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Pharmacology Antidepressants | Questions And Answers Latest {} A+ Graded | 100% Verified
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Pharmacology Antidepressants | Questions And Answers Latest {} A+ Graded | 100% Verified
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Pharmacology Antidepressants | Questions And Answers Latest {2024- 2025} A+ Graded |100% Verified
Generally, how do all antidepressants work? - All currently available antidepressant drugs *enhance
monoamine neurotransmission* by one of several mechanisms. The most common mechanism is the
inhibition of the serotonin transporter (SERT), the norepinephrine transporter (NET), or both.
Name the MAO inhibitors. - • Isocarboxazid (hydrazine derivative)
• Phenelzine (hydrazine derivative)
• Tranylcypromine (non-hydrazine derivative)
• Selegiline (non-hydrazine derivative)
What are the two kinds of MAO? - There are two isozymes of MAO: MAO-A and MAO-B. MAO-A
preferentially deaminates norepinephrine, epinephrine and serotonin. Dopamine and tyramine are
metabolized by both isozymes.
What is the mechanism of action for MAO inhibitors? - MAO inhibitors inactivate the enzyme,
permitting neurotransmitter molecules to escape degradation and, therefore, to both accumulate within
the presynaptic neuron and leak into the synaptic space. This is believed to cause activation of
norepinephrine and serotonin receptors, and it may be responsible for the indirect antidepressant
action of these drugs.
Which MAO inhibitors are non-selective and irreversible? - Isocarboxazid, phenelzine and
tranylcypromine bind irreversibly and nonselectively to MAO-A and MAO-B.
Which kind of MAO inhibitor is better in treating major depression? - Experimentally, selective MAO-A
inhibitors are thought to be more effective in treating major depression than type B inhibitors.
Which MAO inhibitor is approved to treat early Parkinson's disease? - The MAO-B inhibitor *selegiline*
is approved for treatment of early Parkinson's disease.
What happens with high doses of selegiline? - Selegiline has also antidepressant effects, particularly at
high doses that also inhibit MAO-A or yield amphetamine-like metabolites. Selegiline is the first
antidepressant available in a transdermal delivery system.
, Do MAO inhibitors have immediate antidepressant effects? - No. Although MAO is fully inhibited after
several days of treatment, the antidepressant action of the MAO inhibitors is delayed several weeks.
Which MAO inhibitors may produce insomnia or agitation? - Selegiline and tranylcypromine have an
amphetamine-like stimulant effects that may produce agitation or insomnia.
What are the clinical uses of MAO inhibitors? - MAO inhibitors are now *rarely used* due to toxicity and
potentially lethal food and drug interactions. Their primary use is in the *treatment of depression
unresponsive to other antidepressants*.
What are the adverse effects of MAO inhibitors? - Possible adverse effects of treatment with MAO
inhibitors include drowsiness, orthostatic hypotension, blurred vision, dry mouth, dysuria, and
constipation.
How are MAO inhibitors administered? - MAO inhibitors are well absorbed orally but suffer high first-
pass metabolism.
What are the signs of MAO inhibitor overdose, and how can it be managed? - An overdose can produce
autonomic instability, hyperadrenergic symptoms, psychotic symptoms, confusion, delirium, fever, and
seizures. It should be managed with cardiac monitoring, vital support and gastric lavage.
Which drugs may cause serotonin syndrome when given with MAO inhibitors? - Serotonergic agents
such as SSRIs, SNRIs, TCAs or meperidine may result in a life-threatening serotonin syndrome when
given with MAOi.
What are the symptoms of serotonin syndrome? - The syndrome includes hyperthermia, muscle rigidity,
myoclonus, and rapid changes in mental status and vital signs. It is caused by overstimulation of 5-HT1A
and 5-HT2 receptors.
How can serotonin syndrome be avoided with MAO inhibitors? - Most serotonergic antidepressants
should be discontinued at least 2 weeks before starting a MAO inhibitor. Fluoxetine, because of its long
half-life, should be discontinued 4-5 weeks before a MAO inhibitor is started. MAO inhibitors must be
discontinued for at least 2 weeks before starting a serotonergic agent.
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