Question 1

Which of the following selective serotonin reuptake inhibitors (SSRIs) is most associated with prolonging the QTc interval, requiring caution in patients with cardiac risk factors?

Accepted Answer

Citalopram

Question 2

A patient with major depressive disorder (MDD) and significant insomnia is started on an antidepressant. Which medication is most likely to be chosen to address both depression and sleep difficulties?

Accepted Answer

Mirtazapine

Question 3

Which of the following is a common side effect of tricyclic antidepressants (TCAs) that makes them particularly risky for elderly patients?

Accepted Answer

Anticholinergic effects such as confusion and urinary retention

Question 4

A patient is being switched from a monoamine oxidase inhibitor (MAOI) to an SSRI. What is the minimum recommended washout period to avoid serotonin syndrome?

Accepted Answer

At least 2 weeks

Question 5

Which antidepressant is commonly added to an SSRI to help with residual symptoms of fatigue and poor concentration, but should be avoided in patients with a history of seizures?

Accepted Answer

Bupropion

Question 6

A patient presents with agitation, hyperreflexia, tremor, and fever after starting a new antidepressant. Which syndrome is most likely, and which class of medications is most commonly implicated?

Accepted Answer

Serotonin syndrome; SSRIs

Question 7

According to DSM criteria, how long must symptoms persist for a diagnosis of persistent depressive disorder (PDD, dysthymia)?

Accepted Answer

$2$ years

Question 8

Which SSRI is considered safest for use during pregnancy?

Accepted Answer

Sertraline

Question 9

A patient with post-stroke depression and speech difficulties is started on an antidepressant. Which SSRI is preferred due to its favorable side effect profile and evidence in this population?

Accepted Answer

Sertraline

Question 10

Which of the following is a key difference between serotonin syndrome and SSRI discontinuation syndrome?

Accepted Answer

Serotonin syndrome presents with neuromuscular hyperactivity and autonomic instability, while discontinuation syndrome presents with flu-like symptoms and sensory disturbances.

Question 11

A patient with major depressive disorder has failed trials of both an SSRI and an SNRI. Which adjunctive treatment outside the antidepressant category is commonly considered next?

Accepted Answer

Lithium

Question 12

Which of the following antidepressants is contraindicated in patients with liver disease due to its metabolism and risk of toxicity?

Accepted Answer

Duloxetine

Question 13

A patient is diagnosed with major depressive disorder (MDD) using the PHQ-9. At what score is it generally recommended to initiate pharmacologic treatment?

Accepted Answer

$\geq 10$

Question 14

Which SNRI is commonly used for both depression and neuropathic pain, but should be avoided in patients with uncontrolled hypertension?

Accepted Answer

Duloxetine

Question 15

Which antidepressant is most likely to cause weight gain and increased appetite, making it a good choice for patients with depression and poor appetite?

Accepted Answer

Mirtazapine

Question 16

Which SSRI is preferred for children and adolescents due to its safety profile and FDA approval?

Accepted Answer

Fluoxetine

Question 17

A patient with obsessive-compulsive disorder (OCD) is started on an SSRI. Which SSRI is considered most effective for OCD?

Accepted Answer

Sertraline

Question 18

Which of the following is a dietary restriction required for patients taking MAOIs?

Accepted Answer

Avoid foods high in tyramine such as aged cheese and cured meats

Question 19

Which antidepressant is most likely to cause discontinuation syndrome if stopped abruptly due to its short half-life?

Accepted Answer

Paroxetine

Question 20

A patient with a history of cardiac surgery is being considered for antidepressant therapy. Which class of antidepressants should be avoided due to risk of arrhythmias and overdose toxicity?

Accepted Answer

TCAs

Antidepressant Medications and Depressive Disorders: Study Guide

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