RML MAINS 2025
Psychiatric Nursing
Easy
Deficiency of which neurotransmitter is most commonly associated with depression?
Appeared in: RML MAINS 2025
Explanation
- Serotonin is the biogenic amine neurotransmitter most commonly associated with the pathophysiology of depression.
- It plays a crucial role in regulating mood, sleep, appetite, and aggression.
- Evidence shows that depletion of serotonin may precipitate depression in susceptible individuals.
- The mechanism of action for most modern antidepressants, such as Selective Serotonin Reuptake Inhibitors (SSRIs), involves increasing the availability of serotonin in the synaptic cleft.
Why Other Options Were Wrong
- Option A: While reduced dopamine activity can contribute to certain depressive symptoms like anhedonia (inability to feel pleasure), a significant dopamine deficiency is more classically and strongly associated with Parkinson's disease.
- Option C: A deficiency in acetylcholine is the hallmark neurochemical change in Alzheimer's disease, leading to memory loss and cognitive decline. It is not the primary neurotransmitter associated with depression.
- Option D: GABA (gamma-aminobutyric acid) is the primary inhibitory neurotransmitter. Low levels are most commonly associated with anxiety disorders and seizure activity, not primarily depression, although some reduction may be observed.
Related Visual
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Neurochemical basis of depression as background academic context rather than a clinical decision trigger.
- Understanding the role of serotonin is vital for educating patients about how their antidepressant medication (like an SSRI) works, which can improve medication adherence and manage expectations about the time it takes to see effects.
- Nurses must monitor patients starting antidepressants for therapeutic effects (improved mood, sleep) and potential side effects (like gastrointestinal upset or initial increase in anxiety), which are often related to increased serotonin activity.
- What if? - If a patient with depression does not respond to an SSRI, it may indicate that other neurotransmitter systems, like norepinephrine or dopamine, are more significantly involved. This might lead the prescriber to switch to a different class of antidepressant, such as an SNRI (Serotonin-Norepinephrine Reuptake Inhibitor) or a medication that also affects dopamine (like bupropion).
How to Approach the Question
- First, identify the key concept in the question: the neurochemical basis of 'depression'.
- Recall the primary functions of the major neurotransmitters listed in the options.
- Associate 'serotonin' with its well-known role in mood regulation. This is a strong initial link.
- Systematically eliminate the other options by recalling their primary associated conditions: Dopamine with Parkinson's disease, Acetylcholine with Alzheimer's disease, and GABA with anxiety/seizures.
- Conclude that while depression is a complex disorder involving multiple systems, the strongest and most common association in clinical practice and pharmacology is with serotonin deficiency.
Concept Tested & Keywords
- Concept Tested: Neurochemical basis of depression
- Stem keywords: deficiency, neurotransmitter, depression
- Lead-in keywords: most commonly associated
Question ID
QMBH2QJPJTmlNJ1CZ7k51d
Reference Book
E6 Kaplan Sadock's Synopsis of Psychiatry-2022 (pp 1-3768 of 3768) p. 1268-1270
E6 Robert Boland, Marcia L. Verduin - Kaplan and Sadock's Comprehensive Text of Psychiatry-Wolters Kluwer Health (2024) (pp 1-16525 of 16525) p. 5336-5338
Practise the full RML MAINS 2025
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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