combining benzodiazepines with alcohol or other depressants? A) Increased sedation and respiratory insufficiency B) Increased anxiety and confusion C) Enhanced effects of antidepressants D) Increased risk of hypertension

    <p>Increased sedation and respiratory insufficiency</p> Signup and view all the answers

    Which of the following benzodiazepines is short-acting and has minimal hangover effect, but may cause withdrawal symptoms?

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

    Which of the following anti-histamines is available over-the-counter and can be used to treat sleep disturbances?

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

    Melatonin is a naturally occurring hormone used for sleep disturbances. What is its main role in the treatment of insomnia?

    <p>It modulates circadian rhythms.</p> Signup and view all the answers

    Buspirone is most effective in the treatment of generalized anxiety disorder (GAD), but ineffective in controlling which of the following? A) Panic attacks B) Insomnia C) Social anxiety D) Stress-related disorders

    <p>Panic attacks</p> Signup and view all the answers

    Which of the following is a key feature of buspirone as an anxiolytic agent? A) It causes sedation and motor incoordination. B) It has an immediate onset of action. C) It is a partial agonist at the 5-HT 1A receptor. D) It has a high potential for abuse and withdrawal symptoms.

    <p>It is a partial agonist at the 5-HT 1A receptor.</p> Signup and view all the answers

    What is the main advantage of Zolpidem and Zaleplon over benzodiazepines in treating insomnia?

    <p>They have a different structure but a similar mechanism of action.</p> Signup and view all the answers

    Which of the following beta blockers is most commonly used to treat somatic symptoms of anxiety, such as tremor, sweating, and shortness of breath?

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

    Which of the following is true about pregabalin in the treatment of generalized anxiety disorder (GAD)?

    <p>It is a structural analog of GABA that reduces neurotransmitter release by binding to calcium channels.</p> Signup and view all the answers

    Which of the following anti-convulsants is NOT licensed for the treatment of generalized anxiety disorder (GAD), although it may still be used in practice for certain cases?

    <p>Sodium valproate</p> Signup and view all the answers

    Which of the following is NOT a feature of barbiturates, such as phenobarbital, when used for treating anxiety?

    <p>They are considered safe and commonly prescribed for long-term use in anxiety.</p> Signup and view all the answers

    Which of the following is true regarding the use of pregabalin for generalized anxiety disorder (GAD)?

    <p>It is an anticonvulsant that binds to calcium channels to reduce neurotransmitter release.</p> Signup and view all the answers

    Which of the following anti-convulsants was historically used for anxiety but is now rarely used due to potential safety concerns?

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

    Which of the following is the most common age of onset for schizophrenia in men?

    <p>18 years</p> Signup and view all the answers

    Which neurotransmitter imbalance is most commonly associated with the symptoms of schizophrenia?

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

    Which of the following is a known genetic risk factor for schizophrenia?

    <p>Both A and B</p> Signup and view all the answers

    What type of schizophrenia is characterized by the presence of severe motor symptoms, such as immobility or excessive movement?

    <p>Catatonic schizophrenia</p> Signup and view all the answers

    Which of the following substances is most likely to induce psychosis in individuals predisposed to schizophrenia?

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

    Which of the following is a common environmental risk factor for schizophrenia? A) Early childhood vaccinations B) Urban living C) Consuming dairy products D) Adequate prenatal nutrition

    <p>Urban living</p> Signup and view all the answers

    Which of the following symptoms is considered a positive symptom of schizophrenia?

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

    What is the primary role of antipsychotic medications in the treatment of schizophrenia?

    <p>To block dopamine receptors</p> Signup and view all the answers

    Which side effect is more commonly associated with typical (first-generation) antipsychotics than atypical (second/third-generation) antipsychotics?

    <p>Tardive dyskinesia</p> Signup and view all the answers

    Which dopamine receptor subtype is most targeted by first-generation antipsychotics (typical antipsychotics)?

    <p>D2</p> Signup and view all the answers

    Which of the following is the primary effect of first-generation antipsychotics (typical) on dopamine receptors?

    <p>Blocking dopamine binding to D2 receptors in the mesolimbic pathway</p> Signup and view all the answers

    Which of the following first-generation antipsychotics (typical) has a high affinity for D2 receptors?

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

    Which of the following side effects is commonly associated with first-generation antipsychotics (typical)?

    <p>Extrapyramidal symptoms (EPS)</p> Signup and view all the answers

    Which of the following is most likely to occur with first-generation antipsychotics (typical) due to their binding affinity for D2 receptors?

    <p>Relieving positive symptoms of schizophrenia</p> Signup and view all the answers

    Which of the following best describes the onset of antipsychotic effects with first-generation antipsychotics (typical)?

    <p>Full effect achieved within 2-4 weeks</p> Signup and view all the answers

    Which of the following is a common long-term benefit of first-generation antipsychotics (typical)?

    <p>Protection against future relapse of psychotic symptoms</p> Signup and view all the answers

    Which receptor binding is characteristic of first-generation antipsychotics (typical) like Haloperidol and Chlorpromazine?

    <p>High binding affinity for D1 and D2 receptors</p> Signup and view all the answers

    Which of the following is most characteristic of typical antipsychotics (first-generation) in terms of receptor affinity?

    <p>Broad receptor profile including D2 and 5-HT2 receptors</p> Signup and view all the answers

    Which of the following is a common adverse effect of typical antipsychotic drugs due to their action on dopamine receptors in the nigrostriatal pathway?

    <p>Extrapyramidal symptoms (EPS)</p> Signup and view all the answers

    Extrapyramidal symptoms (EPS) commonly seen with typical antipsychotics are due to dopamine receptor antagonism in which of the following pathways?

    <p>Nigrostriatal pathway</p> Signup and view all the answers

    Which of the following is most likely to be a manifestation of acute extrapyramidal side effects (EPS) when starting a typical antipsychotic drug?

    <p>Parkinsonism (bradykinesia, rigidity, tremor)</p> Signup and view all the answers

    Which of the following is the recommended action if a patient develops tardive dyskinesia while on a typical antipsychotic drug?

    <p>Discontinue the antipsychotic and switch to another agent</p> Signup and view all the answers

    Which of the following is a common anticholinergic side effect associated with typical antipsychotics?

    <p>Dry mouth</p> Signup and view all the answers

    Which of the following cardiovascular side effects is commonly associated with typical antipsychotic drugs?

    <p>Orthostatic hypotension</p> Signup and view all the answers

    Neuroleptic malignant syndrome (NMS) is a life-threatening complication associated with typical antipsychotic use. Which of the following is a characteristic feature of NMS?

    <p>Muscle rigidity and rapid rise in body temperature</p> Signup and view all the answers

    Which of the following is a key feature of second-generation (atypical) antipsychotic drugs compared to first-generation (typical) antipsychotics?

    <p>They have a greater affinity for 5HT2 receptors than D2 receptors, reducing extrapyramidal side effects.</p> Signup and view all the answers

    Which of the following second-generation antipsychotic drugs has the greatest affinity for the 5HT2 receptors?

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

    Which of the following is true regarding the mechanism of action of second-generation antipsychotics like clozapine and olanzapine?

    <p>They block both D2 and 5HT2 receptors.</p> Signup and view all the answers

    Which of the following second-generation antipsychotics is most associated with a potent D2 antagonistic activity, making it more likely to cause extrapyramidal symptoms (EPS)?

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

    Which of the following second-generation antipsychotics is most associated with potent D2 antagonistic activity, making it more likely to cause extrapyramidal symptoms (EPS)?

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

    Which of the following second-generation (atypical) antipsychotic drugs is most likely to cause metabolic side effects such as weight gain and diabetes?

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

    What is the primary reason why second-generation (atypical) antipsychotics are less likely to cause extrapyramidal side effects (EPS) compared to first-generation (typical) antipsychotics?

    <p>They have a lower affinity for D2 receptors and higher affinity for 5HT2 receptors.</p> Signup and view all the answers

    Which of the following second-generation antipsychotic drugs is most commonly associated with the treatment of refractory schizophrenia due to its efficacy and unique side effect profile?

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

    Which of the following second-generation antipsychotics is most likely to cause sedation and orthostatic hypotension due to its strong α-adrenergic blockade?

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

    Which of the following describes the mechanism of action of third-generation (atypical) antipsychotics like aripiprazole?

    <p>They are D2 partial agonists, reducing dopamine transmission in areas with excess dopamine but leaving normal dopamine transmission unaffected.</p> Signup and view all the answers

    Which of the following is true about aripiprazole in comparison to other atypical antipsychotics?

    <p>It has partial agonist activity at D2, D3, and 5HT-1a receptors and an antagonist effect at 5HT-2a receptors.</p> Signup and view all the answers

    How do partial agonists like aripiprazole help reduce extrapyramidal symptoms (EPS) in schizophrenia treatment?

    <p>By stabilizing dopamine activity, reducing excess dopamine in certain brain areas without affecting normal dopamine activity in other regions, such as the nigrostriatal pathway.</p> Signup and view all the answers

    Which of the following third-generation (atypical) antipsychotic drugs is considered a partial agonist at dopamine D2 receptors and is commonly used in the treatment of schizophrenia?

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

    Aripiprazole, as a partial agonist at D2 receptors, primarily works by:

    <p>Reducing dopamine transmission where it is excessively high, such as in the mesolimbic pathway, and stabilizing dopamine levels in other regions like the nigrostriatal pathway.</p> Signup and view all the answers

    Which of the following is a serious side effect associated with the use of clozapine that requires regular monitoring?

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

    Which of the following is true regarding the use of risperidone in elderly patients with dementia?

    <p>It increases the risk of stroke and mortality in elderly patients with dementia-related psychosis.</p> Signup and view all the answers

    Which of the following is a partial agonist at the D2 and D3 receptors and an antagonist at the 5HT-2A receptor, helping to reduce EPS and improve both positive and negative symptoms in schizophrenia?

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

    Which of the following is NOT typically used in the acute management of a manic episode in bipolar disorder?

    <p>Sertraline (SSRI)</p> Signup and view all the answers

    In the treatment of bipolar disorder, which drug has delayed action in acute mania but is considered a first-line treatment for mood stabilization in long-term management?

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

    Which of the following drugs is considered a second-line treatment for mania in bipolar disorder?

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

    Which of the following is a common long-term treatment option for bipolar disorder that can be administered as an injectable?

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

    Which of the following best describes the mechanism of action of lithium in bipolar disorder?

    <p>Lithium reduces intracellular sodium concentrations, partially reducing depolarization and excitability.</p> Signup and view all the answers

    What is the most common side effect associated with lithium therapy?

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

    What is the therapeutic range for lithium?

    <p>0.5-1.0 mmol/l</p> Signup and view all the answers

    Which of the following drugs is most effective in preventing the depressive phase of bipolar disorder?

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

    Which of the following antiepileptic drugs is considered effective in the treatment of bipolar disorder?

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

    Which of the following drugs is primarily used to treat psychotic depression and bipolar depression?

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

    Which of the following is the most common combination therapy used for preventing relapse in bipolar disorder?

    <p>Lithium and an antipsychotic</p> Signup and view all the answers

    What is a key characteristic of Lithium treatment?

    <p>Toxicity occurs at doses &gt; 0.5 mmol/L</p> Signup and view all the answers

    Why is Olanzapine prescribed for a 22-year-old male exhibiting both positive and negative symptoms of schizophrenia?

    <p>It offers better treatment of negative symptoms</p> Signup and view all the answers

    Which statement is true regarding second-generation antipsychotics compared to first-generation ones?

    <p>Second-generation antipsychotics can increase the risk of metabolic syndromes</p> Signup and view all the answers

    Which medication is commonly used as a mood stabilizer for depressive symptoms in bipolar disorder?

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

    What is a common misconception about first-generation antipsychotics?

    <p>They generally result in less metabolic side effects</p> Signup and view all the answers

    Study Notes

    Lithium

    • Slow onset of action
    • Toxicity occurs at doses > 0.5 mmol/L

    Antipsychotics

    • Second generation antipsychotics (SGAs) are more effective in treating negative symptoms of schizophrenia compared to first-generation antipsychotics (FGAs)
    • SGAs have a higher risk of metabolic syndromes compared to FGAs
    • FGAs have a lower risk of tardive dyskinesia compared to SGAs

    Mood Stabilizers

    • Lamotrigine is a mood stabilizer used for patients with predominantly depressive symptoms in bipolar disorder.

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    Description

    This quiz explores the criteria for diagnosing depression, including the minimum duration of symptoms required. Test your knowledge on the diagnostic guidelines and deepen your understanding of mental health.

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