Paper I — 2023 July (Supplementary) (2010 Scheme) — Q2
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Paper I
2023 July (Supplementary) (2010 Scheme) · 40 marks · 120 min
Question
A 25-year-old male with symptom of excessive fatigue and lack of sleep was brought to
the clinic. His relatives say that he is socially withdrawn and has made two attempts of
suicide. He was prescribed tab fluoxetine.
Explain the mechanism of action, uses and adverse effects of fluoxetine.
Classify other drugs useful in the above condition. (3+3)
Q26 marksEssays
Answer
The presentation (fatigue, insomnia, social withdrawal, suicide attempts) is consistent with major depressive disorder, for which fluoxetine (an SSRI) has been prescribed.
Adverse effects: nausea and GI disturbance, sexual dysfunction, insomnia/agitation (fluoxetine is more activating than other SSRIs), serotonin syndrome risk with other serotonergic drugs/MAOIs, an initial transient increase in suicidal ideation particularly in adolescents (requiring close monitoring at treatment initiation) — a specific caution highly relevant to this patient’s presentation.
Classification of other drugs useful in depression
