NIMHANS Nursing Officer - 2021
Pharmacology
Easy
Examples of SSRI, except?
Appeared in: NIMHANS Nursing Officer - 2021
Explanation
- Selegiline is the correct choice as it is not an SSRI.
- It is a Monoamine Oxidase Inhibitor (MAOI), specifically a selective MAO-B inhibitor at lower doses.
- Its mechanism involves preventing the breakdown of neurotransmitters (like dopamine, norepinephrine, and serotonin) by inhibiting the monoamine oxidase enzyme.
- This mechanism is fundamentally different from SSRIs, which work by blocking the reuptake of serotonin.
Why Other Options Were Wrong
- Option A: Duloxetine is a Serotonin-Norepinephrine Reuptake Inhibitor (SNRI), not an SSRI. While it is also an exception, Selegiline is the better answer because its mechanism (enzyme inhibition) is more distinct from SSRIs (reuptake inhibition) compared to SNRIs (also reuptake inhibition).
- Option B: Citalopram is a classic example of a Selective Serotonin Reuptake Inhibitor (SSRI). Therefore, it fits the category and is not the exception.
- Option C: Fluoxetine is one of the most well-known SSRIs. As it belongs to the SSRI class, it is not the exception.
Related Visual
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Classification of antidepressant medications as background academic context rather than a clinical decision trigger.
- Understanding the different classes of antidepressants is critical for patient safety. MAOIs like Selegiline have a high risk of drug-drug interactions and require strict dietary restrictions (avoiding tyramine-rich foods like aged cheese, cured meats, and red wine) to prevent a life-threatening hypertensive crisis.
- Nurses must educate patients on the specific side effects and precautions associated with their prescribed antidepressant class.
- Combining MAOIs with SSRIs or SNRIs can lead to serotonin syndrome, a potentially fatal condition. This highlights the importance of accurate medication history and knowledge of drug classes.
How to Approach the Question
- First, identify the core subject of the question, which is 'SSRI' (Selective Serotonin Reuptake Inhibitors).
- Note the keyword 'except'. This means you are looking for the option that does NOT belong to the SSRI class.
- Review each option and classify it based on your pharmacology knowledge.
- Citalopram is an SSRI. Fluoxetine is an SSRI. Duloxetine is an SNRI. Selegiline is an MAOI.
- Both Duloxetine and Selegiline are not SSRIs. In such cases, select the option that is most different from the primary category. MAOIs have a fundamentally different mechanism of action (enzyme inhibition) compared to SSRIs and SNRIs (reuptake inhibition).
- Therefore, Selegiline is the most distinct exception and the best answer.
Concept Tested & Keywords
- Concept Tested: Classification of antidepressant medications
- Stem keywords: SSRI, antidepressants
- Lead-in keywords: except
- Negative lead-in flag: Question asks for the exception (NOT an SSRI).
Question ID
QgSwmMtIEnKMHsQC2oxaXd
Reference Book
E6 Robert Boland, Marcia L. Verduin - Kaplan and Sadock's Comprehensive Text of Psychiatry-Wolters Kluwer Health (2024) (pp 1-16525 of 16525) p. 9854-9856
E6 Pharmacology KD Tripathi Essentials 9e Part 2 p. 124-126
Practise the full NIMHANS Nursing Officer - 2021
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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