Psychopharmacology: practice question

A Psychiatry question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Psychiatry · Psychopharmacology

Sample item

A 24-year-old woman with depression and a history of binge eating and purging asks for a non-sedating, non-sexually-dysfunctional antidepressant. Which drug should be avoided in her?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Bupropion

Bupropion is a norepinephrine-dopamine reuptake inhibitor with a dose-related risk of seizures, which is increased by electrolyte disturbance from purging in bulimia nervosa. It is therefore contraindicated in bulimia and anorexia nervosa and in seizure disorders. Fluoxetine, in contrast, is the SSRI with evidence for bulimia.

Option by option

  • A. Bupropion (correct)

    Correct. Seizure risk is raised in bulimia, making bupropion contraindicated.

  • B. Fluoxetine

    Fluoxetine is the recommended drug for bulimia nervosa.

  • C. Mirtazapine

    Mirtazapine has no seizure-lowering contraindication here, although it increases appetite and weight.

  • D. Sertraline

    Sertraline is an SSRI that carries no specific contraindication in bulimia.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More Psychiatry questions

Questions about this Psychiatry question

What is the answer to this Psychiatry question?

The best answer is A, Bupropion. Bupropion is a norepinephrine-dopamine reuptake inhibitor with a dose-related risk of seizures, which is increased by electrolyte disturbance from purging in bulimia nervosa.

Why is "Fluoxetine" not the answer?

Fluoxetine is the recommended drug for bulimia nervosa.

Why is "Mirtazapine" not the answer?

Mirtazapine has no seizure-lowering contraindication here, although it increases appetite and weight.

Why is "Sertraline" not the answer?

Sertraline is an SSRI that carries no specific contraindication in bulimia.

What concept does this question test?

It tests Psychopharmacology in Psychiatry. It is therefore contraindicated in bulimia and anorexia nervosa and in seizure disorders. Fluoxetine, in contrast, is the SSRI with evidence for bulimia.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Psychopharmacology?

Learn each diagnosis by its core features and its first-line treatment. Then use the flashcards and the other Psychiatry questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.