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A 28-year-old woman presents to the clinic for the first time with symptoms
of major depressive disorder lasting
several weeks. She requests medication because, apart from feeling
low and tired, she feels distracted,
forgetful, and unable to focus on her work. She reports having been
diagnosed as a child with attention
deficit/hyperactivity disorder and dyslexia, and she had been given
methylphenidate. Which of the following
therapeutic agents would be most appropriate for treatment?
A. Alprazolam
B. Bupropion C. Lithium
D. Olanzapine
E. Paroxetine
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EE
paroxetine
depression in a patient with ADHD treated with serotonin reuptake inhibitors
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provided that she is also on methylphenidate
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The correct answer is B. Bupropion is an antidepressant with both dopaminergic and noradrenergic
properties that would essentially help this patient not only improve depression but also cognitive functioning
related to her prior history of attention deficit/hyperactivity disorder.
Alprazolam (choice A) is a benzodiazepine with a rapid onset of action and a relatively short metabolite
half-life. It has strong anxiolytic properties. Even though initially it was claimed to have antidepressant
properties too, its highly addictive potential prevents it from wider and long-term use.
Lithium (choice C) is a mood stabilizer with potential use for treatment of aggression in attention
deficit/hyperactivity disorder. Lithium appears to be effective only as an adjunct in the treatment of depressive
disorder. Its long-term use may cause cognitive impairment.
Olanzapine (choice D) is an atypical antipsychotic with some mood stabilizing properties. It has not been used
solely for treatment of depression.
Paroxetine (choice E) is a selective serotonin reuptake inhibitor (SSRI). Although it is effective in most
patients, its anticholinergic properties might impair cognitive function more in this case.
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hi..
ans is B...buporpion...coz act by inhibiting reuptake of dopa, NE & serotonin...so used in...
1.depression
2. smoking cesssoin
3.seasonal affective ds
4.dysthymia
5.PTSD
6.ADHD
7.chr fatigue synd
8. narcolepsy
9.periodic leg movt
10.neuropathic pain...!!!!!
wht an amazing drug!!!
