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When D 2 blockers were approved for schizophrenia, it was not surprising that
these agents would work for psychotic symptoms associated with mania since
what?
the D 2 antagonist actions predict efficacy for psychosis
it was somewhat surprising when these dopamine/serotonin blockers proved
effective for the core nonpsychotic symptoms of mania and for maintenance
treatment to prevent what?
the recurrence of mania
Selective inhibitors of MAO-B do not have antidepressant efficacy. This is because
of what?
MAO-B metabolizes serotonin (5HT) and norepinephrine (NE) only at high
concentrations
Selective inhibition of MAO-B has somewhat limited effects on dopamine
concentrations because of what?
MAO-A continues to destroy dopamine
Inhibition of MAO-B does increase dopamine to some extent which can be
therapeutic in other disease states such as what?
Parkinson's disease
Combined inhibition of MAO-A and MAO-B may have a robust antidepressant
actions owing to increases not only in 5HT and norepinephrine but what?
Dopamine
Some of the serotonin/dopamine antagonists/partial antagonists are effective for
bipolar depression likely due to what?
D2 antagonism/partial agonism
, Some of the serotonin/dopamine drugs have evidence of efficacy in unipolar
depression as augmenting what?
SSRIs/SNRIs when there is inadequate response
Some of the serotonin/dopamine drugs have evidence of efficacy in unipolar and
bipolar depression with what?
mixed features of mania
Blocking the excessive dopamine at D2 receptors should have as much of an
antimanic effect in bipolar as it does in what?
Antipsychotic effect in schizophrenia
Not all agents in the serotonin/dopamine blocker class approved to treat
schizophrenia are also approved to treat what?
acute bipolar mania
Not all agents in the serotonin/dopamine blocker class approved to treat acute
bipolar mania are also approved to treat what?
bipolar maintenance
To enhance antimanic response and to [prevent relapse into another episode of
mania, what agents are commonly used in conjunction with dopamine serotonin
blockers?
lithium and valproate
Lithium and valproate do not augment the efficacy of serotonin/dopamine blockers
in the treatment of what?
schizophrenia
The serotonin/dopamine antagonists/partial agonists have proven to be quite
versatile therapeutics from schizophrenia, to mania, to adjuncts for what
SSRIs/SNRIs in unipolar depression
Practice guidelines are moving away from treating bipolar depression or
depression with mixed features with monoamine reuptake inhibitors. Reuptake
inhibitors are being reserved for the treatment of what?