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BB2 > 17 - Anti-depressant Drugs > Flashcards

17 - Anti-depressant Drugs Flashcards

1
Q

Symptoms of major depression

A

Fatigue, loss of energy, diminished ability to concentrate, depressed mood, insomnia, weight loss, decreased appetite

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2
Q

Brain regions associated with depression

A 
o	Amygdala
o	Ventrolateral prefrontal cortex
o	Dorsolateral prefrontal cortex
o	Medial prefrontal cortex
o	Striatal regions (ventral striatum)
o	Hippocampus
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3
Q

Function of prefrontal cortex and how it relates to depression

A

Prefrontal cortex gives us control over our reactions

This control is weak in depression

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4
Q

Genes linked to depression?

A

5HT transporter polymorphism
May lead to different levels of transcription of the transporter
Higher risk of depression after significant life events
Modulates response to stress

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5
Q

Where would there be abnormal action in a depressed brain

A

Sub genial prefrontal cortex

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6
Q

What is the default mode network

A

Imaging technique that shows what regions of the brain are active when brain is in wakeful rest

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7
Q

Which NTS are associated with mood disorders

A

NA

5HT

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8
Q

MoA of tricyclic antidepressant

A

Inhibits reuptake of amines (5ht and NA)

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9
Q

Examples of TCAs

A 
Clomipramine
Imipramine 
Desipramine
Amitriptyline 
Nortritryptaline
Prototypes line
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10
Q

Which other receptors do TCAs have affinity for

A

H1
Muscarinic
A1 and a2 adrenoreceptors

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11
Q

Adverse effects of TCAs

A

Overdose can cause cardiotoxicity

Adverse effects include dry mouth, blurred vision, constipation, weight gain, arrhythmia

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12
Q

Example of monoamine oxidase inhibitors

A

Phenelzine
Tranylcypromine
Iproniazid

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13
Q

What is the cheese effect

A

MOAs can react with tyramine containing foods such as mature cheese and red wine
So avoid when taking the medication

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14
Q

Ex of Selective Serotonin Reuptake Inhibitors

A

Citalopram
Fluoxetine
Parole tine

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15
Q

SE of SSRIs

A

Nausea, insomnia,headaches, GI problems

However no cardiotoxicity so safe in overdose

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16
Q

Example of Reversible monoamine oxidase inhibitors

A

Moclobemide

17
Q

Serotonin noradrenaline reuptake inhibitors

A

Venlafaxine

18
Q

noradrenaline reuptake inhibitors

A

Reboxetine

19
Q

Noradrenic and specific serotonin antidepressants

A

Mirtazapine

20
Q

Serotonin antagonist and reuptake inhibitor

A

Trazodone

21
Q

Agomelatine

A

Melatonin mt1 and mt2 receptor agonist

5ht2c receptor antagonist

22
Q

Reason for delay of action of antidepressants

A

Regulatory adaptation

Change in auto receptors

23
Q

Drug discontinuation syndrome

A

When you suddenly stop taking antidepressants
Effects such as insomnia, agitation, nausea, dizziness
Prevent by gradual discontinuation of the drug

24
Q

Outcomes of depression

A

Poor
Under diagnosis and treatment
50% patients stop treatment in first month

25
Q

Phases of treatment of depression

A

Acute phase - first 6-12 weeks of treatment with aims of remission
Continuation - take medication for 6 months after full symptom control to maintain remission and prevent relapse
Maintenance treatment- prevention of recurrence, indicated in high risk patients

26
Q

Non pharmacological treatment

A

Electro convulsive therapy
CBT
Vagus nerve stimulation
DBS - subcallosal singulate White matter area 25

27
Q

Role of inflammation in depression

A

Neuronal loss in hippocampus caused by increase in cortisol and pro inflammatory cytokines

28
Q

Bipolar disorder

A

Mood disorder characterised by cycles of depression and mania

29
Q

Management of bipolar disorder

A

Lithium

30
Q

Side effects of lithium for bd

A

Thirst, nausea, tremor
Must check renal and thyroid function
Narrow therapeutic margin 0.6 to 1mm

BB2 (27 decks)

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