Updated: 12/15/2016

Atypical Antidepressants

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Questions
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Evidence
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Topic
Psychiatric Drug Introduction
  • Psychiatric medications can be broken down into the following categories
    • Antidepressants
    • Antipsychotics
    • Bipolar Medications
    • Anxiolytics
 
Overview
  • Buproprion
    • mechanism
      • ↑ NE and dopamine via unknown mechanism
    • other uses
      • smoking cessation
    • toxicity
      • stimulant effects (tachycardia, insomnia)
      • headache
      • seizure in bulimic patients
      • no sexual side effects
  • Mirtazapine
    • mechanism
      • α2 receptor antagonist
        • ↑ release of NE and serotonin
      • 5-HT2 and 5-HT3 receptor antagonist
    • other uses
      • depression + anorexia nervosa
        • due to weight gain side effect
    • toxicity
      • sedation, ↑ appetite, weight gain, dry mouth
  • Amoxapine
    • mechanism
      • antagonism of dopamine receptor
    • toxicity
      • EPS, seizures, cardiotoxicity
  • Maprotiline
    • mechanism
      • blocks NE reuptake
    • toxicity
      • sedation, orthostatic hypotension, seizures, cardiotoxicity
  • Trazodone
    • mechanism
      • primarily inhibits serotonin reuptake
    • other uses
      • causes sedation
        • therefore used for insomnia
      • high doses are needed for antidepressant effects
    • toxicity
      • sedation, nausea, priapism in adolescent boys, orthostatic hypotension

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Questions (2)
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(M1.PY.15.75) A 23-year-old Caucasian male presents to the emergency department with a persistent penile erection for the last 6 hours. He recently began outpatient treatment for depression with associated insomnia. He traveled to Mexico 5 months ago. His medical history is otherwise unremarkable.

Which of the following is the most likely precipitating factor for priapism in this patient?

QID: 106857
1

Depression treatment with bupropion

10%

(12/116)

2

Depression treatment with venlafaxine

9%

(11/116)

3

Depression treatment with trazodone

73%

(85/116)

4

Sickle cell disease

3%

(4/116)

5

Infection acquired in Mexico

1%

(1/116)

M 3 C

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