Personality and Mood Disorders Q 44

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The following medications will likely be prescribed for the client except:

  

     A. Prozac

     B. Tofranil

     C. Parnate

     D. Zyprexa

    

    

Correct Answer: D. Zyprexa

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This is an antipsychotic. Olanzapine is a second-generation (atypical) antipsychotic medication. Olanzapine also has approval for use with fluoxetine, a selective serotonin reuptake inhibitor (SSRI), in patients with episodes of depression associated with bipolar disorder type 1 and treatment-resistant depression. It is important to note that olanzapine is not FDA approved for patients under the age of 13, and the combination of olanzapine with fluoxetine does not have approval for patients under the age of 10.

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Option A: Prozac is a SSRI antidepressant. Fluoxetine has FDA-approval for major depressive disorder (age eight and older), obsessive-compulsive disorder (age seven and older), panic disorder, bulimia, binge eating disorder, premenstrual dysphoric disorder, bipolar depression (as an adjunct with olanzapine also known as Symbyax), and treatment-resistant depression when used in combination with olanzapine.

Option B: Tofranil antidepressant belongs to the Tricyclic group. Imipramine is a tertiary amine tricyclic antidepressant. Tricyclic antidepressants (TCAs) had been approved by the Food and Drug Administration (FDA) as antidepressants in the 1950s. Although it is FDA approved for the treatment of depression, it is a second-line treatment notably in severe depression with melancholic and atypical features, due to its undesirable side effects and due to its toxicity in overdose.

Option C: Parnate is a MAOI antidepressant. The main FDA-approved indication of tranylcypromine is for major depressive disorder without melancholia. The non-FDA-approved indications for this medication include treatment-resistant depression, treatment-resistant social anxiety disorder, treatment-resistant panic disorder, and atypical depression. Atypical depression consists of hyperphagia, hypersomnia, rejection sensitivity, and leaden paralysis accompanying the depression.

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