This is chapter five: neuro, the third of three videos about antidepressants. This video will also touch on different
medications that can be used for smoking cessation.
Here are the drugs we will be going over in this video.
The first is a selective serotonin reuptake inhibitor, or an SSRI. The example
we'll use today is paroxetine, the brand name is Paxil. As you recall from previous video, selective serotonin reuptake
inhibitors prevent the breakdown of serotonin to increase levels of serotonin in the brain to improve our mood.
The second drug we will focus on today is a
serotonin norepinephrine reuptake inhibitor, or an SNRI, and the example we'll use today is duloxetine or Cymbalta.
Duloxetine, even though it has the '-oxetine' stem like paroxetine and
fluoxetine, just remember that this is an SNRI and not an SSRI. As an SNRI, it will inhibit
the breakdown of serotonin and norepinephrine in the brain.
The next drug is an atypical antidepressant, which is bupropion or
Wellbutrin or Zyban. It doesn't fit in with any of the other
drug classes like SSRIs, SNRIs,
TCAs or MAOIs.
This medication bupropion does not really have a real serotonergic effect -
most of its effect is on increasing the amounts of dopamine and norepinephrine in the brain.
They found when they were giving bupropion to patients who were smokers,
they actually quit smoking, so the Zyban is the brand name that is used typically with smoking.
It was named that so you can remember that you will be 'BAN'-ning smoking. The last medication is a smoking cessation aid,
varenicline or Chantix, and varenicline works by stimulating
nicotine receptors in the brain to block the pleasant effect of nicotine.
Now we'll go into some questions, so question number one,
we'll look at the drug classes, so the question is" 'An antidepressant that is an SSRI is?' A)
paroxetine, B) duloxetine,
C) bupropion or D) varenicline.
The answer is A)
paroxetine. Paroxetine is an SSRI, just focused on working on serotonin. B)
is incorrect, it is duloxetine; it does have the same stem as a couple other SSRIs
but it is an SNRI, so it has an effect on both serotonin and norepinephrine.
C) is incorrect because bupropion is an atypical
antidepressant, mostly works with dopamine and norepinephrine, and D)
varenicline is incorrect because it is used for smoking cessation, and it works on nicotine receptors.
Now we'll go into a couple more questions, and we will change the question to make the answer correct.
Question three, we're making B) correct: 'An
antidepressant that works on serotonin and norepinephrine is?' B) duloxetine.
You can recall that duloxetine is an SNRI, so it works on serotonin and norepinephrine
A) is incorrect - paroxetine is an SSRI which is selective for serotonin.
C) bupropion is incorrect - that is an atypical
Antidepressant which works on dopamine and norepinephrine, and D) varenicline is a nicotine
receptor agonist, and it is also not an antidepressant.
Question four, we're making C)
correct: 'An antidepressant that can also be used for smoking cessation is?' C) bupropion.
Bupropion is, as you can recall, an antidepressant and a smoking cessation aid. A) and B) are incorrect because
paroxetine and duloxetine are only
Indicated for depression as antidepressants and D) varenicline is incorrect because it is only used in smoking cessation.
Question five, make D) correct: 'A smoking cessation aid that causes bad dreams and suicidal thoughts is?' D) varenicline.
These are some side effects that have been noted when patients are taking this medication.
A) and B) are incorrect because they are not for smoking cessation, and
C) is incorrect because even though bupropion can be for smoking cessation,
it does not cause the bad dreams or suicidal thoughts.
Bupropion, the side effect we think of to be concerned with with that one is seizures.