Mental Health and Psychology Psychopharmacology 1 — Questions and Answers
Question 1: SSRIs work primarily by:
- Blocking dopamine receptors
- Inhibiting the reuptake of serotonin into presynaptic neurons (Correct answer)
- Increasing norepinephrine synthesis
- Stimulating GABA receptors
Correct answer: Inhibiting the reuptake of serotonin into presynaptic neurons
SSRIs (Selective Serotonin Reuptake Inhibitors) block the serotonin transporter, preventing reuptake and increasing serotonin availability in the synapse.
Question 2: Which class of medication is most associated with the risk of discontinuation syndrome?
- Antipsychotics
- Mood stabilizers
- SSRIs and SNRIs (Correct answer)
- Anticonvulsants
Correct answer: SSRIs and SNRIs
SSRIs and SNRIs can cause discontinuation syndrome — flu-like symptoms, dizziness, and 'brain zaps' — if stopped abruptly rather than tapered gradually.
Question 3: Antipsychotic medications primarily act on which receptor type?
- Serotonin-1A receptors
- GABA-B receptors
- Dopamine D2 receptors (Correct answer)
- Opioid receptors
Correct answer: Dopamine D2 receptors
All antipsychotics share D2 dopamine receptor antagonism as a primary mechanism, which reduces positive psychotic symptoms.
Question 4: What is 'tardive dyskinesia' as a medication side effect?
- Early onset muscle rigidity from antipsychotics
- Late-onset involuntary repetitive movements, often of the face and mouth, from prolonged antipsychotic use (Correct answer)
- Tremor from lithium toxicity
- Sedation from benzodiazepines
Correct answer: Late-onset involuntary repetitive movements, often of the face and mouth, from prolonged antipsychotic use
Tardive dyskinesia is a potentially irreversible movement disorder characterized by involuntary, repetitive movements caused by long-term dopamine antagonism.
Question 5: Which mood stabilizer requires regular blood level monitoring and has a narrow therapeutic index?
- Valproate (Depakote)
- Lamotrigine
- Lithium (Correct answer)
- Quetiapine
Correct answer: Lithium
Lithium has a narrow therapeutic window (0.6–1.2 mEq/L therapeutic; toxicity begins at 1.5 mEq/L), requiring regular blood level monitoring to ensure safety.
Question 6: Benzodiazepines are generally NOT recommended for long-term anxiety management primarily because of:
- Lack of effectiveness for anxiety
- High cost and limited insurance coverage
- Risk of tolerance, dependence, and cognitive side effects (Correct answer)
- Interactions with all SSRIs
Correct answer: Risk of tolerance, dependence, and cognitive side effects
Long-term benzodiazepine use is associated with tolerance (requiring higher doses), physiological dependence, rebound anxiety, and cognitive impairment, particularly in older adults.
Mental Health and Psychology Psychopharmacology 1
SSRIs work primarily by: