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Antidepressant Wiki2Web Clarity Challenge

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Study Guide: Antidepressants: Efficacy, Side Effects, and Controversies

Cheat Sheet:
Antidepressants: Efficacy, Side Effects, and Controversies Study Guide

Core Concepts and Mechanisms

The monoamine hypothesis suggests depression is caused by an excess of serotonin and norepinephrine.

Answer: False

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A 2022 umbrella review supported the serotonin theory of depression.

Answer: False

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Alternative hypotheses for antidepressant action focus solely on glutamate.

Answer: False

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The monoamine hypothesis of depression originated in the late 19th century.

Answer: False

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According to the source, what is the primary condition treated by antidepressants?

Answer: Major Depressive Disorder

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The monoamine hypothesis of depression suggests that depression is caused by:

Answer: An imbalance, often a deficiency, in monoamine neurotransmitters

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What did a 2022 umbrella review conclude about the serotonin theory of depression?

Answer: It is not supported by the available evidence.

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What is a limitation of the monoamine hypothesis of depression?

Answer: It does not explain the delayed onset of action for antidepressants.

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What alternative hypotheses have been proposed for antidepressant action?

Answer: Factors like glutamate, neurogenesis, and inflammation

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Therapeutic Applications and Efficacy

Antidepressants are primarily prescribed for the treatment of chronic pain conditions.

Answer: False

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Research suggests that the benefits of antidepressants over placebos for adult depression are substantial and undisputed.

Answer: False

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Critics of antidepressant efficacy studies cite industry funding and selective publication of positive results as potential biases.

Answer: True

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Escitalopram and mirtazapine are considered among the least effective antidepressants for adults.

Answer: False

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Fluoxetine and sertraline are considered effective treatments for anxiety disorders in children and adolescents.

Answer: True

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The placebo-subtracted effect size for antidepressants in treating anxiety disorders is significantly larger than for depression.

Answer: False

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Paroxetine was the first antidepressant approved by the FDA specifically for social anxiety disorder.

Answer: True

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SSRIs are recommended as a first-line treatment for all levels of obsessive-compulsive disorder (OCD) in adults.

Answer: False

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When starting SSRIs or SNRIs for panic disorder, the initial dose should be higher than that used for major depressive disorder.

Answer: False

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SSRIs, particularly fluoxetine, are the preferred choice for treating bulimia nervosa due to their effectiveness.

Answer: True

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Clinical trials have shown SSRIs to be highly effective in treating anorexia nervosa.

Answer: False

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A 2012 meta-analysis found tricyclic antidepressants to be the most effective class for pain and sleep issues in fibromyalgia syndrome.

Answer: True

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Duloxetine has shown effectiveness in treating pain associated with diabetic neuropathy.

Answer: True

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Approximately 70-90% of individuals treated with a specific antidepressant show a significant response.

Answer: False

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Switching to a different medication is a strategy used to overcome limitations in antidepressant efficacy.

Answer: True

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Publication bias refers to the practice of pharmaceutical companies paying researchers to write studies.

Answer: False

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Adjunct medications are used when initial antidepressant treatments have been completely successful.

Answer: False

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Combining two antidepressants from the same class is a common adjunct technique.

Answer: False

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Ghostwriting involves researchers publishing studies with favorable results more readily.

Answer: False

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Antidepressants are generally considered ineffective for treating panic disorder.

Answer: False

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Vortioxetine is mentioned as potentially beneficial for social anxiety disorder.

Answer: True

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Amitriptyline is noted for its strong evidence base from randomized clinical trials for neuropathic pain.

Answer: False

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Antidepressants are generally not recommended for treating anorexia nervosa.

Answer: True

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What criticism is leveled against studies examining the effectiveness of antidepressants in adults?

Answer: They lack sufficient follow-up periods.

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Which of the following is cited as a potential bias in antidepressant efficacy studies?

Answer: Selective publication of positive results

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Which antidepressant is mentioned as being among the most effective and well-tolerated for adults?

Answer: Sertraline

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For anxiety disorders in children and adolescents, which SSRIs are considered effective?

Answer: Escitalopram and fluvoxamine

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What is the approximate placebo-subtracted effect size for antidepressants in treating anxiety disorders?

Answer: 0.3

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Which antidepressant was the first approved by the FDA for social anxiety disorder?

Answer: Paroxetine

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For adults with moderate or severe OCD, SSRIs are recommended as:

Answer: A first-line treatment

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What caution is advised when initiating SSRIs or SNRIs for panic disorder?

Answer: Use a lower starting dose than for depression

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Why are SSRIs, particularly fluoxetine, preferred for bulimia nervosa?

Answer: They show superior symptom reduction in short-term trials.

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What have clinical trials generally shown regarding the use of SSRIs for anorexia nervosa?

Answer: Negative results, leading to recommendations against their use

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Which class of antidepressants was found most effective for pain and sleep in fibromyalgia syndrome according to a 2012 meta-analysis?

Answer: Tricyclic Antidepressants (TCAs)

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What did a 2014 meta-analysis find regarding duloxetine for neuropathic pain?

Answer: Effective for diabetic neuropathy pain

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Which of the following is a strategy to overcome limitations in antidepressant efficacy?

Answer: Switching to a different medication

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What does publication bias entail in the context of antidepressant research?

Answer: Studies with positive results are more likely to be published.

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Adjunct medications are typically considered when:

Answer: Initial treatments have not been fully successful

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Which of the following is NOT mentioned as a potential bias in antidepressant studies?

Answer: Use of double-blind methodologies

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Adverse Effects, Risks, and Discontinuation

Emotional blunting and sexual dysfunction are potential side effects of antidepressant use.

Answer: True

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The risk of suicidal thinking and behavior associated with antidepressants is primarily observed after several months of continuous treatment.

Answer: False

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Antidepressant discontinuation syndrome can manifest with symptoms similar to flu-like illnesses.

Answer: True

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Antidepressant discontinuation syndrome symptoms are typically mild and resolve quickly.

Answer: False

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Which of the following is listed as a common side effect of antidepressants?

Answer: Weight gain

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What specific risk is associated with antidepressants in children, adolescents, and young adults, particularly early in treatment?

Answer: Increased risk of suicidal thinking and behavior

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Antidepressant discontinuation syndrome is characterized by symptoms such as:

Answer: Flu-like symptoms and nausea

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Pharmacological Landscape

SSRIs increase extracellular serotonin levels by preventing its reabsorption into the presynaptic cell.

Answer: True

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SNRIs affect only serotonin reuptake, similar to SSRIs.

Answer: False

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TCAs have been largely replaced due to significantly fewer adverse effects compared to SSRIs.

Answer: False

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MAOIs are effective for atypical depression and are also used for Parkinson's disease.

Answer: True

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Ketamine and esketamine work by blocking dopamine receptors to achieve antidepressant effects.

Answer: False

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Fluoxetine, approved in 1988, was the first selective serotonin reuptake inhibitor (SSRI).

Answer: True

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How do Selective Serotonin Reuptake Inhibitors (SSRIs) primarily work?

Answer: By blocking serotonin reabsorption into the presynaptic cell

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What neurotransmitters do Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs) affect?

Answer: Serotonin and norepinephrine

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Why were TCAs largely replaced by newer antidepressants?

Answer: They had similar adverse effects and less tolerable alternatives became available.

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Monoamine Oxidase Inhibitors (MAOIs) prevent the breakdown of which type of substances?

Answer: Monoamine neurotransmitters

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What is the mechanism of action for ketamine and esketamine as antidepressants?

Answer: Blocking NMDA glutamate receptors

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Which drug was the first blockbuster SSRI, and when was it approved?

Answer: Fluoxetine

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