Deck 12: Antidepressant Drugs

Question 1

All of the following are recognized symptoms of depression EXCEPT:

A)sleep difficulties.
B)excessive feelings of guilt.
C)decreased blood pressure.
D)fatigue or loss of energy.

Answer 1

C

Question 2

Depression is responsible for up to _____ percent of all psychiatric hospitalizations.

A)10
B)30
C)50
D)70

Answer 2

D

Question 3

_____ is responsible for up to 70 percent of psychiatric hospitalizations.

A)Anxiety
B)Depression
C)Schizophrenia
D)Bipolar disorder

Answer 3

B

Question 4

The __________ can suffer damage that is attributed to mental stress.

A)temporal lobes
B)thalamus
C)pons
D)hippocampus

Question 5

TCAs are __________ compared to SSRIs.

A)more effective and less expensive
B)no more effective and more expensive
C)more effective and more expensive
D)no more effective but less expensive

Question 6

_____ is currently the leading cause of disability worldwide.

A)Anxiety
B)Depression
C)Alcoholism
D)Heroin addiction

Question 7

First-generation tricyclic antidepressants are defined by a commonality in basic:

A)effect.
B)mechanism of action.
C)structure.
D)site of action.

Question 8

Today,anxiety disorders may be treated with:

A)anxiolytics.
B)antidepressants.
C)antipsychotics.
D)barbiturates.

Question 9

Evidence suggests that _____ may be a final common target of antidepressant treatment.

A)cAMP-dependent protein kinase (PKA)
B)brain-derived neurotrophic factor (BDNF)
C)neurotrophins
D)cAMP response-element-binding protein (CREB)

Question 10

Evidence suggests that _____ during antidepressant treatment provides evidence to _____ the neurogenic hypothesis of depression.

A)cAMP response-element-binding protein (CREB); discredit
B)brain-derived neurotrophic factor (BDNF); support
C)cAMP response-element-binding protein (CREB); support
D)brain-derived neurotrophic factor (BDNF); discredit

Question 11

The neurogenic theory of depression stems from recent findings that neurons in the mature brain:

A)are incapable of repairing themselves.
B)are incapable of being newly produced.
C)can neither be repaired nor produced.
D)are capable of being repaired and produced.

Question 12

__________ are affected by tricyclic antidepressants (TCAs).

A)Norepinephrine and glutamate
B)Norepinephrine and serotonin
C)Dopamine and serotonin
D)Dopamine and acetylcholine

Question 13

Availability of newer antidepressants has:

A)decreased the number of treatment-resistant people with major depression.
B)increased the efficacy of antidepressants.
C)accelerated the onset of action of antidepressants.
D)improved the side-effect profile.

Question 14

Imipramine (Tofranil)and desipramine (Norpramin)are examples of:

A)MAOIs.
B)SSRIs.
C)second-generation antidepressants.
D)TCAs.

Question 15

Tricyclic antidepressants have all of the following actions EXCEPT blocking:

A)glutamate receptors.
B)histamine receptors.
C)acetylcholine receptors.
D)norepinephrine reuptake.

Question 16

The first-generation antidepressants consist of:

A)TCAs only.
B)MAOIs only.
C)atypical antidepressants.
D)TCAs and MAOIs.

Question 17

In the 1960s,__________ would be more often used to treat patients with depression.

A)tricyclic antidepressants (TCAs)
B)selective serotonin reuptake inhibitors (SSRIs)
C)monoamine oxidase
D)atypical second-generation antidepressants

Question 18

Antidepressants have been prescribed to treat anxiety because:

A)they are less prone to induce compulsive use.
B)depression is always associated with panic disorder.
C)they are useful for treatment of psychosis.
D)mild depression often occurs with obsessive compulsive disorder (OCD).

Question 19

The neurogenic theory of depression involves the notion that:

A)existing neurons are unable to repair themselves in some people resulting in accumulating "depression" of the cells.
B)the brain is capable of making new neurons.
C)there is an upregulation of neurogenesis in depressed patients.
D)existing neurons are resistant to damage in depressed patients.

Question 20

The use of antidepressants has:

A)eliminated depression.
B)been associated with few side effects.
C)not been effective for relief of anxiety.
D)resulted in modest improvements in depression.

Question 21

The tricyclic antidepressants differ from SSRIs in that they also have major effects on the following neurotransmitter:

A)glutamate.
B)norepinephrine.
C)serotonin.
D)GABA.

Question 22

In depressed patients,tricyclic antidepressants _____ and are _____ in resistant patients.

A)elevate mood; effective
B)elevate mood; ineffective
C)do not affect mood; effective
D)do not affect mood; ineffective

Question 23

Tricyclic antidepressants (TCAs):

A)produce euphoria.
B)cause a number of side effects.
C)are known teratogens.
D)are advantageous for treatment because of the rapid onset of action.

Question 24

Blockade of acetylcholine receptors can result in all the following EXCEPT:

A)blurred vision.
B)dry mouth.
C)cognitive deficits.
D)motor deficits.

Question 25

The _____ are considered the first dual-action antidepressants.

A)TCAs
B)MAOIs
C)SSRIs
D)SNRIs

Question 26

The __________ is the mechanism of action of MAOIs.

A)blockade of postsynaptic receptors
B)inhibition of degradation by enzymes
C)inhibition of neurotransmitter reuptake
D)inhibition of neurotransmitter release

Question 27

Patients categorized with atypical depression may be prescribed _____.

A)atypical antidepressants
B)MAOIs
C)SARIs
D)SNRIs

Question 28

__________ is the therapeutic mechanism of action of tricyclic antidepressants.

A)Blockade of postsynaptic receptors
B)Inhibition of degradation by enzymes
C)Inhibition of neurotransmitter reuptake
D)Inhibition of neurotransmitter release

Question 29

Therapeutic drug monitoring (TDM)involves monitoring:

A)side effects.
B)blood levels.
C)efficacy.
D)genetics.

Question 30

Impairment of memory is a side effect clearly associated with the use of:

A)TCAs.
B)SSRIs.
C)second-generation antidepressants.
D)MAOIs.

Question 31

Because they __________,interest in the MAOIs as potential drugs to treat depression persists.

A)are safer than SSRIs
B)are particularly good for treating major depression and even better than SSRIs or TCAs
C)are an excellent choice for patients with substance abuse issues
D)work in patients who do not respond to TCAs and SSRIs

Question 32

When discontinuing an MAOI,patients may:

A)switch immediately to a new drug.
B)switch immediately to a new drug and ignore dietary restrictions.
C)discontinue use but must continue to follow dietary restrictions for about 2 weeks.
D)discontinue use and take twice as much as prescribed on the new medication.

Question 33

In addition to treating depression,__________ can also be treated with tricyclic antidepressants (TCAs).

A)sexual dysfunction
B)cognitive dysfunction
C)chronic pain
D)cardiac arrhythmias

Question 34

Cardiac toxicity is an effect most clearly associated with overdose of:

A)TCAs.
B)SSRIs.
C)second-generation antidepressants.
D)MAOIs.

Question 35

Significant sedation is a side effect of the:

A)MAOIs.
B)SSRIs.
C)second-generation antidepressants.
D)TCAs.

Question 36

Dangerous interactions with aged cheese and other food products containing tyramine is associated with:

A)TCAs.
B)SSRIs.
C)atypical second-generation antidepressants.
D)MAOIs.

Question 37

Nortriptyline and desipramine are typically the most favorable of the TCA medications because they cause less problems related to _____ receptors.

A)acetylcholine
B)epinephrine
C)norepinephrine
D)dopamine

Question 38

Blockade of acetylcholine receptors can result in all the following EXCEPT:

A)cognitive deficits.
B)memory loss.
C)diuresis.
D)constipation.

Question 39

Tricyclic antidepressants (TCAs)exert which of the following pharmacological actions?

A)Presynaptic reuptake transporter for acetylcholine
B)Blockade of postsynaptic receptors for serotonin (5-HT)
C)Presynaptic reuptake transporter for norepinephrine
D)Blockade of postsynaptic transporters for GABA

Question 40

The dry mouth,memory impairment,and confusion associated with use of tricyclic antidepressants are a result of action on the following neurotransmitter:

A)norepinephrine.
B)serotonin.
C)histamine.
D)acetylcholine.

Question 41

Which of the following statements is NOT a reason why MAOIs are still an attractive antidepressant for treating depression?

A)MAOIs are as safe as SSRIs.
B)MAOIs may be effective for patients that do not respond to SSRIs or TCAs.
C)MAOIs are very effective for treating atypical depression.
D)MAOIs are effective as an adjunct in treating chronic pain.

Question 42

The __________ is mechanism of action of newer antidepressants such as Prozac and Zoloft.

A)Blockade of postsynaptic receptors
B)Inhibition of degradation by enzymes
C)Inhibition of neurotransmitter reuptake
D)Inhibition of neurotransmitter release

Question 43

Of the atypical antidepressants,______ is unique in that it acts as a reuptake inhibitor of dopamine and is useful for smoking cessation.

A)clomipramine (Anafranil)
B)trazodone (Desyrel)
C)bupropion (Wellbutrin,Zyban)
D)vilazodone (Viibryd)

Question 44

The various SSRIs (Prozac,Zoloft,Paxil)differ in terms of:

A)efficacy but not mechanism of action.
B)mechanism of action but not efficacy.
C)neither efficacy nor mechanism of action.
D)both efficacy and mechanism of action.

Question 45

Formulated as a short-acting,immediate-release atypical antidepressant medication in the 1980s,trazodone (Desyrel):

A)has been used as an antidepressant anxiolytic.
B)causes drowsiness resulting in its use as an antidepressant hypnotic.
C)blocks D₂ receptors as well as 5HT_2A receptors.
D)stimulates acetylcholine function resulting in improved memory.

Question 46

Of the following classes of antidepressant drugs,__________ are associated with the highest incidence of sexual dysfunction.

A)TCAs
B)SSRIs
C)SNRIs
D)MAOIs

Question 47

Shameka recently stopped taking her meds for depression.She did so without following her physician's instructions.Now Shameka has problems with her balance.She was most likely taking a(n):

A)tricyclic antidepressant.
B)selective serotonin reuptake inhibitor.
C)monoamine oxidase inhibitor.
D)atypical second-generation antidepressant.

Question 48

__________ is involved in MAO-B's mechanism of action.

A)Norepinephrine
B)Serotonin
C)Dopamine
D)Glutamate

Question 49

The biggest concern with using psychostimulants,such as amphetamines,to treat depression is the:

A)side effects.
B)dosage level.
C)potential for abuse.
D)stimulant effects.

Question 50

Of the tricyclic antidepressants (TCAs),_____ is particularly effective at serotonin reuptake inhibition.

A)clomipramine (Anafranil)
B)imipramine (Tofranil)
C)desipramine (Norpramin)
D)amitriptyline (Elavil)

Question 51

_____ may induce a cluster of physiological and behavioral effects such as cognitive disturbances,restlessness,fever,and ataxia.

A)Tricyclic antidepressants
B)Selective serotonin reuptake inhibitors
C)Monoamine oxidase inhibitors
D)Atypical second-generation antidepressants

Question 52

Muriel recently stopped taking her medication,which resulted in her flulike symptoms.She was most likely taking a(n):

A)tricyclic antidepressant.
B)SSRI.
C)MAOI.
D)atypical second-generation antidepressant.

Question 53

As noted by some patients,the discontinuation of __________ can result in sensations that feel like electric shocks.

A)tricyclic antidepressants
B)SSRIs
C)MAOIs
D)atypical second-generation antidepressants

Question 54

Which of the following statements is TRUE?

A)TCAs,but not SSRIs,are useful in treating clinical pain syndromes.
B)SSRIs,but not TCAs,are useful in treating anxiety disorders.
C)Both TCAs and SSRIs are useful in treating clinical pain syndromes.
D)Neither TCAs nor SSRIs are useful in treating anxiety disorders.

Question 55

One of the primary compliance issues for those taking __________ is a general loss of desire for sex in those taking the medication.

A)monoamine oxidase inhibitors
B)selective serotonin reuptake inhibitors
C)atypical antidepressants
D)tricyclic antidepressants

Question 56

The SSRI __________ is mostly associated with "serotonin syndrome."

A)sertraline (Zoloft)
B)fluoxetine (Prozac)
C)fluvoxamine (Luvox)
D)paroxetine (Paxil)

Question 57

Presumably because they __________,some patients do not respond to SSRIs.

A)lack serotonin receptors
B)are slow metabolizers resulting in accumulation of the drug
C)are rapid metabolizers resulting in inadequate blood levels
D)have in poor absorption due to certain patient dietary issues

Question 58

Because it __________,maprotiline (Ludiomil),an atypical antidepressant developed in the 1980s,is no longer a first-choice antidepressant.

A)has a short half-life.
B)blocks glutamate receptors.
C)makes people feel anxious.
D)can cause seizures.

Question 59

______ has a particularly long half-life due to an active metabolite.For this reason,patients may not take this drug on a daily basis.

A)Sertraline (Zoloft)
B)Fluoxetine (Prozac)
C)Fluvoxamine (Luvox)
D)Paroxetine (Paxil)

Question 60

Developed as an SNRI antidepressant,_____ has been approved by the FDA to treat ADHD in children,adolescents,and adults.

A)reboxetine (Vestra)
B)imipramine (Tofranil)
C)atomoxetine (Strattera)
D)bupropion (Wellbutrin,Zyban)

Question 61

Evidence suggests that fish oil supplements that contain _____ have been shown to combat depression.

A)eicospaentaenoic acid (EPA)
B)docosahexaenoic acid (DHA)
C)vitamin B folate
D)vitamin D

Question 62

Mirtazapine (Remeron)works by increasing release of both _____ and _____.

A)norepinephrine; serotonin
B)dopamine; acetylcholine
C)epinephrine; histamine
D)serotonin; dopamine

Question 63

A deficiency of the B vitamin folate:

A)increases monoamine levels and the risk of depression.
B)decreases monoamine levels and the risk of depression.
C)increases monoamine levels and decreases the risk of depression.
D)decreases monoamine levels and increases the risk of depression.

Question 64

The antidepressant tianeptine's mechanism of action is unique for its:

A)blockade of presynaptic reuptake of norepinephrine.
B)facilitation of presynaptic reuptake of norepinephrine.
C)blockade of presynaptic reuptake of serotonin.
D)facilitation of presynaptic reuptake of serotonin.

Question 65

In general,the response to the initial treatment with an antidepressant medication is in the range of _____ percent.

A)10 to 20
B)20 to 30
C)40 to 50
D)50 to 60

Question 66

The dual-acting antidepressant nefazodone (Serzone)blocks _______; however,its use has been associated with ______.

A)5-HT₁; kidney failure
B)5-HT₁; liver failure
C)5-HT₂; kidney failure
D)5-HT₂; liver failure

Question 67

The use of S-Adenosylmethionine (SAM-e):

A)is a frequent addition to SSRI treatment for depression.
B)may be helpful for mild depression.
C)is commonly used to treat major depression.
D)involves substance P antagonism.

Question 68

Selective norepinephrine reuptake inhibitors (SNRIs)are:

A)ineffective in treating depression.
B)ineffective in treating ADHD.
C)effective in treating depression,but not ADHD.
D)effective in treating depression and ADHD.

Question 69

Mirtazapine (Remeron)works by blocking _____ and increasing _____.

A)reuptake; norepinephrine
B)reuptake; dopamine
C)autoreceptors; norepinephrine
D)autoreceptors; dopamine

Question 70

_____ is a combination of fluoxetine and olanzapine (an atypical antipsychotic)that has been formulated for the treatment of depressive episodes associated with bipolar disorder.

A)Sertraline (Zoloft)
B)Symbyax
C)Fluvoxamine (Luvox)
D)Vilazodone

Question 71

St.John's wort is known to directly enhance _____.

A)neurotransmitter release
B)receptor sensitivity
C)BDNF
D)autoreceptors

Question 72

The atypical second-generation antidepressant venlafaxine (Effexor)differs most from the tricyclic antidepressants in its effect or lack thereof on the __________ neurotransmitter.

A)dopamine
B)serotonin
C)norepinephrine
D)acetylcholine

Question 73

The __________ are responsible for buspirone's mechanism of action.

A)5-HT_1A receptors
B)5-HT₂ receptors
C)D₂ receptors
D)alterations in GABA levels

Question 74

The dual-acting antidepressant Effexor EX (extended release)is FDA-approved for the treatment of:

A)bipolar disorder.
B)panic disorder.
C)decreased libido.
D)ADHD.