21. pharmacotherapy + somatic txs of depr Flashcards

1
Q

name of the first antidepressant - what kind of drug is it?

A

imipramine - tricyclic

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2
Q

when was prozac introduced? what is it?

A

1987 - SSRI

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3
Q

4 categories of antidepressants

A
  1. tricyclics TCA
  2. monoamine oxidase inhibitors MAOIs
  3. selective serotonin reuptake inhibitors SSRI
  4. serotonin norepinephrin reuptake inhibitors SNRIs
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4
Q

what are the first line meds for depression?

which used for most severe depr?

A

SSRI + SNRI

SNRI

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5
Q

what are TCAs usually used for? why aren’t they as popular today?

A

sleep problems, have lots of side effects

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6
Q

why aren’t MAOIs popular?

A

require dietary restrictions

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7
Q

who most benefits from use of antidepressants? why? what about the others?

A
  • severe depression
  • can’t engage in CBT, v difficult
  • effects minimal or non-existent at mild/moderate sx
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8
Q

when’s it most important to track progress with antidepressants? why?

A

most early stages - if don’t work early, won’t work at all

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9
Q
  1. why do people discontinue their meds?
  2. when do people usually discontinue?
  3. how long should people use antidepress to feel full effects?
A
  1. feel like it doesn’t work/feel like don’t need anymore
  2. within 3 mo
  3. at least 9 mo, full cycle
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10
Q

how do SSRIs work?

A
  • inhibit reuptake of seroronin in synaptic cleft
  • makes serotonin more available in CNS
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11
Q

dx that also use SSRIs

A
  • OCD (higher doses)
  • panic disorder
  • ED (reduce bingeing)
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12
Q

biggest difference between SSRIs and TCAs

A

TCA can be deadly if OD

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13
Q

what happens if you stop SNRI abruptly?

A

flu like sx

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14
Q

what’s wellbutrin? talk about it chop chop

A
  • bupropion
  • act on NE + DOP (no effects on SERT)
  • stimulating
  • no sexual side effects, no weight gain
  • side effects: insomnia, anx, tremor, headache
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15
Q

meds + therapy works best on…

A

mild/moderate depr

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16
Q

what is tx-refractory?

A
  • when someone is tx resistant
  • refers to people who haven’t responded to min. 2 forms of tx
  • for depr: no response to 2 distinct classes of meds
17
Q

what is ECT?

mode of delivery, pros, cons, post-administration

A
  • electroconvulsive therapy
  • induce seizures via electrical current
  • delivered unilaterally
  • anesthetic + muscle relaxants given prior
  • effective in short-term
  • 50% relapse
  • only give if life threatning
18
Q

why do we administer ECT unilaterally?

A
  • best results if bilateral, but too many neg side effects + mem loss
  • retrograde amnesia still reported
19
Q

what is deep brain stimulation?

used for?

A
  • neurostimulator sends electrical impulses to specific (subcortical) region of brain
  • for tx of mvmt + affective disorders
20
Q

what is ketamine?

results from study?

A
  • drug used as horse tranquilizer
  • marked improvement in 24h post administration
  • good to reduce suicidal ideation in emergency situations
  • maintained effects over time
21
Q

limits of ket

A

not lots of research
doesn’t nec decr suicide