Depression – Treatment

Amoxapine

B i.e. Tranylcypromine

B i.e. Fluoxetine

A i.e. Imipramine

Ans. is ‘b’ i.e., Amoxapine

o Amoxapine is the only antidepressant which blocks D₂ receptors along with inhibition of NA reuptake —> has mixed antidepressant + neurolepic property.

Ans. is ‘d’ i.e., Both NE uptake inhibition and antimuscarinic action on heart

o The commonest cardiovascular effect of tricyclic antidepressant overdose is sinus tachycardia, which is attributable to the inhibition of norepinephrine reuptake and the anticholinergic action.

Ans. is ‘c’ i.e., Amoxapine

• Amoxapine is the only antidepressant which blocks D₂ receptors along with inhibition of NA reuptake → has mixed antidepressant + neurolepic property.
• Due to blockade of D, receptors it causes extrapyramidal side effects → Parkinsonism, Tardive dyskinesia, Akathesia, neuropeptic malignant syndrome

Ans. is ‘d’ i.e., Chlorpromazine

Ans. is ‘a’ i.e., Fluoxetine

Ans. is ‘d’ i.e., Pimozide

Ans. is ‘a’ i.e., Muscarinic acetylcholine receptors

“Blurred vision, dry mouth, urinary hesitancy or retention, and constipation represent the most common antimuscarinic complaints”.

Ans. is ‘c’ i.e., Fluoxamine

Antidepressants with no anticholinergic (antimuscarinic) action.

• Bupropion
• Escitalopram
• Fluvoxamine
• Paroxetine
• Trazodone
• Citalopram
• Duloxetine
• Venlafaxine
• Sertaline
• Mirtazapine Fluoxetine is the only SSRI which has some anticholinergic action.

Remember

Antidepressants with no sedative action

• Bupropion
• Citalopram
• Fluvoxamine
• Protriptyline
• Duloxetine
• Escitalopram 
• Venlafaxine

(Note : First 6 drugs are same in both groups)

Ans. is ‘c’ i.e., Venlafaxine

Antidepressants

A. Typical

• Tricyclic antidepressants

1. NA + 5HT reuptake inhibitors :- Imipramine, Trimipramine, Amitriptyline, Clomipramine.
2. Predominantly NA reuptake inhibitors :- Desipramine, Nortriptyline, Amoxapine, Reboxetine.

• Selective serotonin reuptake inhibitors :- Fluoxetine, Paroxetine, Sertaline, Citalopram, Scitalopram.

B. Atypical :- Trazodone, Mianserine, Mitrazapine, Venalafaxin, Duloxetine, Tianeptine, Amineptine, Bupropion.

c. MAO inhibitors :- Tranylcypramine, Meclobemide, Clorgyline.

Ans. is ‘c’ i.e., Doxepine 

Ans. is ‘d’ i.e., Amoxapine

• Amoxapine is the only antidepressant which blocks D₂ receptors along with inhibition of NA reuptake → has mixed antidepressant + neurolepic property.
• Due to blockade of D, receptors it causes extrapyramidal side effects -4 Parkinsonism, Tardive dyskinesia, Akathesia, neuropeptic malignant syndrome.

Ans. is’d’i.e., Tremors &’e’i.e., Urinary retention

[Rel KDT Vh/e p. 459; Goodman & Gilman llth/e p. 448]

Adverse effects of TCAs:

• Anticholinergic- Dry mouth, bad taste, urinary retention, blurred vision, palpitations, constipation.
• Sedation, mental confusion, weakness.
• Increased appetite and weight gain.
• Sweating and fine tremor.

Ans. (A) Old age

[Ref. Niraj Ahuja 7th/188.]

• Cases of SSRl-associated hyponatremia & the syndrome of inappropriate antidiuretic hormone have been seen in some patients, especially those who are older or treated with diuretics.