Deck 17: Affective Disorders: Antidepressants and Mood Stabilizers

Question 1

Reactive depression

A) typically results in anhedonia and feelings of worthlessness.
B) leads to such loneliness that the person considers suicide as the only option.
C) is one of the more serious affective disorders.
D) often occurs following loss, failure, or disappointment.

Answer 1

often occurs following loss, failure, or disappointment.

Question 2

Which of the following is not a symptom of mania?

A) Decrease in goal-directed activity
B) Flight of ideas
C) Distractability
D) Elation

Answer 2

Decrease in goal-directed activity

Question 3

Which statement about bipolar disorder is false?

A) It involves cycles of depression and mania that persist throughout the life span.
B) It can provide times of creativity and productivity if the energy during the manic periods is channeled appropriately.
C) It occurs in about 10% of the population.
D) It affects men and women between the ages of 20 and 30 equally.

Answer 3

It occurs in about 10% of the population.

Question 4

Which statement about risk factors for mood disorders is false?

A) Psychiatric disorders develop in response to the interaction of genes and environmental events.
B) For affective disorders, environmental triggers alone are enough to cause serious mood changes.
C) The genetic factors involved in mood disorders indicate that the individual will be more susceptible to the disorder, not that they will definitely develop it.
D) Environmental stress is a likely risk factor for mood disorders.

Question 5

Which statement about the role of heredity in the affective disorders is true?

A) No single dominant gene for these disorders has yet been identified.
B) Adoption studies provide the strongest evidence for a genetic basis to the affective disorders.
C) Twin studies show that the monozygotic-dizygotic twin difference in concordance rates is greater for severe depression than for bipolar disorder.
D) Linkage studies attempt to study the incidence of a disorder in an extended family.

Question 6

Which event does not occur during stress activation of the hypothalamic-pituitary-adrenal (HPA) axis?

A) NE and ACh regulate the release of corticotrophin-releasing factor (CRF) from the hypothalamus.
B) ACTH causes the release of cortisol from the adrenal gland.
C) Cortisol feeds back to shut down HPA activation.
D) Glucocorticoids feedback to stimulate the hippocampus.

Question 7

Researchers know that depressed individuals have an abnormal stress response involving the HPA axis because these individuals have all of the following except

A) elevated levels of cortisol.
B) shrunken pituitary and adrenal glands.
C) higher CRF levels in cerebrospinal fluid (CSF).
D) more CRF cells evident in postmortem hypothalamic tissue.

Question 8

Which of the following is not a sleep abnormality experienced by depressed individuals?

A) Significant decrease in stages 3 and 4 slow-wave sleep
B) Earlier onset of REM sleep
C) Increased REM in the first third of the night
D) Rapid sleep onset

Question 9

All of the following are characteristic of sleep abnormalities in depression except

A) longer time for sleep onset.
B) earlier onset of REM sleep.
C) longer REM periods as sleep progresses.
D) frequent awakenings from sleep.

Question 10

Recently developed models of mania include _______ and the creation of mutant mice targeting genes involved in _______.

A) sleep deprivation; serotonin synthesis
B) maternal separation; lithium resistance
C) sleep deprivation; the circadian clock
D) chronic mild stress; lithium sensitivity

Question 11

Which research finding does not confirm a role for serotonin dysfunction in mood disorders?

A) Decreased numbers of postsynaptic 5-HT₂ receptors are found in depressed patients.
B) Low 5-HIAA turnover is found in depressed individuals.
C) Rapid tryptophan depletion in treated depressed patients causes a relapse in symptoms.
D) Challenge studies indicate that the 5-HT receptors in depressed individuals are less sensitive.

Question 12

Animal studies of the acute and chronic effects of antidepressants on serotonin have shown all of the following except

A) the autoreceptors are activated acutely, causing a decrease in synthesis and release of 5-HT.
B) the reuptake transporters remain blocked for the duration of the drug's action.
C) tolerance to the drug occurs at the autoreceptors chronically, resulting in increased 5-HT release.
D) setotonin occupancy of serotonin autoreceptors activates cell firing following chronic antidepressant treatment

Question 13

Which statement regarding the glucocorticoid hypothesis of depression is false?

A) The amygdala normally inhibits the hypothalamic-pituitary-adrenal axis, whereas the hippocampus activates it.
B) High cortisol levels cause loss of cells as well as reduced neurogenesis in the hippocampus.
C) Behavior characteristic of depression can be elicited in animals by administration of CRF.
D) ECT and antidepressant drugs may exert some of their clinical benefits by decreasing CRF.

Question 14

The neurotrophic hypothesis of depression is supported by all of the following except

A) chronic stress decreases hippocampal brain-derived neurotrophic factor (BDNF).
B) acute antidepressant treatment protects neurons by increasing BDNF.
C) chronic antidepressant treatment increases BDNF in both humans and animals.
D) BDNF is enhanced by upregulation in the cAMP cascade, as occurs with treatments for depression.

Question 15

Which of the following is/are not primarily used for treating major depression?

A) Selective serotonin reuptake inhibitors (SSRIs)
B) Lithium therapy
C) Monoamine oxidase inhibitors (MAO-Is)
D) Atypical antidepressants

Question 16

Which MHPG about MAO inhibitors is false?

A) The first MAOI, iproniazid, was discovered by accident while investigating treatments for tuberculosis.
B) They can be used safely with proper dietary restrictions.
C) They block the metabolism of norepinephrine, dopamine, and serotonin.
D) These drugs have little use in the treatment of depression given the availability of safer drugs, and no use in the treatment of other disorders.

Question 17

What effect of MAOIs at the synapse is correlated with their therapeutic effectiveness?

A) The enzyme MAO is inhibited, elevating the amount of transmitters available for release.
B) The normal amount of transmitter in the presynaptic terminal is properly regulated by the drug, which acts as an enzyme.
C) The synapse adapts by increasing receptors for the amine transmitters.
D) Postsynaptic changes occur in second-messenger systems, up-regulating cAMP.

Question 18

All of the following are foods that should be avoided by people taking MAOIs except

A) aged cheese.
B) eggs.
C) wine.
D) yeasty breads.

Question 19

Which statement about tricyclic antidepressants is false?

A) They enhance the function of the presynaptic transporter protein for serotonin and/or norepinephrine.
B) They cause long-term adaptive changes at the synapse that are related to their therapeutic effects.
C) They affect acetylcholine, histamine, and $\alpha$ -adrenergic receptors.
D) They include the prototype imipramine, which resembles drugs in the phenothiazine class of antipsychotics.

Question 20

Which statement regarding intravenous ketamine as a treatment for depression is false?

A) The dose required to reduce depression symptoms is much higher than that needed for anesthesia.
B) It reduces symptoms in 65-70% of patients who are resistant to other treatments.
C) Its effects typically last 1-3 weeks.
D) In addition to blocking NMDA type glutamate receptors, it enhances AMPA receptor response to glutamate.

Question 21

Which statement about lithium is false?

A) It reduces manic symptoms in about 60-80% of cases.
B) It is taken for the maintenance period of 6-8 months and should then be safely withdrawn.
C) It is often administered with an antidepressant drug.
D) It dramatically increases the time between recurring episodes of mania and depression.

Question 22

Which of the following is not a side effect of lithium?

A) Increased thirst and urination
B) Impaired concentration and memory
C) Anxiety
D) Weight gain

Question 23

All of the following are alternatives to lithium as treatments for bipolar disorder except

A) Tegretol.
B) Gabitril.
C) Depakote.
D) l-DOPA.