Psychopharmacology: esketamine: 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: esketamine

Sample item

An intranasal drug used with an oral antidepressant for treatment-resistant depression acts mainly through which mechanism?

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

The answer and the reasoning

C. NMDA receptor antagonism (esketamine)

Esketamine, the S-enantiomer of ketamine, is an NMDA antagonist that produces rapid antidepressant action through glutamatergic signalling, and is given under supervision because of dissociation and blood pressure rise. It is used for treatment-resistant depression and acute suicidality.

Option by option

  • A. GABA-A potentiation

    GABA-A potentiation is the benzodiazepine mechanism.

  • B. MAO inhibition

    MAO inhibition is the mechanism of phenelzine and moclobemide.

  • C. NMDA receptor antagonism (esketamine) (correct)

    Correct. Esketamine blocks NMDA receptors.

  • D. 5-HT3 antagonism

    5-HT3 antagonism is the mechanism of ondansetron.

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.

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Questions about this Psychiatry question

What is the answer to this Psychiatry question?

The best answer is C, NMDA receptor antagonism (esketamine). Esketamine, the S-enantiomer of ketamine, is an NMDA antagonist that produces rapid antidepressant action through glutamatergic signalling, and is given under supervision because of dissociation and blood pressure rise.

Why is "GABA-A potentiation" not the answer?

GABA-A potentiation is the benzodiazepine mechanism.

Why is "MAO inhibition" not the answer?

MAO inhibition is the mechanism of phenelzine and moclobemide.

Why is "5-HT3 antagonism" not the answer?

5-HT3 antagonism is the mechanism of ondansetron.

What concept does this question test?

It tests Psychopharmacology: esketamine in Psychiatry. It is used for treatment-resistant depression and acute suicidality.

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: esketamine?

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.