MCQ Quiz

1. According to the monoamine theory, depression is primarily caused by reduced levels of:

GABA and glutamate

Serotonin, norepinephrine, and dopamine

Acetylcholine only

Histamine and GABA

Explanation:
Depression is associated with reduced monoamine levels (5-HT, NE, DA) in the synaptic cleft.

2. Which drug provided evidence for the monoamine theory by inducing depression?

Reserpine

Fluoxetine

Lithium

Iproniazid

Explanation:
Reserpine depletes NE, serotonin, and dopamine, producing a depression-like syndrome.

3. Clinical improvement with antidepressants is delayed mainly because:

Monoamine levels rise slowly

Drugs require hepatic activation

Neuronal adaptation and receptor changes take time

Blood–brain barrier penetration is delayed

Explanation:
Although monoamines increase quickly, therapeutic effects appear after weeks due to adaptive neuronal changes.

4. Which SSRI has the longest half-life and an active metabolite?

Paroxetine

Sertraline

Citalopram

Fluoxetine

Explanation:
Fluoxetine has the longest half-life and an active metabolite (norfluoxetine).

5. Which SSRI is FDA-approved for bulimia nervosa?

Fluoxetine

Sertraline

Paroxetine

Fluvoxamine

Explanation:
Fluoxetine is the only SSRI approved for bulimia nervosa.

6. Which SSRI is considered safest after acute myocardial infarction?

Fluoxetine

Sertraline

Citalopram

Paroxetine

Explanation:
Sertraline is preferred post-MI due to its favorable cardiac safety profile.

7. QT prolongation in SSRI overdose is most associated with:

Fluoxetine

Paroxetine

Citalopram

Fluvoxamine

Explanation:
Citalopram causes dose-dependent QT prolongation and arrhythmias.

8. Abrupt discontinuation of SSRIs most commonly causes:

Serotonin syndrome

Hypertensive crisis

Neuroleptic malignant syndrome

Discontinuation syndrome

Explanation:
Sudden SSRI withdrawal can cause flu-like symptoms, insomnia, imbalance, and hyperarousal.

9. Which antidepressant class is MOST effective for depression with chronic pain?

SNRIs

SSRIs

MAOIs

Melatonin agonists

Explanation:
SNRIs (e.g., duloxetine) are effective for depression associated with chronic pain syndromes.

10. Which condition is specifically treated with duloxetine?

Bulimia nervosa

Stress urinary incontinence

Postpartum depression

Smoking cessation

Explanation:
Duloxetine improves urethral sphincter tone and is used in stress urinary incontinence.

11. Which receptor blockade is responsible for orthostatic hypotension with TCAs?

Muscarinic M1

Histamine H1

Alpha-1 adrenergic

Serotonin 5-HT2

Explanation:
Alpha-1 adrenergic blockade leads to orthostatic hypotension and reflex tachycardia.

12. TCAs should be avoided or used cautiously in patients with:

Asthma

Peptic ulcer disease

Hypothyroidism

Pre-existing arrhythmias

Explanation:
TCAs have a narrow therapeutic index and can worsen arrhythmias.

13. Which antidepressant is FDA-approved for smoking cessation?

Bupropion

Mirtazapine

Trazodone

Fluoxetine

Explanation:
Bupropion reduces nicotine cravings and withdrawal symptoms.

14. Which antidepressant causes weight gain and sedation via H1 blockade?

Bupropion

Mirtazapine

Fluoxetine

Duloxetine

Explanation:
Mirtazapine blocks H1 receptors, causing sedation and increased appetite.

15. Which antidepressant is most likely to lower seizure threshold?

Fluoxetine

Trazodone

Bupropion

Mirtazapine

Explanation:
Bupropion increases seizure risk and is contraindicated in epilepsy and eating disorders.

16. Which drug is used for treatment-resistant depression and has rapid onset?

Lithium

Fluoxetine

Brexanolone

Esketamine

Explanation:
Esketamine is an NMDA antagonist used intranasally for treatment-resistant depression.

17. First FDA-approved drug for postpartum depression is:

Brexanolone

Esketamine

Lithium

Sertraline

Explanation:
Brexanolone is an allopregnanolone analogue approved for postpartum depression.

18. Drug of choice for bipolar disorder is:

Fluoxetine

Lithium

Bupropion

Haloperidol

Explanation:
Lithium is effective acutely and prophylactically and reduces suicide risk.

19. A major limitation of lithium therapy is:

Hepatotoxicity

Sedation

Very narrow therapeutic index

Weight loss

Explanation:
Lithium has a very narrow therapeutic index and requires close monitoring.

20. Which drugs are common alternatives to lithium for mood stabilization?

SSRIs

TCAs

MAOIs

Antiepileptics (valproate, carbamazepine)

Explanation:
Antiepileptic drugs are commonly used as alternative mood stabilizers with fewer side effects.

4# Antidepressants

1. According to the monoamine theory, depression is primarily caused by reduced levels of:

2. Which drug provided evidence for the monoamine theory by inducing depression?

3. Clinical improvement with antidepressants is delayed mainly because:

4. Which SSRI has the longest half-life and an active metabolite?

5. Which SSRI is FDA-approved for bulimia nervosa?

6. Which SSRI is considered safest after acute myocardial infarction?

7. QT prolongation in SSRI overdose is most associated with:

8. Abrupt discontinuation of SSRIs most commonly causes:

9. Which antidepressant class is MOST effective for depression with chronic pain?

10. Which condition is specifically treated with duloxetine?

11. Which receptor blockade is responsible for orthostatic hypotension with TCAs?

12. TCAs should be avoided or used cautiously in patients with:

13. Which antidepressant is FDA-approved for smoking cessation?

14. Which antidepressant causes weight gain and sedation via H1 blockade?

15. Which antidepressant is most likely to lower seizure threshold?

16. Which drug is used for treatment-resistant depression and has rapid onset?

17. First FDA-approved drug for postpartum depression is:

18. Drug of choice for bipolar disorder is:

19. A major limitation of lithium therapy is:

20. Which drugs are common alternatives to lithium for mood stabilization?