PTSD Pharmacology & Medication Management 3

Question 1

Paroxetine is FDA-approved for PTSD. Compared to sertraline, what is a notable pharmacokinetic concern with paroxetine?

Accepted Answer

Significant CYP2D6 inhibition and shorter half-life increasing discontinuation risk

Answer

Paroxetine inhibits CYP2D6 and has a shorter half-life, making it more prone to causing discontinuation syndrome and drug-drug interactions than sertraline.

Question 2

Which neurotransmitter system does prazosin target to reduce PTSD nightmares, and what is its mechanism?

Accepted Answer

Norepinephrine system via alpha-1 receptor antagonism

Answer

Prazosin blocks alpha-1 adrenergic receptors, reducing the central noradrenergic hyperactivation that drives PTSD nightmares and sleep disturbances.

Question 3

A clinician considers topiramate for a patient with PTSD. What is topiramate's proposed mechanism relevant to PTSD?

Accepted Answer

Glutamate modulation and GABA potentiation

Answer

Topiramate modulates glutamate activity and potentiates GABA, which may reduce traumatic memory reconsolidation and hyperarousal in PTSD.

Question 4

D-cycloserine has been investigated as an adjunct to PTSD psychotherapy. What is its proposed role?

Accepted Answer

NMDA partial agonism to enhance fear extinction learning

Answer

D-cycloserine is an NMDA partial agonist hypothesized to enhance fear extinction by facilitating synaptic plasticity during exposure-based therapy sessions.

Question 5

A patient with PTSD also has alcohol use disorder. Which PTSD medication is most appropriate to use cautiously due to additive CNS depression risk?

Accepted Answer

Quetiapine

Answer

Quetiapine carries significant CNS sedation and should be used cautiously in patients with alcohol use disorder due to additive CNS depression and aspiration risk.

(PTSD) Post Traumatic Stress Disorder Certification Practice Test

(PTSD) Post Traumatic Stress Disorder Certification Practice Test

PTSD Pharmacology & Medication Management 3