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Psychopharmacology Final Exam 2025
Questions with 100% Correct Answers
Acute anxiety - Correct answer - Occurs in response to real-life stressors, and symptoms occur only in response to these events -Anxiolytics in the benzodiazepine are effective for relieving this type of anxiety Generalized Anxiety Disorder (GAD) - Correct answer - Symptoms of anxiety but with no real focus
- Present for much of the day, and persist for months or years
- Constant worry and continuously predict, anticipate, or imagine dreadful events
- Life is generally stressful, and even minor events provoke worry
- Being late for an appointment, not completing a task, or making a minor mistake are all causes of worry
- Muscle tension and agitation lead to fatigue, poor concentration, irritability, and sleep problems
- Most cases begin gradually in the teens or early adulthood and persist throughout life Panic Attack - Correct answer - When a person experiences all the responses of a fear reaction without a threatening stimulus
- Sudden intense fearfulness is accompanied by strong arousal of the sympathetic ANS
- Pounding or chest pain, sweating, shortness of breath, faintness, choking, and the fear of losing control
- May occur in the response to a particular environmental cue OR
- Totally without warning in unexpected fashion OR
- In a situation where an attack occurred previously, this making it more likely to occur again Panic Disorder - Correct answer - Late 20's and may last for many years, with attacks occurring at different frequencies and intensities over that time
- Person experiences both panic, and anxiety (called anticipatory anxiety) over the possibility that he or she my have an attack in a place that is not safe
Anticipatory Anxiety - Correct answer Feeling of extreme worry over the possibility that a certain unpleasant event will occur in a particular, often public situation Agoraphobia - Correct answer - A fear of public places and subsequent avoidance of many common situations
- People with this often lead very limited lives because they never leave the safety of their own home
- Can be in some panic disorders Phobias - Correct answer - Involve fears that the individual recognizes as irrational
- May focus on specific objects or situations such as high places, closed-in spaces, water, mice, or snakes, or they may relate to interpersonal situations such as speaking in public
- Can affect daily existence and quality of life -Significantly alters daily activities
- What is fear can be due, in part, by culture
- Medication rarely needed Behavioral Desensitization - Correct answer - Common modern method treatment for phobias
- Behavior therapy that involves presenting the fear-inducing stimulus in gradual increments, allowing the individual to maintain a relaxed state while confronting the source of their fear Social Phobia - Correct answer - Fear of being around others because of individual is concerned that they might do something embarrassing
- Restricts public speaking, attending parties, taking exams, and even eating in public places
- Cognitive therapy that modifies negative thoughts such as the likelihood of looking foolish, plus social skills training- frequently beneficial PTSD - Correct answer - Experience nightmares and memories that may occur as sudden flashbacks of the traumatic event
- Show increased physiological activity to reminders of the trauma, sleep disturbances, avoidance of stimuli associated with the trauma, and a numbing of emotional responses for many years after the original stress
Anxiolytics - Correct answer Drugs that are used to relieve anxiety
- may belong to the class of sedative hypnotics
- Drug should relieve tension and worry and signs of stress that are typical of an anxious person Sedative Hypnotics - Correct answer - Anxiolytics
- Belong to larger category of CNS depressants why depression is often associated with pain - Correct answer dysregulation of descending 5HT and NA pathways to the spinal cord may explain an increased pain perception among depressed patients imbalances of 5HT and NA may explain the presence of both emotional and physical symptoms emotional symptoms of depression - Correct answer sadness loss of interest/pleasure overwhelmed anxiety diminished ability to think/concentrate/decide excessive/inappropriate guilt physical symptoms of depression - Correct answer vague aches/pains headache sleep disturbances fatigue back pain significant change in appetite resulting in weight loss or gain Often the chief complaint in depressed patients the two neurotransmitters that mediate depressive symptoms - Correct answer 5HT & NA what 5HT takes away in depression - Correct answer sex appetite aggression
what NA takes away in depression - Correct answer concentration interest motivation characteristics of the manic component of bipolar disorder - Correct answer burst of energy predominant mood - irritability, belligerence,impatience less need for sleep racing thoughts/ideas impulsive decisions (extreme) Genetics of affective disorders - Correct answer strong predispositiokn for affective disorders 50% MZ twins concordant for depression 10% DZ twins concordant since 1940, age of onset has become younger and younger seasonal affective disorder - Correct answer mixture of depressive symptoms -increased weight gain -increased carb craving -increased sleep diathesis stress model - Correct answer inherited genetic susceptibility + stressor = depression support for model: 50% depressed people release more cortisol fail dexamethasone suppression test - normal negative feedback cortisol not functioning hypothalamic/neuroendocrine internal clock disruption sleep in a patient with endogenous depression - Correct answer reduced sleep latency reduced REM latency
BUT chronic intake of ketamine will cause symptoms of schizophrenia Define the following: -Psychedelic -Enactogenic -Entheogenic -Empathogenic -Psychotomimetic - Correct answer -Psychedelic: Mind expanding (exposing of the inner mind) -Enactogenic: Touching within (getting more in touch with oneself) -Entheogenic: Generating the divine within -Empathogenic: Empathy enhancers (i.e. MDMA & social bonding) -Psychotomomimetic: Like psychosis Describe the categories of hallucinogens. - Correct answer a. Serotonergic (monoaminergic) Hallucinogens: Most bear some kind of resemblance to and can affect serotonin, norepinephrine, and dopamine -Lysergic acid diethylamide: Structurally similar to serotonin -Mescaline: Structurally similar to dopamine and norepinephrine -Psilocybin: "Magic mushroom" -Dimethyltryptamine (DMT) b. Methylated Amphetamines: -MDMA: Similar to both amphetamines and mescaline c. Anticholinergic Hallucinogens: -Atropine -Scopolamine d. Dissociative Anesthetics/Glutamatergic Hallucinogens: -Ketamine -PCP Describe the following hallucinogens: Psilocybin, DMT, Mescaline. - Correct answer Psilocybin: "Shrooms" -Native to southern Mexico and Central America -1958: Albert Hofmann identified the active ingredient in mushrooms -Administration: Can boil mushrooms and make tea or eat them -Effects last 4 to 6 hours -Only 1% as potent as LSD
-Works on serotonin system -- 5HT2A receptors Dimentyltryptamine (DMT): -Derived from plants (Virola shrub) in South America -Devoid of psychoactivity when taken orally; smoked --Has to be taken with another medication in order for it to be active when taken through oral route because DMT is quickly broken down by monoamine oxidase -- must be taken alongside MAO inhibitor -Onset of effects are rapid and short-lasting: Effects come in seconds to minutes and last as little as 15 to 20 minutes -Hallucinations, feelings of euphoria Mescaline -From the Peyote cactus: Take off of top of peyote cactus, dry it out -Administration: Chewed raw or cooked and eaten; Pure powder form that you can snort -Structurally similar to norepinephrine, but most effects come from effects on 5HT2A receptor -Natural source of hallucinogens -Considered legal by Native American tribes, used commonly in religious rights, but not usually legal What is ergot? Describe the effects of ergot poisoning. - Correct answer Lysergic acid: Derived from ergot alkaloids found in fungus that tends to grow on grains -Due to famine, individuals were faced to eat moldy grains, and those who ate the moldy grains would have hallucinatory experiences, convulsions, delusions -St. Anthony's Fire: Individuals would develop gangrene on limbs and had burning sensation throughout their bodies -Causes uterine contractions Who first synthesized LSD? What is MK-ULTRA? - Correct answer Albert Hofmann (1938): Synthesized LSD- -LSD was 25th compound that he synthesized - LSD -First synthesized in 1938, but not known to have effects until 1943. At this point, accidentally ingested some of the LSD25 and experienced trip, then went back into lab and used 25 mg of LSD
--Haloperidol, which only antagonizes D2 receptors, did not prevent hallucinogenic effects, suggesting effects are mediated primarily through 5- HT2A receptor --Visual Cortex: A lot of 5-HT2A and 5-HT1A receptors in the visual cortex, which contributes to visual hallucinations Describe the regions of the brain that are thought to be important in the effects of LSD. How does activation of 5-HT receptors in these regions impact perception and behavior? What is the role of glutamate and GABA?
- Correct answer Visual Cortex: 5-HT2A and 5-HT1A receptors in visual cortex contributes to visual hallucinations Locus Coeruleus: -Activates postsynaptic 5-HT2A receptors, which works to modulate the release of glutamate and GABA -Glutamate: Increases glutamate signals from locus coeruleus to PFC -GABA: Decreases spontaneous release of GABA in locus coeureleus Prefrontal Cortex -Activates 5-HT2A receptors directly in prefrontal cortex -Increases glutamate within prefrontal cortex, enhancing signal from outside environment -Level of signal vs. noise: Reducing background information while increasing information about relevant signals -Changes in gating of sensory information from exterior to frontal cortex where you begin to process and understand sensory information from outside -Increase in salience of sensory information that's already in your environment leads to distortion in perception of stimuli -Increase in the perception of color and contrast Describe the physiological and psychological effects of LSD. - Correct answer Sympathomimetic effects: Within minutes of ingesting drug -Dilation of pupils -Nausea -Increased body temperature -Dilation of pupils Perception:
-Due to effects in prefrontal and visual cortex and locus coeruleus, enhanced color perception or greater contrast of colors; Altered perception of motion -Synesthesia: Mixing of sensory qualities -- sounds can take on visual forms - thought to be due to mix-up in wiring between areas of brain processing different types of sensations like connections between visual cortex temporal lobe and parietal lobe are getting mixed up, LSD is working on circuits to create mixing of sensory qualities -Music may take on enhanced meaning or intensity Emotion: Elated, uncontrollable laughter; or very scared and frightened, hostile and aggressive -Ego disintegration: Loss of sense of self, detached from bodies, feel like they are coming out of their bodies and coming out of outside, thinking is not happening in logical and meaningful way Describe the qualities of visual hallucinations experienced while under the influence of LSD. How did Heinrich Kluver and Ronald Siegel study the hallucinogenic effects of LSD? What did they find? - Correct answer -Reliable types of visual occurrences: Lattice pattern, tunnel/vortex, spiral explosion -Seeing things that aren't there? Some say small animal or human figures, but unlikely without high doses -70% of people report religious imagery Discuss the typical progression of an LSD 'trip' - Correct answer -Onset: 30 minutes to 1 hour -- Visual effects begin -Plateau: Next 2 hours -- Sense of time slows, visual effects intensify -Peak: After about 3 hours and lasts 2-3 hours: Each trip is unique and highly dependent on setting and personal expectations; Separate from body, "in another world," synesthesia -Come down: 2 hours -- May take up until next day to feel normal again What are the typical characteristics of a 'bad trip'? What might help an individual experiencing a bad trip? - Correct answer Adverse Effects: "Bad Trips" -Traumatizing, dark imagery, insights appalling -Ranges from anxiety to terror and panic -Research has shown that this depends on mindset
-Used in combo with psychotherapy to get people to get more in touch with their feelings -Animal studies show real wakeup call that it potentially has damaging effects on brain -Each pill can contain 100 mg or more of MDMA -Most impact through serotonin system -Effects on dopamine seen with higher doses Describe the pharmacokinetics of MDMA. What CYP450 enzymes metabolize MDMA? Describe variations in the activity of a CYP450 that contributes to prolonged effects and greater adverse events. - Correct answer -Oral administration -Peak concentration within 2 hours -Half-life: 9 hours -Metabolism: CYP2D6, CYP1A --About 10% of Caucasians and 10% of African Americans have version of gene that regulates enzyme that leads to inhibition of metabolism of the drug -- the drug has stronger effects and lasts longer over time in these people, and they are more prone to adverse effects -Much is excreted unchanged in urine or metabolized to MDA, an active metabolite that contributes to long length of action --MDA is also used to get high -It takes 40 hours for 95% of drug to be eliminated, stays in system longer than you actually feel effects -SSRIS can also inhibit workings of CYP2D6, which is why it's bad to mix SSRIs and MDMA What are the mechanisms of action of MDMA? What happens to neurotransmitter levels following the use of MDMA? - Correct answer - Increases release and blocks reuptake of serotonin, norepinephrine, and dopamine, increasing availability of neurotransmitters --Most of impact is through serotonin system ---MDMA blocks vesicular transporter where serotonin is normally packaged up ---Empty vesicle because of blocking transporter ---Greater serotonin within cytoplasm of cell ---Transporters work in reverse and dump extra serotonin into synaptic cleft -After serotonin and dopamine are dumped into synaptic cleft, rebound effect in serotonin and dopamine available for release
-Effects on dopamine seen with higher doses -Also impacts the release of oxytocin What are the physiological and psychological effects of MDMA? - Correct answer Physiological Effects -Sympathomimetic: Increased heart rate & blood pressure -Bruxism & Trismus: teeth grinding and jaw clenching -Hyperthermia: Increase in body temperature (gum might melt in mouth) -Tachycardia: Issue with increase in body temperature Psychological effects: -Increased alertness, arousal, insomnia - stimulant effects -Euphoria, increased emotional warmth -Increased empathy and connectedness to others -Increased sensitivity to tactile stimulation -Hallucinogenic effects are largely absent, unless combined with other hallucinatory drug -Comedown from peak effects: Similar to coming down from other stimulant drugs -- insomnia, agitation, people try to take additional doses to get back to peak but that doesn't work because of acute tolerance Is MDMA self-administered by animals? How can you block the reinforcing effects of MDMA? - Correct answer -In contrast to LSD, MDMA is self- administered by primates and mice --Difference in self-administration of methamphetamine vs. MDMA: Animals prefer to self-administer methamphetamine -Reinforcing effects can be eliminated by blocking 5-HT2A receptors, suggesting that they have some kind of reinforcing properties -MDMA also has stronger impact on dopamine pathways than LSD Describe the symptoms of MDMA toxicity. What accounts for the majority of MDMA deaths? - Correct answer -Hyperthermia and dehydration: The problem -- People try to drink water & end up with electrolyte imbalances --You can have seizures, heart arrhythmias, strokes --Therapeutic index = 15, not incredibly fatal; But effects on body temperature and dehydration in environment is unsafe -Renal failure -Disintegration of muscle tissue -Most MDMA-related fatalities have been attributed to hyperthermia and electrolyte imbalances
Describe the physiological and psychological effects of PCP. - Correct answer Physiological effects -Numbness -Loss of motor coordination -Slurred speech -Blurred vision Higher doses lead to: -Hyperexcitability or stupor -Coma -Seizures -Death Subjective Effects of PCP -Sensations of light -Bizarre distortions of body shape or size -Sensations of floating or hovering in space -Visions of spiritual or supernatural beings -Emotions ranging from euphoria to hostility -Can be a rather intense experience, especially if you're having any negative types of distortions of emotions What effect does PCP have on LTP? - Correct answer PCP and LTP: NMDA antagonist -Use of PCP impacts long-term potentiation, which happens between cells where one cell connects to other cell and becomes more sensitive to further activation from that cell -Involves both AMPA and NMDA receptors -Bursts of firing between these cells causes activation of NMDA receptors, which will lead to increase in AMPA receptors on postsynaptic membrane, making cell more sensitive to stimulation -If you block NMDA receptor with PCP, you're blocking ability of cell to make types of changes in order to see long-term potentiation Describe Ketamine. - Correct answer -Special K -Liquid, but can be powdered for snorting or smoking -Also used as an analgesic and anesthetic in animals -Similar to PCP, but safer, shorter-acting, and milder -Lasts 35-40 minutes -Lethal dose is about 25x the effective dose - not horribly lethal, but more lethal than LSD
--With very high doses: convulsions, coma, death Describe the following anticholinergic hallucinogens: a. Atropine b. Scopolamine - Correct answer - Atropine: Deadly nightshade/Belladona, Datura, Jimson weed, and Mandrake -Scopolamine: from Datura, Jimson weed, Mandrake and Henbane Plants and bushes --Atropine is still used in medicine by opthomologists to dilate pupils --Will at times produce true hallucinations, but more so tend to produce things like delusional thinking --Can become very disoriented about where you are What are anticholinergic effects? - Correct answer Anticholinergic Effects: Due to impact on cholinergic system in both CNS and PNS -Dry mouth, blurred vision, loss of motor control, hypertension -Dream-like trance state -Little or no memory of experience: Acetylcholine is important for leraning and memory, so blocking this can give you issues with remembering events that happened to you Compare and contrast muscarine and muscimol? What neurotransmitter systems are impacted? What are the effects of the drugs? - Correct answer Muscarine/Muscimol -Found in mushrooms (Amanita Muscaria) -Muscimol is a GABAa agonist -Muscarine is an Acetylcholine agonist (muscarinic receptors) Both produce Trance-like state and peripheral effects that include Profuse sweating, muscle twitching, seizure activity THC is a ____ at Cannabinoid receptor (CB) - Correct answer Partial agonist Cannabinoid Receptor activation inhibits release of transmitters such as _______. - Correct answer GABA creates presynaptic inhibition THC causes _____ inhibition - Correct answer presynaptic
used in rituals of indigenous peoples can be smoked or eaten Describe Scopolamine - Correct answer Ach direct agonist found naturally in belladona, datura & mandrake causes mental cloudiness, disorientation, memory problems, etc. Describe Mescalin - Correct answer Affects NE AKA Peyote Similar to NE but has added 5-ht2A agonist properties Somewhat different than LSD subjectively Describe MDMA - Correct answer Ecstasy NE indirect agonist Oxytocin agonist 5-HT neurtoxin (greater in females) causes memory impairment & executive impairment and problems with temperature regulaiton Name three drugs that are NMDA Receptor Antagonists - Correct answer Phencyclidine (PCP) Ketamine Dextromethorphan - used in medicines LSD emerged from research on - Correct answer migraine relief in Switzerland Name 2 drugs still widely used in animals as anesthetics - Correct answer phencyclidine (PCP) & Ketamine Name two drugs that can produce a schizophrenic like condition as a reaction to taking them - Correct answer phencyclidine & Ketamine
- LSD thought to do so also What is meant by "hallucinogen persisting perception disorder" - Correct answer a disorder characterized by a continual presence of sensory disturbances, most commonly visual, that are reminiscent of those generated by the use of hallucinogenic substances.
What is the major active ingredient of psilocybe mushrooms? - Correct answer Psilocybin What is the major active ingredient of peyote? - Correct answer mescaline phantastica - Correct answer term for hallucinogens dubbed by Lewin in 1931 Examples of phantastica drugs - Correct answer Peyote Psilocybin LSD psychedelic - Correct answer -"mind-viewing" -term used in the 1960s as users believed hallucinogens allowed them to see into their own minds psychotomimetic drugs - Correct answer -"mimicking psychosis" -term for hallucinogens; implies they produce dangerous effects and a form of mental disorder, which is a controversial conclusion entheogen, entactogen - Correct answer newer terms used to describe group of drugs known as hallucinogens -entheogen: used to describe substances (sacred mushrooms) through to create spiritual experiences -entactogen: "to produce a touching within"; used to describe substances (MDMA) through to enhance empathetic feelings classical phantastica - Correct answer capable of altering perceptions while allowing person to remain in communication with present world -you can be aware of both fantasy world and real world at the same time -more purely hallucinogenic effects; do not produce much acute physiological toxicity (little danger of dying from overdose) 2 major classes of classical phantastica, grouped according to chemical structure - Correct answer 1) indole hallucinogens
- catechol hallucinogens Where does LSD come from? - Correct answer -not found in nature; synthesized from ergot alkaloids extracted from ergot fungus CLAVICEPS
