365 Advanced Topics in Psychopharmacology: Quiz 27

Answer: False

Explanation: Some behavioral symptoms in persons with dementia are unlikely to improve with antipsychotic treatment. These include:

Unfriendliness

Poor self-care

Not paying attention or caring about what is going on

Repetitive verbalizations or questioning

Rejection or refusal of care

Shadowing

Wandering

An antipsychotic should usually not be prescribed for these symptoms. Educating the patient’s family members and clinical staff that these symptoms do not respond to antipsychotic medications can be helpful.

Review: Behavioral symptoms in dementia that are unlikely to improve with an antipsychotic

Answer: False

Explanation: There is a difference in the number of days that a medication has to be avoided BEFORE versus AFTER being on the MAO inhibitor.

After the use of an irreversible MAOI, it takes about two weeks to generate new MAO enzyme in the liver. That’s why we repeatedly read that patients have to be off the MAO inhibitor for “two weeks” before starting the medication that may interact with the MAO inhibitor.

But, BEFORE the person is on an MAO inhibitor, we just have to make sure that the drug that should not be combined with an MAOI has left the body, which occurs in about five half-lives of that particular drug. The half-life of sertraline is about 24 hours, so being off the sertraline for about 5 to 7 days before starting tranylcypromine is sufficient.

Review: MAO inhibitors (MAOIs) and contraindicated medications: How long do we have to wait?

Answer: False

Explanation: There is no difference in the efficacy of the various SSRIs, including fluvoxamine, for the treatment of OCD. So, it is a psychopharmyth that fluvoxamine is more efficacious for OCD than other SSRIs. Of course, individual patients may respond better to one SSRI or another, or respond to another SSRI after not responding to the first one.

Review: Is fluvoxamine (Luvox®) more effective for OCD than other SSRIs?