ADVANCED PSYCHOPHARMACOLOGY NR
546 EXAM STUDY GUIDE 2026 COMPLETE
QUESTIONS AND SOLUTIONS
◉PFC & Amygdala Symptoms of MDD. Answer: Guilt
Suicidality
Worthlessness
◉Striatum Symptoms of MDD. Answer: Physical fatigue
◉Nucleus Accumbens Symptoms of MDD. Answer: Pleasure
interests
◉Hypothalamus Symptoms of MDD. Answer: Sleep
Appetite
◉Thalamus & Hypothalamus Symptoms of Mania. Answer:
Decreased sleep/arousal
◉Striatum Symptoms of Mania. Answer: Motor/agitation
,◉Prefrontal cortex (PFC) Symptoms of Mania. Answer: Risk-taking
Talkative/pressured speech
◉Nucleus Accumbens & PFC Symptoms of Mania. Answer: Racing
thoughts, grandiosity
◉PFC & Amygdala Symptoms of Mania. Answer: Mood
◉Medication Management. Answer: SSRI-Selective Serotonin
Reuptake Inhibitors
*Inhibit 5 HT reuptake
SNRI-Serotonin Norepinephrine Reuptake Inhibitors
*inhibit 5-HT reuptake
*inhibit NE reuptake (increase energy, focus)
*increase DA in prefrontal cortex (increase cognition)
NDRI-Norepinephrine Dopamine Reuptake inhibitors
*inhibit DA reuptake (increase alertness, motivation)
*inhibit NE reuptake (increase energy)
SARI-Serotonin Antagonist Reuptake Inhibitors
,◉Selective Serotonin Reuptake Inhibitors (SSRIs): Most adverse
effects will subside after 4-5 days once the body adjusts to increased
serotonin levels.. Answer: diarrhea
headache
weight gain
sexual side effects
◉Serotonin Norepinephrine Reuptake Inhibitors (SNRIs):
Medications should not be abruptly stopped to avoid
discontinuation symptoms. NE effects of the medication may
increase anxiety in some clients. Report worsening anxiety to the
provider.. Answer: elevated blood pressure
anxiety
insomnia
constipation
◉Norepinephrine Dopamine Reuptake Inhibitors (NDRI): Take
medication in the morning. Stop taking medication if seizures occur.
Stop taking medication if anxiety is noted.. Answer: agitation
headache
dry mouth
constipation
weight loss
, ◉escitalopram (Lexapro) SSRI. Answer: no known drug interactions
best tolerated SSRI
27-32 hour half-life good for forgetful prone clients
least CYP reactions
Substrate for 3A4
◉citalopram (Celexa) SSRI. Answer: mild antihistamine effects; Half-
Life: 23-45 hours
Weak Inhibitor of 2D6
◉fluoxetine (Prozac) SSRI. Answer: longest half-life
Use caution in patients with comorbid anxiety due to risk for
activation and panic attacks
Half-Life: 2-3 days parent, 2 week metabolite
Inhibits 2D6 and 3A4
◉paroxetine (Paxil) SSRI. Answer: also treats social anxiety and
insomnia
associated with weight gain
will experience withdrawal with missed dose or abrupt stop
Half-Life: 24 hours
Inhibits 2D6
546 EXAM STUDY GUIDE 2026 COMPLETE
QUESTIONS AND SOLUTIONS
◉PFC & Amygdala Symptoms of MDD. Answer: Guilt
Suicidality
Worthlessness
◉Striatum Symptoms of MDD. Answer: Physical fatigue
◉Nucleus Accumbens Symptoms of MDD. Answer: Pleasure
interests
◉Hypothalamus Symptoms of MDD. Answer: Sleep
Appetite
◉Thalamus & Hypothalamus Symptoms of Mania. Answer:
Decreased sleep/arousal
◉Striatum Symptoms of Mania. Answer: Motor/agitation
,◉Prefrontal cortex (PFC) Symptoms of Mania. Answer: Risk-taking
Talkative/pressured speech
◉Nucleus Accumbens & PFC Symptoms of Mania. Answer: Racing
thoughts, grandiosity
◉PFC & Amygdala Symptoms of Mania. Answer: Mood
◉Medication Management. Answer: SSRI-Selective Serotonin
Reuptake Inhibitors
*Inhibit 5 HT reuptake
SNRI-Serotonin Norepinephrine Reuptake Inhibitors
*inhibit 5-HT reuptake
*inhibit NE reuptake (increase energy, focus)
*increase DA in prefrontal cortex (increase cognition)
NDRI-Norepinephrine Dopamine Reuptake inhibitors
*inhibit DA reuptake (increase alertness, motivation)
*inhibit NE reuptake (increase energy)
SARI-Serotonin Antagonist Reuptake Inhibitors
,◉Selective Serotonin Reuptake Inhibitors (SSRIs): Most adverse
effects will subside after 4-5 days once the body adjusts to increased
serotonin levels.. Answer: diarrhea
headache
weight gain
sexual side effects
◉Serotonin Norepinephrine Reuptake Inhibitors (SNRIs):
Medications should not be abruptly stopped to avoid
discontinuation symptoms. NE effects of the medication may
increase anxiety in some clients. Report worsening anxiety to the
provider.. Answer: elevated blood pressure
anxiety
insomnia
constipation
◉Norepinephrine Dopamine Reuptake Inhibitors (NDRI): Take
medication in the morning. Stop taking medication if seizures occur.
Stop taking medication if anxiety is noted.. Answer: agitation
headache
dry mouth
constipation
weight loss
, ◉escitalopram (Lexapro) SSRI. Answer: no known drug interactions
best tolerated SSRI
27-32 hour half-life good for forgetful prone clients
least CYP reactions
Substrate for 3A4
◉citalopram (Celexa) SSRI. Answer: mild antihistamine effects; Half-
Life: 23-45 hours
Weak Inhibitor of 2D6
◉fluoxetine (Prozac) SSRI. Answer: longest half-life
Use caution in patients with comorbid anxiety due to risk for
activation and panic attacks
Half-Life: 2-3 days parent, 2 week metabolite
Inhibits 2D6 and 3A4
◉paroxetine (Paxil) SSRI. Answer: also treats social anxiety and
insomnia
associated with weight gain
will experience withdrawal with missed dose or abrupt stop
Half-Life: 24 hours
Inhibits 2D6
