ACT Pharmacology & Medication Management 3 — Questions and Answers
Question 1: When integrating ACT with pharmacotherapy, which outcome is considered ideal?
- Medication eliminates all symptoms so ACT can focus on values
- ACT skills reduce reliance on medication over time
- Medication and ACT work synergistically to enhance psychological flexibility (Correct answer)
- The client chooses either medication or ACT, not both
Correct answer: Medication and ACT work synergistically to enhance psychological flexibility
The ideal integrated outcome is synergy — medication may reduce symptom burden while ACT builds psychological flexibility and coping skills.
Question 2: A client on clonazepam for panic disorder asks why the medication is prescribed for only short-term use. The best explanation is:
- Clonazepam loses effectiveness within 30 days
- Long-term use carries risk of physical dependence and cognitive impairment (Correct answer)
- Insurance will not cover it beyond 30 days
- It must be cycled to prevent serotonin depletion
Correct answer: Long-term use carries risk of physical dependence and cognitive impairment
Benzodiazepines like clonazepam carry significant risks of physical dependence and cognitive side effects with prolonged use.
Question 3: Which antidepressant is most often prescribed for clients with both depression and chronic pain due to its dual mechanism?
- Fluoxetine (Prozac)
- Sertraline (Zoloft)
- Duloxetine (Cymbalta) (Correct answer)
- Escitalopram (Lexapro)
Correct answer: Duloxetine (Cymbalta)
Duloxetine is an SNRI FDA-approved for both major depressive disorder and several chronic pain conditions.
Question 4: A client taking quetiapine (Seroquel) for bipolar disorder reports significant weight gain and increased thirst. These symptoms most likely indicate a risk of:
- Hypothyroidism
- Metabolic syndrome and type 2 diabetes (Correct answer)
- Renal failure
- Tardive dyskinesia
Correct answer: Metabolic syndrome and type 2 diabetes
Atypical antipsychotics like quetiapine commonly cause metabolic side effects including weight gain, hyperglycemia, and dyslipidemia.
Question 5: In an ACT framework, a client's avoidance of taking prescribed medication because it 'makes the anxiety real' is best understood as:
- Appropriate health advocacy
- Experiential avoidance driven by fusion with anxiety-related thoughts (Correct answer)
- A sign of poor therapeutic alliance
- Evidence that medication is not indicated
Correct answer: Experiential avoidance driven by fusion with anxiety-related thoughts
ACT conceptualizes this as experiential avoidance — the client is fused with the thought that taking medication confirms their anxiety is real.
Question 6: Which medication requires regular blood level monitoring to ensure it stays within therapeutic range and avoid toxicity?
- Sertraline
- Lithium (Correct answer)
- Buspirone
- Hydroxyzine
Correct answer: Lithium
Lithium has a narrow therapeutic index and requires regular serum level monitoring to prevent toxicity.
Question 7: A client is prescribed bupropion (Wellbutrin). Which contraindication is most important to screen for before starting this medication?
- History of hypertension
- History of seizure disorder or eating disorders (Correct answer)
- Current use of aspirin
- Mild renal impairment
Correct answer: History of seizure disorder or eating disorders
Bupropion lowers the seizure threshold and is contraindicated in clients with seizure disorders or eating disorders (which increase seizure risk).
ACT Pharmacology & Medication Management 3
When integrating ACT with pharmacotherapy, which outcome is considered ideal?