Psychopharmacology: SSRI of choice in cardiac disease: 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: SSRI of choice in cardiac disease

Sample item

In a patient with depression after a myocardial infarction, which antidepressant has the best safety evidence?

ASertralineBCitalopram at high doseCVenlafaxine at high doseDAmitriptyline

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

The answer and the reasoning

A. Sertraline

Sertraline was shown to be safe in post-MI and unstable angina patients in randomised trials (SADHART). TCAs cause arrhythmias, citalopram prolongs QT in high doses, and venlafaxine can raise blood pressure.

Option by option

A. Sertraline (correct)
Correct. Sertraline is the preferred drug in ischaemic heart disease.
B. Citalopram at high dose
High-dose citalopram prolongs QTc.
C. Venlafaxine at high dose
High-dose venlafaxine raises blood pressure.
D. Amitriptyline
TCAs are proarrhythmic.

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.

Questions about this Psychiatry question

What is the answer to this Psychiatry question?

The best answer is A, Sertraline. Sertraline was shown to be safe in post-MI and unstable angina patients in randomised trials (SADHART).

Why is "Citalopram at high dose" not the answer?

High-dose citalopram prolongs QTc.

Why is "Venlafaxine at high dose" not the answer?

High-dose venlafaxine raises blood pressure.

Why is "Amitriptyline" not the answer?

TCAs are proarrhythmic.

What concept does this question test?

It tests Psychopharmacology: SSRI of choice in cardiac disease in Psychiatry. TCAs cause arrhythmias, citalopram prolongs QT in high doses, and venlafaxine can raise blood pressure.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. 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: SSRI of choice in cardiac disease?

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.