NR547 FINAL EXAM QUESTIONS AND
ANSWERS | 2026 UPDATE | 100%
CORRECT.
Medications for depression - ANS SSRIs
SNRIs
SDRIs
TCAs
MAOIs
SSRIs - ANS -Action: inhibit 5-HT reuptake
-Examples: citalopram, escitalopram, fluoxetine, paroxetine, sertraline
-Adverse effects:
• nausea
• agitation
• diarrhea
• headache
• weight gain
• sexual side effects
SNRIs - ANS -inhibit 5-HT reuptake
-inhibit NE reuptake (↑ energy, focus)
-increase DA in prefrontal cortex (↑ cognition)
-Examples: desvenlafaxine, duloxetine, levomilnacipran, venlafaxine
@COPYRIGHT ALL RIGHTS RESERVED PAGE 1 OF 76
,-Adverse effects:
• elevated blood pressure
• nausea
• sweating
• tremors
• anxiety
• insomnia
• constipation
• anorexia
• sexual dysfunction
SDRIs - ANS -inhibit DA reuptake (↑alertness, motivation)
-inhibit NE reuptake (↑energy)
-Adverse effects:
• agitation
• headache
• dry mouth
• constipation
• weight loss
TCAs - ANS -Action: inhibits the reuptake of serotonin and norepinephrine; blocks
norepinephrine, histamine, and acetylcholine receptors
-Examples: amitriptyline, clomipramine, desipramine, doxepin
-Common Side Effects:
• dry mouth
• constipation
• blurred vision
• urinary retention
• sedation
@COPYRIGHT ALL RIGHTS RESERVED PAGE 2 OF 76
,• weight gain
• hypotension
• tachycardia
• sexual dysfunction
MAOIs - ANS -Action: increases norepinephrine and serotonin by inhibiting the enzyme that
inactivates it
-Examples: isocarboxazid, phenelzine, tranylcypromine
-Common Side Effects:
• sedation
• dizziness
• sexual dysfunction
• hypertensive crisis
Prescribing pearls: citalopram (Celexa) - ANS mild antihistamine effects
Prescribing pearls: escitalopram (Lexapro) - ANS no known drug interactions
Prescribing pearls: fluoxetine (Prozac) - ANS longest half-life
Prescribing pearls: paroxetine (Paxil) - ANS also treats social anxiety and insomnia
Prescribing pearls: fluvoxamine (Luvox) - ANS treats anxious depression smokers require
increased dose
Prescribing pearls: sertraline (Zoloft) - ANS also treats social anxiety and hypersomnolence
@COPYRIGHT ALL RIGHTS RESERVED PAGE 3 OF 76
, Prescribing pearls: bupropion (Wellbutrin) - ANS NDRI may improve energy, alertness, and
motivation; not first line treatment for anxiety; contraindicated in clients with a history of
seizures
Prescribing pearls: duloxetine (Cymbalta) - ANS effective for atypical pain at higher doses;
appropriate for clients who present with somatic symptoms of depression; effective for atypical
pain, such as fibromyalgia and diabetic neuropathy
Prescribing pearls: venlafaxine (Effexor) - ANS treats both depression and anxiety disorders,
ensure trial of higher dose before switching to a different medication
Prescribing pearls: desvenlafaxine (Pristiq) - ANS effective for perimenopausal vasomotor
symptoms
considered when selecting a medication: - ANS -Client preference
-Prior treatment response
-Anticipated adverse effects
-Comorbidities
-Half-life and interactions
-Cost
if a medication is not achieving efficacy: - ANS -Increase dose gradually
-Switch to a different drug within the same class
-Switch to drug in a different class
-Add a second medication
Use to protect against suicide - ANS lithium
MDD and BPD genetics - ANS genetic factors contribute 31-42% of the disease risk in MDD
and 59-85% in BPD
@COPYRIGHT ALL RIGHTS RESERVED PAGE 4 OF 76
ANSWERS | 2026 UPDATE | 100%
CORRECT.
Medications for depression - ANS SSRIs
SNRIs
SDRIs
TCAs
MAOIs
SSRIs - ANS -Action: inhibit 5-HT reuptake
-Examples: citalopram, escitalopram, fluoxetine, paroxetine, sertraline
-Adverse effects:
• nausea
• agitation
• diarrhea
• headache
• weight gain
• sexual side effects
SNRIs - ANS -inhibit 5-HT reuptake
-inhibit NE reuptake (↑ energy, focus)
-increase DA in prefrontal cortex (↑ cognition)
-Examples: desvenlafaxine, duloxetine, levomilnacipran, venlafaxine
@COPYRIGHT ALL RIGHTS RESERVED PAGE 1 OF 76
,-Adverse effects:
• elevated blood pressure
• nausea
• sweating
• tremors
• anxiety
• insomnia
• constipation
• anorexia
• sexual dysfunction
SDRIs - ANS -inhibit DA reuptake (↑alertness, motivation)
-inhibit NE reuptake (↑energy)
-Adverse effects:
• agitation
• headache
• dry mouth
• constipation
• weight loss
TCAs - ANS -Action: inhibits the reuptake of serotonin and norepinephrine; blocks
norepinephrine, histamine, and acetylcholine receptors
-Examples: amitriptyline, clomipramine, desipramine, doxepin
-Common Side Effects:
• dry mouth
• constipation
• blurred vision
• urinary retention
• sedation
@COPYRIGHT ALL RIGHTS RESERVED PAGE 2 OF 76
,• weight gain
• hypotension
• tachycardia
• sexual dysfunction
MAOIs - ANS -Action: increases norepinephrine and serotonin by inhibiting the enzyme that
inactivates it
-Examples: isocarboxazid, phenelzine, tranylcypromine
-Common Side Effects:
• sedation
• dizziness
• sexual dysfunction
• hypertensive crisis
Prescribing pearls: citalopram (Celexa) - ANS mild antihistamine effects
Prescribing pearls: escitalopram (Lexapro) - ANS no known drug interactions
Prescribing pearls: fluoxetine (Prozac) - ANS longest half-life
Prescribing pearls: paroxetine (Paxil) - ANS also treats social anxiety and insomnia
Prescribing pearls: fluvoxamine (Luvox) - ANS treats anxious depression smokers require
increased dose
Prescribing pearls: sertraline (Zoloft) - ANS also treats social anxiety and hypersomnolence
@COPYRIGHT ALL RIGHTS RESERVED PAGE 3 OF 76
, Prescribing pearls: bupropion (Wellbutrin) - ANS NDRI may improve energy, alertness, and
motivation; not first line treatment for anxiety; contraindicated in clients with a history of
seizures
Prescribing pearls: duloxetine (Cymbalta) - ANS effective for atypical pain at higher doses;
appropriate for clients who present with somatic symptoms of depression; effective for atypical
pain, such as fibromyalgia and diabetic neuropathy
Prescribing pearls: venlafaxine (Effexor) - ANS treats both depression and anxiety disorders,
ensure trial of higher dose before switching to a different medication
Prescribing pearls: desvenlafaxine (Pristiq) - ANS effective for perimenopausal vasomotor
symptoms
considered when selecting a medication: - ANS -Client preference
-Prior treatment response
-Anticipated adverse effects
-Comorbidities
-Half-life and interactions
-Cost
if a medication is not achieving efficacy: - ANS -Increase dose gradually
-Switch to a different drug within the same class
-Switch to drug in a different class
-Add a second medication
Use to protect against suicide - ANS lithium
MDD and BPD genetics - ANS genetic factors contribute 31-42% of the disease risk in MDD
and 59-85% in BPD
@COPYRIGHT ALL RIGHTS RESERVED PAGE 4 OF 76
