Tricyclic Antidepressants

TRICYCLIC ANTIDEPRESSANTS

Q. 1

All of the following are predictable adverse effects of tricyclic antidepressants, EXCEPT:

 A

Decrease in seizure threshold

 B

Weight gain

 C

Insomnia

 D

Dry mouth

Q. 1

All of the following are predictable adverse effects of tricyclic antidepressants, EXCEPT:

 A

Decrease in seizure threshold

 B

Weight gain

 C

Insomnia

 D

Dry mouth

Ans. C

Explanation:

Tricyclic antidepressants produce sedation rather than arousal.
Use of tricyclics can be therapeutic for insomnias associated with depression.
Other effects include antimuscarinic effects (dry mouth, blurred vision, tachycardia, urinary retention), a-adrenergic effects (orthostatic hypotension), weight gain, and a decrease in seizure threshold, which means that patients are more susceptible to having seizures.
 
Ref: O’Donnell J.M., Shelton R.C. (2011). Chapter 15. Drug Therapy of Depression and Anxiety Disorders. In L.L. Brunton, B.A. Chabner, B.C. Knollmann (Eds),Goodman & Gilman’s The Pharmacological Basis of Therapeutics, 12e.

Q. 2

All of the following is are serotonin-dopamne antagonist except:

 A

Zotepine

 B

Loxapine

 C

Sertindole

 D

All

Q. 2

All of the following is are serotonin-dopamne antagonist except:

 A

Zotepine

 B

Loxapine

 C

Sertindole

 D

All

Ans. B

Explanation:

B  i.e. Loxapine 


Q. 3

Narrow therapeutic index is seen with –

 A

Desipramine

 B

Lithium

 C

Penicillin

 D

a and b

Q. 3

Narrow therapeutic index is seen with –

 A

Desipramine

 B

Lithium

 C

Penicillin

 D

a and b

Ans. D

Explanation:

Ans. is ‘a’ i.e., Desipramine; ‘b’ i.e., Lithium

Drugs with low therapeutic index (High alert drugs)

o Amphotericin B

o Aminoglycosides

o Carbamezapine

o Cyclosporine

o Clindamycin

o Clonidine

o Digoxin

o Disopyrami de

o Dimercapral

o Guanethidine

o Isoetharine

o I soproterenol

o Levothyroxine

 

Lignocaine

o Lithium

o Metaproterenal

o Minoxidil

o Primidone

o Procainamide

o Phenytoin

o Quinidine

o Tricyclic antidepressants

o Theophylline

o  Warfarin

o Valproate

Note : Desipramine is a Tricyclic antidepressant.

Quiz In Between


Q. 4

Cardiac conduction defect seen with Tricyclic antidepressants are due to-

 A

NE & serotonin uptake inhibitor

 B

Antimuscarinic action on heart

 C

Only NE uptake inhibition

 D

Both NE uptake inhibition and antimuscarinic action on heart

Q. 4

Cardiac conduction defect seen with Tricyclic antidepressants are due to-

 A

NE & serotonin uptake inhibitor

 B

Antimuscarinic action on heart

 C

Only NE uptake inhibition

 D

Both NE uptake inhibition and antimuscarinic action on heart

Ans. D

Explanation:

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.


Q. 5

Which of the following is not a side effect of amitriptyline

 A

Constipation

 B

Fine tremors

 C

Weight loss

 D

Dry mouth

Q. 5

Which of the following is not a side effect of amitriptyline

 A

Constipation

 B

Fine tremors

 C

Weight loss

 D

Dry mouth

Ans. C

Explanation:

Ans. is ‘c’ i.e., Weight loss

TCAs (e.g. amitriptyline) cause weight gain


Q. 6

True about Imipramine is:         

September 2007

 A

Antiepileptic

 B

Antidepressant

 C

Anxiolytic

 D

Antipsychotic

Q. 6

True about Imipramine is:         

September 2007

 A

Antiepileptic

 B

Antidepressant

 C

Anxiolytic

 D

Antipsychotic

Ans. B

Explanation:

Ans. B: Antidepressant

Imipramine is a tricyclic antidepressant with general pharmacological properties similar to amitriptyline and doxepin. It possesses anticholinergic properties which are responsible for certain of its side effects.

The most prominent action of TCA’s is their ability to inhibit norepinephrine transporter and serotonin transporter located at neural/platelet membrane at low and therapeutically attained concentrations.

Quiz In Between


Q. 7

True regarding bupropion is:     

September 2009

 A

Dopamine reuptake stimulator

 B

It is an antianxiety drug

 C

No precipitation of seizures

 D

Nicotinic receptor antagonist

Q. 7

True regarding bupropion is:     

September 2009

 A

Dopamine reuptake stimulator

 B

It is an antianxiety drug

 C

No precipitation of seizures

 D

Nicotinic receptor antagonist

Ans. D

Explanation:

Ans. D: Nicotinic receptor antagonist

Bupropion/amfebutamone is an atypical antidepressant and smoking cessation aid.

It acts as a norepinephrine and dopamine reuptake inhibitor (NDRI), as well as alpha3 beta4-nicotinic receptor antagonist.

Bupropion belongs to the chemical class of aminoketones and is similar in structure to stimulants cathinone and diethylpropion, and to phenethylamines in general.

Bupropion is an effective antidepressant on its own but it is particularly popular as an add-on medication in the cases of incomplete response to the first-line selective serotonin reuptake inhibitor (SSRI) antidepressant.

Since it does not inhibit serotonin reuptake at all (or very insignificantly), bupropion does not cause weight gain or sexual dysfunction like the SSRI group of antidepressants.

It precipitates seizures


Q. 8

The tricyclic antidepressant with LEAST autonomic and cardiotoxic effects:             

March 2004

 A

Amitriptyline

 B

Desipramine

 C

Lofepramine

 D

Protriptyline

Q. 8

The tricyclic antidepressant with LEAST autonomic and cardiotoxic effects:             

March 2004

 A

Amitriptyline

 B

Desipramine

 C

Lofepramine

 D

Protriptyline

Ans. C

Explanation:

Ans. C i.e. Lofepramine


Q. 9

Which of the following is a tricyclic antidepressant‑

 A

Vanalafexine

 B

Fluoxetine

 C

Doxepine

 D

Citalopram

Q. 9

Which of the following is a tricyclic antidepressant‑

 A

Vanalafexine

 B

Fluoxetine

 C

Doxepine

 D

Citalopram

Ans. C

Explanation:

Ans. is ‘c’ i.e., Doxepine 

Quiz In Between



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