1B CNS: Depression Flashcards
theories of depression (3)
amine hypothesis
neutrophic hypothesis
endocrine factors
Neurotransmitter of Wakefulness and Mania
noradrenaline
Neurotransmitter of Sleep, Mood, Feeding & Appetite
serotonin
block the reuptake of serotonin and norepinephrine in presynaptic terminals, which
leads to increased concentration of these neurotransmitters in the synaptic cleft
TCA
act as competitive antagonists on post-synaptic alpha (alpha1 and alpha2),
cholinergic muscarinic, and histaminergic receptor
TCA
mitochondrial enzyme involved in the oxidative deamination of biogenic amines (Adr, NA, DA,
5-HT).
MAO
Preferentially deaminates 5-HT and NA,
MAO A
Preferentially deaminates phenylethylamine
MAO B
It is a reversible and selective MAO-A inhibitor with short duration of
action; full MAO activity is restored within 1–2 days of stopping the drug.
Moclobemide
This tetracyclic compound is unusual in that it blocks
dopamine D2 receptors in addition to inhibiting NA
reuptake.
AMOXAPINE
This is a newer selective NA reuptake blocker with weak effect
on 5-HT reuptake
REBOXETINE
A bicyclic compound, is the first SSRI to be introduced, and the longest acting.
► Its plasma t½ is 2 days and that of its active demethylated metabolite is 7–10 days.
FLUOXETINE
It is a shorter-acting SSRI with a t½ of 18 hours and no active metabolite,
which has been specifically recommended for generalized anxiety
disorder and OCD, rather than for depression
FLUVOXAMINE
It is a shorter-acting SSRI with a t½ of 18 hours and no active metabolite,
which has been specifically recommended for generalized anxiety
disorder and OCD, rather than for depression.
FLUVOXAMINE
Efficacy in juvenile depression has been demonstrated, and it is
recommended for anxiety and post-traumatic stress disorder (PTSD) as
well.
SERTRALINE
This SSRI shares with sertraline a lower propensity to cause drug
interactions. Its t½ is 33 hours and no active metabolite is known.
► However, few deaths due to overdose of citalopram are on
CITALOPRAM
An SSRI indicated for premature ejaculation
DAPOXETINE
1st choice drugs for OCD, panic disorder,
social phobia, eating disorders, premenstrual dysphoric disorder
and PTSD
SSRI
novel antidepressant referred to as SNRI, because it inhibits uptake of both NA and 5-HT but, in contrast
to older TCAs, does not interact with cholinergic, adrenergic or histaminergic receptors or have sedative
propert
VENLAFAXINE
A newer SNRI similar to venlafaxine. It is neither sedative, nor anticholinergic, nor antihistaminic, nor α
blocker
DULOXETINE
It is the first atypical antidepressant; less efficiently blocks 5-HT uptake and has prominent α
adrenergic and weak 5-HT2 antagonistic actions
TRAZODONE
is unique in not inhibiting either NA or 5-HT uptake; but blocks
presynaptic α2 receptors thereby increasing release and turnover of NA in
brain which may be responsible for the antidepressant effect.
MIANSERIN
This inhibitor of DA and NA uptake has excitant rather than sedative propert
BUPROPION
This antidepressant is reported to increase rather than inhibit
5-HT uptake, and is neither sedative nor stimulant.
TIANEPTINE
The only antidepressants clearly shown to be effective in juvenile depression
fluoxetine and sertraline
well tolerated option for mild to moderate depression, especially
suited for elderly and cardiac patients
Moclobemide
DOC for OCD
fluvoxamine
reduces intensity of post-herpetic neuralgia in ~50% patients.
Amitriptyline
a SNRI, is now a first line drug for diabetic neuropathy, fibromyalgia
Duloxetine
a NA reuptake inhibitor unrelated to both TCAs as well as
amphetamine, which is used specifically in ADHD.
Atomoxetine
a SSRI which has been specifically introduced foR premature ejaculation
Dapoxetine
In children above 5 years, this drug given at bedtime is effective,
but bed wetting may again start when the drug is stopped.
imipramine
(enuresis)
prophylaxis for migrainre
amitriptyline, doxepine
has been used to relieve itching in atopic dermatitis, lichen simplex
Topical doxepin
antidepressants
MAOI
TCA
SSRI
SNRI
ATypicl
