1. Q: What is the mechanism of action of SSRIs? A: SSRIs selectively
inhibit the reuptake of serotonin at the presynaptic neuronal membrane,
increasing serotonin availability in the synaptic cleft.
2. Q: Which antidepressant is most associated with sexual dysfunction?
A: Paroxetine (Paxil) has the highest rate of sexual dysfunction among
SSRIs.
3. Q: What is the first-line treatment for ADHD in children? A:
Stimulant medications such as methylphenidate or amphetamine
preparations.
4. Q: What is serotonin syndrome? A: A potentially life-threatening
condition caused by excess serotonergic activity, characterized by mental
status changes, autonomic hyperactivity, and neuromuscular
abnormalities.
5. Q: Which mood stabilizer requires regular therapeutic drug
monitoring? A: Lithium requires regular monitoring of serum levels
(therapeutic range 0.6-1.2 mEq/L).
6. Q: What is the mechanism of action of benzodiazepines? A:
Benzodiazepines enhance GABA activity at GABA-A receptors,
producing anxiolytic, sedative, and anticonvulsant effects.
7. Q: Which atypical antipsychotic has the lowest risk of weight gain?
A: Ziprasidone (Geodon) and lurasidone (Latuda) have lower weight gain
profiles.
8. Q: What is neuroleptic malignant syndrome (NMS)? A: A rare but
life-threatening reaction to antipsychotic medications characterized by
hyperthermia, muscle rigidity, altered mental status, and autonomic
instability.
,9. Q: What baseline labs are needed before starting lithium? A: TSH,
BUN/creatinine, urinalysis, CBC, pregnancy test (if applicable), and EKG
if indicated.
10.Q: Which SSRI has the longest half-life? A: Fluoxetine (Prozac) has a
half-life of 4-6 days, with its active metabolite norfluoxetine having a
half-life of 4-16 days.
11.Q: What is the FDA black box warning for antidepressants? A:
Increased risk of suicidal thinking and behavior in children, adolescents,
and young adults (ages 18-24) during initial treatment.
12.Q: What is the mechanism of action of bupropion? A:
Norepinephrine-dopamine reuptake inhibitor (NDRI).
13.Q: Which antipsychotic has the highest risk for extrapyramidal
symptoms (EPS)? A: First-generation/typical antipsychotics, particularly
high-potency agents like haloperidol.
14.Q: What is akathisia? A: A movement disorder characterized by
subjective feelings of inner restlessness and an inability to sit still,
commonly caused by antipsychotics.
15.Q: What is the treatment for acute dystonia? A: Benztropine
(Cogentin) 1-2 mg IM/IV or diphenhydramine (Benadryl) 25-50 mg
IM/IV.
16.Q: Which mood stabilizer is teratogenic and causes neural tube
defects? A: Valproic acid/divalproex (Depakote).
17.Q: What is the mechanism of action of naltrexone? A: Opioid receptor
antagonist used for alcohol and opioid use disorders.
18.Q: What labs should be monitored with valproic acid? A: Liver
function tests (LFTs), CBC with platelets, and valproic acid levels.
19.Q: What is the therapeutic range for valproic acid? A: 50-125
mcg/mL for seizure disorders; may be 50-100 mcg/mL for mood
disorders.
20.Q: Which benzodiazepine has the shortest half-life? A: Triazolam
(Halcion) has a half-life of 1.5-5.5 hours.
21.Q: What is the first-line pharmacological treatment for panic
disorder? A: SSRIs or SNRIs are first-line; benzodiazepines may be used
short-term.
, 22.Q: What is tardive dyskinesia? A: Involuntary movements, typically of
the face, tongue, and extremities, caused by long-term antipsychotic use.
23.Q: Which SNRI is FDA-approved for generalized anxiety disorder?
A: Venlafaxine (Effexor) and duloxetine (Cymbalta).
24.Q: What is the antidote for benzodiazepine overdose? A: Flumazenil
(Romazicon), though use is controversial due to seizure risk.
25.Q: What cardiovascular side effect is associated with tricyclic
antidepressants? A: Cardiac conduction delays, orthostatic hypotension,
and arrhythmias.
26.Q: Which antipsychotic requires absolute neutrophil count (ANC)
monitoring? A: Clozapine (Clozaril) due to risk of agranulocytosis.
27.Q: What is the mechanism of action of lamotrigine? A: Inhibits
voltage-sensitive sodium channels and modulates glutamate release.
28.Q: What serious dermatological reaction is associated with
lamotrigine? A: Stevens-Johnson syndrome and toxic epidermal
necrolysis, especially with rapid titration.
29.Q: What is the first-line medication for alcohol withdrawal? A:
Benzodiazepines, typically chlordiazepoxide (Librium) or lorazepam
(Ativan).
30.Q: Which antidepressant is contraindicated in patients with seizure
disorders? A: Bupropion (Wellbutrin) lowers seizure threshold.
31.Q: What is cytochrome P450? A: A family of enzymes responsible for
metabolizing many psychiatric medications, leading to potential drug-
drug interactions.
32.Q: Which SSRI is a strong CYP2D6 inhibitor? A: Paroxetine (Paxil)
and fluoxetine (Prozac).
33.Q: What medication is used for opioid use disorder maintenance? A:
Methadone, buprenorphine, or naltrexone.
34.Q: What is the mechanism of disulfiram (Antabuse)? A: Inhibits
aldehyde dehydrogenase, causing accumulation of acetaldehyde when
alcohol is consumed, producing unpleasant effects.
35.Q: Which atypical antipsychotic is available as a long-acting
injectable? A: Risperidone (Risperdal Consta), paliperidone (Invega
Sustenna), aripiprazole (Abilify Maintena), and others.
inhibit the reuptake of serotonin at the presynaptic neuronal membrane,
increasing serotonin availability in the synaptic cleft.
2. Q: Which antidepressant is most associated with sexual dysfunction?
A: Paroxetine (Paxil) has the highest rate of sexual dysfunction among
SSRIs.
3. Q: What is the first-line treatment for ADHD in children? A:
Stimulant medications such as methylphenidate or amphetamine
preparations.
4. Q: What is serotonin syndrome? A: A potentially life-threatening
condition caused by excess serotonergic activity, characterized by mental
status changes, autonomic hyperactivity, and neuromuscular
abnormalities.
5. Q: Which mood stabilizer requires regular therapeutic drug
monitoring? A: Lithium requires regular monitoring of serum levels
(therapeutic range 0.6-1.2 mEq/L).
6. Q: What is the mechanism of action of benzodiazepines? A:
Benzodiazepines enhance GABA activity at GABA-A receptors,
producing anxiolytic, sedative, and anticonvulsant effects.
7. Q: Which atypical antipsychotic has the lowest risk of weight gain?
A: Ziprasidone (Geodon) and lurasidone (Latuda) have lower weight gain
profiles.
8. Q: What is neuroleptic malignant syndrome (NMS)? A: A rare but
life-threatening reaction to antipsychotic medications characterized by
hyperthermia, muscle rigidity, altered mental status, and autonomic
instability.
,9. Q: What baseline labs are needed before starting lithium? A: TSH,
BUN/creatinine, urinalysis, CBC, pregnancy test (if applicable), and EKG
if indicated.
10.Q: Which SSRI has the longest half-life? A: Fluoxetine (Prozac) has a
half-life of 4-6 days, with its active metabolite norfluoxetine having a
half-life of 4-16 days.
11.Q: What is the FDA black box warning for antidepressants? A:
Increased risk of suicidal thinking and behavior in children, adolescents,
and young adults (ages 18-24) during initial treatment.
12.Q: What is the mechanism of action of bupropion? A:
Norepinephrine-dopamine reuptake inhibitor (NDRI).
13.Q: Which antipsychotic has the highest risk for extrapyramidal
symptoms (EPS)? A: First-generation/typical antipsychotics, particularly
high-potency agents like haloperidol.
14.Q: What is akathisia? A: A movement disorder characterized by
subjective feelings of inner restlessness and an inability to sit still,
commonly caused by antipsychotics.
15.Q: What is the treatment for acute dystonia? A: Benztropine
(Cogentin) 1-2 mg IM/IV or diphenhydramine (Benadryl) 25-50 mg
IM/IV.
16.Q: Which mood stabilizer is teratogenic and causes neural tube
defects? A: Valproic acid/divalproex (Depakote).
17.Q: What is the mechanism of action of naltrexone? A: Opioid receptor
antagonist used for alcohol and opioid use disorders.
18.Q: What labs should be monitored with valproic acid? A: Liver
function tests (LFTs), CBC with platelets, and valproic acid levels.
19.Q: What is the therapeutic range for valproic acid? A: 50-125
mcg/mL for seizure disorders; may be 50-100 mcg/mL for mood
disorders.
20.Q: Which benzodiazepine has the shortest half-life? A: Triazolam
(Halcion) has a half-life of 1.5-5.5 hours.
21.Q: What is the first-line pharmacological treatment for panic
disorder? A: SSRIs or SNRIs are first-line; benzodiazepines may be used
short-term.
, 22.Q: What is tardive dyskinesia? A: Involuntary movements, typically of
the face, tongue, and extremities, caused by long-term antipsychotic use.
23.Q: Which SNRI is FDA-approved for generalized anxiety disorder?
A: Venlafaxine (Effexor) and duloxetine (Cymbalta).
24.Q: What is the antidote for benzodiazepine overdose? A: Flumazenil
(Romazicon), though use is controversial due to seizure risk.
25.Q: What cardiovascular side effect is associated with tricyclic
antidepressants? A: Cardiac conduction delays, orthostatic hypotension,
and arrhythmias.
26.Q: Which antipsychotic requires absolute neutrophil count (ANC)
monitoring? A: Clozapine (Clozaril) due to risk of agranulocytosis.
27.Q: What is the mechanism of action of lamotrigine? A: Inhibits
voltage-sensitive sodium channels and modulates glutamate release.
28.Q: What serious dermatological reaction is associated with
lamotrigine? A: Stevens-Johnson syndrome and toxic epidermal
necrolysis, especially with rapid titration.
29.Q: What is the first-line medication for alcohol withdrawal? A:
Benzodiazepines, typically chlordiazepoxide (Librium) or lorazepam
(Ativan).
30.Q: Which antidepressant is contraindicated in patients with seizure
disorders? A: Bupropion (Wellbutrin) lowers seizure threshold.
31.Q: What is cytochrome P450? A: A family of enzymes responsible for
metabolizing many psychiatric medications, leading to potential drug-
drug interactions.
32.Q: Which SSRI is a strong CYP2D6 inhibitor? A: Paroxetine (Paxil)
and fluoxetine (Prozac).
33.Q: What medication is used for opioid use disorder maintenance? A:
Methadone, buprenorphine, or naltrexone.
34.Q: What is the mechanism of disulfiram (Antabuse)? A: Inhibits
aldehyde dehydrogenase, causing accumulation of acetaldehyde when
alcohol is consumed, producing unpleasant effects.
35.Q: Which atypical antipsychotic is available as a long-acting
injectable? A: Risperidone (Risperdal Consta), paliperidone (Invega
Sustenna), aripiprazole (Abilify Maintena), and others.
