Mental Health and Psychology Psychopharmacology 2 — Questions and Answers
Question 1: What is the mechanism of action of bupropion (Wellbutrin) compared to SSRIs?
- It also inhibits serotonin reuptake like SSRIs
- It inhibits reuptake of dopamine and norepinephrine, with no significant serotonin effect (Correct answer)
- It is a serotonin partial agonist
- It works by blocking histamine receptors
Correct answer: It inhibits reuptake of dopamine and norepinephrine, with no significant serotonin effect
Bupropion is an NDRI (norepinephrine-dopamine reuptake inhibitor) that does not significantly affect serotonin, giving it a different side effect profile including no sexual dysfunction.
Question 2: Clozapine is an atypical antipsychotic reserved for treatment-resistant schizophrenia because it requires monitoring for:
- Tardive dyskinesia
- Agranulocytosis (dangerous reduction of white blood cells) (Correct answer)
- QT prolongation
- Hypothyroidism
Correct answer: Agranulocytosis (dangerous reduction of white blood cells)
Clozapine can cause potentially fatal agranulocytosis, requiring mandatory regular blood count monitoring through a Risk Evaluation and Mitigation Strategy (REMS) program.
Question 3: MAOIs (Monoamine Oxidase Inhibitors) require dietary restrictions because food containing tyramine can cause:
- Serotonin syndrome
- Hypertensive crisis (Correct answer)
- Agranulocytosis
- QTc prolongation
Correct answer: Hypertensive crisis
MAOIs prevent tyramine breakdown; consuming tyramine-rich foods (aged cheese, wine, cured meats) while on MAOIs can cause dangerous, potentially fatal hypertensive crises.
Question 4: Stimulant medications for ADHD (e.g., methylphenidate, amphetamines) primarily work by:
- Sedating overactive neural circuits
- Increasing dopamine and norepinephrine availability in the prefrontal cortex (Correct answer)
- Blocking glutamate receptors
- Enhancing GABA inhibition
Correct answer: Increasing dopamine and norepinephrine availability in the prefrontal cortex
ADHD stimulants increase dopamine and norepinephrine in the prefrontal cortex, improving attention, impulse control, and executive functioning.
Question 5: What is serotonin syndrome and what combination of drugs most commonly causes it?
- A kidney disorder caused by lithium; lithium + diuretics
- A life-threatening excess of serotonin; often caused by combining two serotonergic medications (Correct answer)
- Sedation from combining two CNS depressants
- A withdrawal syndrome from stopping SSRIs suddenly
Correct answer: A life-threatening excess of serotonin; often caused by combining two serotonergic medications
Serotonin syndrome is a potentially life-threatening condition from excess serotonergic activity, classically caused by combining SSRIs with MAOIs, tramadol, or other serotonergic agents.
Question 6: Naltrexone is used in addiction medicine primarily as a treatment for:
- Opioid withdrawal symptoms
- Cocaine dependence
- Alcohol use disorder and opioid use disorder by blocking opioid receptors (Correct answer)
- Stimulant use disorder
Correct answer: Alcohol use disorder and opioid use disorder by blocking opioid receptors
Naltrexone is an opioid receptor antagonist that reduces the reinforcing effects of alcohol and opioids, decreasing cravings and relapse rates in both alcohol and opioid use disorders.
Mental Health and Psychology Psychopharmacology 2
What is the mechanism of action of bupropion (Wellbutrin) compared to SSRIs?