Affective disorders Flashcards
In the diagnosis of depression what are the steps?
1.primary indicators
2. persistence of behaviour
3. associated symptoms
4. 1+2+3 = diagnosis of disease. number of symptoms determines the severity of the depression.
Can stress trigger depressions? True/False
True
What effect does elevated glucocorticoids have on the brain?
can kill cells and cause synapse loss. Are inhibitory to synaptogenesis ad neurogensisis in the brain (hippocampus)
WHat changes in CRF(corticotrophin releasing factor) are seen in depressed brains? what has this indicated for potential treatments?
elevated levels of CRF in depressed brains.
antagonists against CRF receptors have some indications for treatment of depression
What serendipitous drug observations were made that brought about the monoamine theory of depression?
Iproniazid: in TB trials and showed mood elevation after inhibiting Monoamine oxidase (MAO) and thus increased bioavailability of neuroactive monoamines.
Imipramine: in trials for antipsychotic drugs and indicated improvement of mood. blocked reuptake of released transmitters (monoamines) and thus elevated their levels.
What is an examples of a selective serotonin reuptake inhibitor (SSRI)?
Fluoxetine (Prozac)
Citalopram
What is the SERT?
serotonin transporter and terminates serotonin signalling throigh the sodium and chloride dependant reuptake of the neurotransmitter into the presynaptic neurons.
How does the antidepressant Citalopram affect SERT?
lodges into the central binding site and locks it into an outwad open conformation directly blocking serotonin.
Also has an allosteric site in the complex that sterically hinders ligand unbinding.
How do NaSSA (noradrealin serotonin selective antidepressants) work>
selective increase in noradreanalin by autoreceptor block
selective increase in serotonin by hetroreceptor block
additional blocking or activating on sub classes of receptor
what is used to catagarise affective disorders?
is largely based on categorization of a clinical calssification of what have and dont have.
-Diagnostic statistical manual
-Internal classification of disease
what are pros and cons of categorization for diagnosis?
Pros:
-Has asimproved diagnosis but lacks pathophysical definition
Cons:
-Doesnt consider symptom overlap (comorbidities)
-does not resolve causation of specific disease
-doesnt take into account dimensional expression or causes of physciatric disorders and disease
What does depression cost the UK?
costs £12 billion/year in lost revenue in the UK.
what are primary indicators of depression?
Persistent sadness or low mood,
loss of interests or pleasure,
fatiugue or low energy.
What are some associated symptoms of depression?
1) Disturbed sleep
2) Poor concentration or indecisiveness
3) Low self-confidence
4) Poor or increased appetite
5) Suicidal thoughts or acts
6) Agitation or slowing movements
7)Guilt or self-blame
What is anxiety?
a pathophysiological state that detracts from normal function and likely impedes an organisms success.
