Psych Vivas · Psychopharmacology — atypical and multimodal antidepressants
Mirtazapine, bupropion and multimodal antidepressants — consultant viva
Fellowship viva covering mechanisms, doses, seizure risk, STAR*D/CO-MED evidence, multimodal agents and counselling.
On this page
Study tools
Target exams
FRANZCPMRCPsychABPNMD-DNB
Prompt
Examiner cards: NaSSA vs NDRI labels; mirtazapine 15 mg script; bupropion XL 300 mg; bulimia history; STAR*D L2 switch trio; CO-MED headline; rocket fuel L4; vortioxetine cognition claim; smoking cessation; low-dose sedation pearl.
Opening (30–45 seconds)
These agents are phenotype-driven alternatives and sequential options after SSRIs/SNRIs: mirtazapine (NaSSA), bupropion (NDRI), and multimodal drugs such as vortioxetine, vilazodone and agomelatine. I match mechanism to sleep–appetite versus energy–sexual–smoking problems, name oral doses, and refuse casual polypharmacy or MAOI improvisation.[1][9][10]
References10ShowHide
- [1]de Boer T The pharmacologic profile of mirtazapine J Clin Psychiatry, 1996.PMID 8636062
- [2]Rush AJ, Trivedi MH, Wisniewski SR, et al. Bupropion-SR, sertraline, or venlafaxine-XR after failure of SSRIs for depression N Engl J Med, 2006.PMID 16554525
- [3]Trivedi MH, Fava M, Wisniewski SR, et al. Medication augmentation after the failure of SSRIs for depression N Engl J Med, 2006.PMID 16554526
- [4]McGrath PJ, Stewart JW, Fava M, et al. Tranylcypromine versus venlafaxine plus mirtazapine following three failed antidepressant medication trials for depression: a STAR*D report Am J Psychiatry, 2006.PMID 16946177
- [5]Rush AJ, Trivedi MH, Stewart JW, et al. Combining medications to enhance depression outcomes (CO-MED): acute and long-term outcomes of a single-blind randomized study Am J Psychiatry, 2011.PMID 21536692
- [6]Davidson J Seizures and bupropion: a review J Clin Psychiatry, 1989.PMID 2500425
- [7]Jorenby DE, Leischow SJ, Nides MA, et al. A controlled trial of sustained-release bupropion, a nicotine patch, or both for smoking cessation N Engl J Med, 1999.PMID 10053177
- [8]McIntyre RS, Lophaven S, Olsen CK A randomized, double-blind, placebo-controlled study of vortioxetine on cognitive function in depressed adults Int J Neuropsychopharmacol, 2014.PMID 24787143
- [9]Cipriani A, Furukawa TA, Salanti G, et al. Comparative efficacy and acceptability of 21 antidepressant drugs for the acute treatment of adults with major depressive disorder: a systematic review and network meta-analysis Lancet, 2018.PMID 29477251
- [10]Malhi GS, Bell E, Bassett D, et al. The 2020 Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for mood disorders Aust N Z J Psychiatry, 2021.PMID 33353391