Drugs in Psychiatric Disorders Practice Questions

Q: Which of the following is a tricyclic antidepressant?

Doxepin. ***Doxepin*** - **Doxepin** is a **tricyclic antidepressant (TCA)** that inhibits the reuptake of **serotonin** and **norepinephrine**, and also has significant **histaminergic** and **cholinergic** blocking effects. - TCAs, including doxepin, are commonly used for treating **depression**, **anxiety**, and certain pain conditions. *Venlafaxine* - **Venlafaxine** is a **serotonin-norepinephrine reuptake inhibitor (SNRI)**, not a tricyclic antidepressant. - SNRIs selectively block the reuptake of both **serotonin** and **norepinephrine**, but lack the broad receptor affinity of TCAs. *Fluoxetine* - **Fluoxetine** is a **selective serotonin reuptake inhibitor (SSRI)**, which specifically targets serotonin reuptake. - SSRIs are generally considered a first-line treatment for depression due to a more favorable side effect profile compared to TCAs. *Citalopram* - **Citalopram** is also a **selective serotonin reuptake inhibitor (SSRI)**, much like fluoxetine. - It works by increasing the levels of **serotonin** in the brain by blocking its reuptake, differentiating it from tricyclic antidepressants.

Q: Which anxiolytic acts through 5-HT1A receptor partial agonism without exhibiting significant anticonvulsant or muscle relaxant properties?

Buspirone. ***Buspirone*** - **Buspirone** is a unique anxiolytic that primarily acts as a **partial agonist at 5-HT1A receptors**. - Unlike benzodiazepines, it lacks significant **anticonvulsant**, **muscle relaxant**, or **sedative-hypnotic properties** and does not lead to physical dependence or withdrawal. *Diazepam* - **Diazepam** is a **benzodiazepine** that acts by enhancing the effect of **GABA** at GABA-A receptors, leading to significant anxiolytic, sedative, muscle relaxant, and anticonvulsant effects. - It does not primarily act via **5-HT1A receptor partial agonism**. *Zolpidem* - **Zolpidem** is a **non-benzodiazepine hypnotic** that selectively binds to the **GABA-A receptor** subunit, primarily mediating sedative effects. - While it's used for insomnia, it doesn't primarily act as a **5-HT1A partial agonist** and is not typically used for its anxiolytic properties in the same way as buspirone. *Phenobarbitone* - **Phenobarbitone** is a **barbiturate** that acts by prolonging the opening of **chloride channels** associated with GABA-A receptors, leading to strong sedative, hypnotic, and anticonvulsant effects. - Its mechanism of action is distinct from **5-HT1A receptor partial agonism**, and it carries a high risk of dependence and overdose.

Q: Lithium directly affects which ion ?

Sodium. ***Sodium*** - Lithium directly interferes with **sodium ion transport** across cell membranes, particularly by inhibiting the **Na+/K+-ATPase** pump. - This interference alters intracellular sodium concentrations and affects neural excitability, contributing to its **mood-stabilizing** effects. *Potassium* - While potassium transport is linked to the **Na+/K+-ATPase pump**, lithium primarily acts through its effect on **sodium transport**, rather than directly mimicking or significantly altering potassium. - Changes in potassium levels due to lithium are largely secondary to its primary impact on sodium. *Magnesium* - Lithium has a more direct impact on **sodium channels** and transporters, contrasting with its less direct or significant interaction with magnesium metabolism. - Though magnesium is crucial for numerous cellular processes, it is not the primary ion directly affected by lithium's therapeutic actions. *Calcium* - Lithium does not directly affect **calcium channels** or calcium signaling pathways in the same way it impacts sodium. - While lithium may indirectly influence calcium-dependent processes, its primary direct target for therapeutic effects is not calcium.

Q: Which amino acid-derived neurotransmitter is primarily targeted in the pharmacological treatment of depression?

Serotonin. ***Serotonin*** - **Serotonin** is an amino acid-derived neurotransmitter (from **tryptophan**) known to play a crucial role in mood regulation, sleep, appetite, and other functions, making it a primary target for **antidepressant medications**. - Medications like **Selective Serotonin Reuptake Inhibitors (SSRIs)** increase serotonin levels in the brain to alleviate symptoms of depression. *Histamine* - **Histamine** is an amino acid-derived neurotransmitter (from **histidine**) primarily involved in allergic reactions, inflammation, and regulating wakefulness. - While it has some central nervous system effects, its primary role is not directly in the treatment of **depression**. *Acetylcholine* - **Acetylcholine** is a neurotransmitter involved in muscle contraction, learning, memory, and attention, and is not derived from amino acids; it is synthesized from **choline** and acetyl-CoA. - It is not directly used for treating **depression**, although imbalances can play a role in cognitive aspects of some psychiatric disorders. *None of the options* - This option is incorrect because **Serotonin** is indeed an amino acid-derived neurotransmitter (from tryptophan) targeted for treating **depression**. - Many antidepressant drugs work by modulating **serotonergic pathways**.

Q: Which of the following is a selective serotonin and norepinephrine reuptake inhibitor?

Venlafaxine. ***Venlafaxine*** - **Venlafaxine** is a commonly used antidepressant that inhibits the reuptake of both **serotonin** and **norepinephrine**, making it an SNRI. - Its dual mechanism of action can be effective for a broad range of depressive and anxiety disorders. *Fluoxetine* - **Fluoxetine** is a **selective serotonin reuptake inhibitor (SSRI)**, primarily affecting serotonin levels in the brain. - It does not significantly inhibit norepinephrine reuptake and, thus, is not classified as an SNRI. *Sertraline* - **Sertraline** is another widely prescribed antidepressant that is also a **selective serotonin reuptake inhibitor (SSRI)**. - It works mainly by increasing serotonin availability in the synaptic cleft. *Aripiprazole* - **Aripiprazole** is an **atypical antipsychotic** medication, often used as an adjunct therapy for depression, but its primary mechanism is partial agonism at dopamine D2 and serotonin 5-HT1A receptors, and antagonism at serotonin 5-HT2A receptors. - It is not classified as a selective serotonin and norepinephrine reuptake inhibitor.

Q: Which of the following is not a selective serotonin reuptake inhibitor?

Buspirone. ***Buspirone*** - **Buspirone** is an anxiolytic that primarily acts as a **serotonin 5-HT1A receptor partial agonist**, not an SSRI. - It does not significantly affect the reuptake of serotonin, distinguishing it from SSRIs. *Fluoxetine* - **Fluoxetine** is a well-known and widely used **SSRI**. - It works by selectively inhibiting the reuptake of serotonin, thereby increasing its concentration in the synaptic cleft. *Fluvoxamine* - **Fluvoxamine** is another antidepressant classified as an **SSRI**. - It is often used for the treatment of **obsessive-compulsive disorder (OCD)** due to its strong serotonin reuptake inhibition. *Citalopram* - **Citalopram** is an **SSRI** frequently prescribed for depression and anxiety disorders. - Its mechanism involves potent and selective inhibition of **serotonin reuptake**.

Q: Extrapyramidal syndrome-like side effects are seen in which of the following medications?

Haloperidol. ***Haloperidol*** - **Haloperidol** is a **typical antipsychotic** known for its potent **dopamine D2 receptor blockade**. - This strong blockade in the **nigrostriatal pathway** often leads to **extrapyramidal symptoms (EPS)** such as dystonia, akathisia, and parkinsonism. *Clozapine* - **Clozapine** is an **atypical antipsychotic** that has a lower propensity for causing **extrapyramidal symptoms (EPS)** due to its weaker D2 receptor antagonism and potent serotonin 5-HT2A receptor blockade. - While it can cause other severe side effects, such as **agranulocytosis** and **myocarditis**, EPS are less common compared to typical antipsychotics. *Tetracycline* - **Tetracycline** is an **antibiotic** primarily used to treat bacterial infections. - Its mechanism of action involves inhibiting bacterial protein synthesis, and it is not associated with **neurological side effects** like **extrapyramidal symptoms**. *Ketoconazole* - **Ketoconazole** is an **antifungal medication** that works by inhibiting ergosterol synthesis in fungi. - It is known for potential **hepatotoxicity** and **endocrine dysfunction**, but not for causing **extrapyramidal symptoms**.

Q: Which adverse drug reaction is commonly associated with Haloperidol?

Acute Dystonia. ***Acute Dystonia*** - **Haloperidol** is a **first-generation antipsychotic** that potently blocks **dopamine D2 receptors**, especially in the **nigrostriatal pathway**. - This blockade can lead to acute, involuntary muscle contractions, known as **acute dystonia**, which often manifests as **torticollis**, **oculogyric crisis**, or **laryngospasm**. *Weight Gain* - While **weight gain** can occur with some antipsychotics, it is more commonly associated with **second-generation antipsychotics** (e.g., olanzapine, clozapine) due to their effects on histamine and serotonin receptors. - Haloperidol's risk of significant weight gain is generally considered to be lower. *Sedation* - **Sedation** can be an adverse effect of haloperidol, but it is not considered the **most common** or distinguishing adverse reaction compared to extrapyramidal symptoms. - Sedation is often a general side effect seen with many psychotropic medications. *Nausea* - **Nausea** is a possible gastrointestinal side effect of many medications, including haloperidol, but it is not a hallmark adverse reaction. - It is far less specific and less commonly problematic than the **extrapyramidal symptoms (EPS)** associated with haloperidol.

Q: Which of the following is NOT a common effect of tricyclic antidepressants?

Metabolic alkalosis. ***Metabolic alkalosis*** - **Tricyclic antidepressants (TCAs)** do not typically cause metabolic alkalosis. Their overdose or therapeutic use is not associated with this acid-base imbalance. - While TCAs can disrupt various physiological processes, **metabolic alkalosis** is not a characteristic adverse effect or sign of overdose. *Prolongation of QRS complexes* - **TCAs block sodium channels** in the myocardium, which can lead to widening of the **QRS complex**, indicating delayed ventricular depolarization. - This is a significant cardiac toxicity of TCA overdose, increasing the risk of **ventricular arrhythmias**. *Myoclonic jerks* - **TCA overdose** can manifest with **neurological symptoms**, including involuntary muscle contractions like **myoclonic jerks**. - These are often part of the **seizure activity** that can occur with severe TCA toxicity. *Coma* - **Central nervous system depression** is a common and serious effect of TCA overdose, often leading to **coma**. - This is due to the broad **anticholinergic** and **sedative effects** of these drugs at high doses.

Q: Which of the following drugs has the maximum chances of causing hyperprolactinemia?

Risperidone. ***Risperidone*** - **Risperidone** has a higher propensity to cause **hyperprolactinemia** compared to other atypical antipsychotics due to its strong **dopamine D2 receptor antagonism**, which disinhibits prolactin secretion [1]. - This side effect can lead to symptoms like **galactorrhea**, **amenorrhea**, **gynecomastia**, and **sexual dysfunction** [1]. *Clozapine* - **Clozapine** generally has a **low risk of hyperprolactinemia** because it has a relatively weak affinity for **dopamine D2 receptors** and also acts as a **serotonin 5-HT2A antagonist**, which can counteract prolactin elevation [1]. - While other severe side effects like **agranulocytosis** are associated with clozapine, hyperprolactinemia is not a prominent concern. *Olanzapine* - **Olanzapine** has a moderate potential for elevating **prolactin levels**, often less than risperidone but more than aripiprazole or quetiapine. - Its effects on prolactin are attributable to its **dopamine D2 receptor antagonism**, but other pharmacological properties can modulate this effect. *Ziprasidone* - **Ziprasidone** is known for its **low risk of hyperprolactinemia**, similar to aripiprazole [1]. - This is partly due to its **less potent D2 receptor antagonism** and its additional actions as a serotonin 5-HT1A agonist, which can actually decrease prolactin release.

Question 1

Which of the following is a tricyclic antidepressant?

Accepted Answer

Doxepin

Answer

Fluoxetine

Answer

Citalopram

Answer

Venlafaxine

Question 2

Which anxiolytic acts through 5-HT1A receptor partial agonism without exhibiting significant anticonvulsant or muscle relaxant properties?

Accepted Answer

Buspirone

Answer

Diazepam

Answer

Zolpidem

Answer

Phenobarbitone

Question 3

Lithium directly affects which ion ?

Accepted Answer

Sodium

Answer

Potassium

Answer

Magnesium

Answer

Calcium

Question 4

Which amino acid-derived neurotransmitter is primarily targeted in the pharmacological treatment of depression?

Accepted Answer

Serotonin

Answer

Histamine

Answer

None of the options

Answer

Acetylcholine

Question 5

Which of the following is a selective serotonin and norepinephrine reuptake inhibitor?

Accepted Answer

Venlafaxine

Answer

Fluoxetine

Answer

Sertraline

Answer

Aripiprazole

Question 6

Which of the following is not a selective serotonin reuptake inhibitor?

Accepted Answer

Buspirone

Answer

Citalopram

Answer

Fluoxetine

Answer

Fluvoxamine

Question 7

Extrapyramidal syndrome-like side effects are seen in which of the following medications?

Accepted Answer

Haloperidol

Answer

Clozapine

Answer

Tetracycline

Answer

Ketoconazole

Question 8

Which adverse drug reaction is commonly associated with Haloperidol?

Accepted Answer

Acute Dystonia

Answer

Weight Gain

Answer

Sedation

Answer

Nausea

Question 9

Which of the following is NOT a common effect of tricyclic antidepressants?

Accepted Answer

Metabolic alkalosis

Answer

Prolongation of QRS complexes

Answer

Myoclonic jerks

Answer

Coma

Question 10

Which of the following drugs has the maximum chances of causing hyperprolactinemia?

Accepted Answer

Risperidone

Answer

Clozapine

Answer

Olanzapine

Answer

Ziprasidone

Drugs in Psychiatric Disorders — MCQs

Drugs in Psychiatric Disorders — MCQs

On this page

Practice by Chapter

Want unlimited practice?