Depression: Overview and Treatment Options

Authors: Scott Kiker, Pharm.D. Candidate, Harrison School of Pharmacy, Auburn University;

Kayla Osbourn, Pharm.D. Candidate, Harrison School of Pharmacy, Auburn University;

Sean Murphy, Pharm.D. Candidate, Harrison School of Pharmacy, Auburn University;

Wesley T. Lindsey, Pharm.D., Associate Clinical Professor in Drug Information, Drug Information and Learning Resource Center Harrison School of Pharmacy, Auburn University

Universal Activity #: 0178-0000-15-101-H01-P | 1.25 contact hours (.125 CEUs)

Initial Release Date: March 1, 2015 | Expires: March. 1, 2017

Alabama Pharmacy Association | 334.271.4222 | www.aparx.org | [email protected] QUIZ - DEPRESSION: OVERVIEW AND TREATMENT OPTIONS | ACPE#: 0178-0000-15-101-H01-P

1. All of the following are true except: 7. Which SSRI is not metabolized by CYP3A4? a. Women are more likely to experience depression than a. men b. b. Patients are more likely to experience depression if c. they had at least 1 parent diagnosed with depression d. c. Patients who have suffered the death of a loved one are more likely to become depressed d. The typical onset of depression is early 40s 8. Which SSRI causes the most weight gain and should never be used during pregnancy? a. Paroxetine 2. Which of the following are more likely to experience recurrent depression? b. Citalopram a. 22 year old female who experienced her first and only c. episode of depression 5 months ago d. Fluvoxamine b. 20 year old male with no prior history of depression

c. 22 year old female who experienced her first and only 9. What is not a contraindication to treatment with an MAOI? episode of depression at the age of 18 a. Renal impairment d. 22 year old male who experienced his first episode of depression 5 months ago b. Abnormal liver function tests c. Pheochromocytoma 3. Which of the following is a chemical not involved in d. Seizure disorder depression?

a. 10. What is the maximum daily dose of Remeron? b. a. 10 mg c. b. 45 mg d. Acetylcholine c. 150 mg d. 300 mg 4. According to DSM-V, the symptoms of depression must be present for what time period to meet criteria? 11. Which TCA has the least anticholinergic side effects and a. 4 weeks causes the least sedation? b. 2 weeks a. c. 6 months b. d. 12 months c. d. 5. All of the following are true except,

a. Suicidal ideation must be present to meet criteria for MDD 12. How should the total daily dose of be adjusted b. Symptoms of grief can resemble MDD in a patient with hepatic impairment? c. Mood changes in MDD are persistent and are not tied a. Decreased by 25% to a specific thought b. Increased by 25% d. MDD is characterized by an inability to experience c. Decreased by 50% pleasure or happiness d. Increased by 50%

6. What is a minimum duration of treatment for patients who achieve partial or complete response? 13. Which antidepressant is contraindicated in a patient with a history of bulimia? a. 3 months a. b. 1 year b. Paroxetine c. 4 to 9 months c. Amitriptylline d. 15 months d. Selegiline QUIZ - DEPRESSION: OVERVIEW AND TREATMENT OPTIONS | ACPE#: 0178-0000-15-101-H01-P

14. Which of the following is true about (Viibryd)? a. The maximum dose is 60 mg daily b. Selectively inhibits norepinephrine reuptake c. Does not require dose adjustment in patients with hepatic impairment d. Gradual dose-titration strategy is used to minimize the occurrence of headaches

15. Which of the following more accurately represents the dose titration of (Fetzima)? a. Start at the initial dose of 10 mg daily for 2 days then increase to 20 mg daily on day 3 to avoid CNS adverse effects b. Start at the initial dose of 20 mg daily for 2 days then increase to 40 mg daily on day 3 to avoid GI-related adverse effects c. Start at the initial dose of 20 mg daily for 2 days then increase to 40 mg daily on day 3 to avoid orthostatic hypotension d. Start at the initial dose of 10 mg daily for 2 days then increase to 20 mg daily on day 3 to avoid orthostatic hypotension

16. Which of the following drugs is a 5-HT1A partial agonist? a. (Brintellix) b. Levomilnacipran (Fetzima) c. Vilazodone (Viibryd) d. GLYX 13

17. Sexual dysfunction is a common side effect for which of the following? a. Mirtazipine b. Vortioxetine c. Levomilnacipran d. A and B

18. What antidepressant showed a faster response to treatment compared to conventional therapy in a phase II trial? a. GLYX 13 b. c. Liafensine d. Pipamperone QUIZ - DEPRESSION: OVERVIEW AND TREATMENT OPTIONS | ACPE#: 0178-0000-15-101-H01-P

Participant Information: CE Assessment Answers AL License #______Please circle your answers (one answer per question).

1. A B C D Name______2. A B C D Address______3. A B C D 4. A B C D City______State_____ Zip______5. A B C D 6. A B C D E-mail______7. A B C D NABP e-Profile #______8. A B C D 9. A B C D MM/DD (month/day of birth)______10. A B C D

How long did it take you to read the program and complete this test? 11. A B C D 12. A B C D ______hours ______minutes 13. A B C D 14. A B C D My signature certifies that I have independently taken this CE examination. 15. A B C D

______16. A B C D 17. A B C D 18. A B C D

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