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BB 2 > Anti-depressant drugs > Flashcards

Anti-depressant drugs Flashcards

1
Q

How many people worldwide have depression

A

350 million people

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2
Q

Name some symptoms of major depression

A 
Feelings of guilt and worthlessness
Depressed mood
Psychomotor retardation
Fatigue
Diminished ability to concentrate
Diminished interest in social activity
Psychomotor agitation
Insomnia
Weight loss
Adhedonia
Suicidal ideation
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3
Q

Name 5 genes thought to be related to depression

A 
GRIK4
CRHR1
SLC6A4
COMT
MAOA
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4
Q

What does GRIK4 stand for

A

kainic acid type glutamate receptors KA1

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5
Q

What does CRHR1 stand for

A

corticotropin releasing hormone receptor 1

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6
Q

Which 2 pathways are mainly associated with mood disorders

A

Noradrenergic and serotonergic pathway

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7
Q

When does 5-HT neuronal activity decrease

A

Sleep

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8
Q

When do 5-HT neurones have slow activity

A

During resting/ waking phase

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9
Q

Name some brain areas associated with depression

A 
Amygdala
Ventrolateral prefrontal cortex
Dorsolateral prefrontal cortex
Medial prefrontal cortex
Striatal regions
Hippocampus
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10
Q

Is there increased or decreased brain metabolism in these areas

A

Decreased

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11
Q

Increased or decreased cortical thickness in majoro depression

A

Decreased

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12
Q

When is 5-HT transporter polymorphism associated with major depression

A

After a significant life event

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13
Q

Name 4 areas of the brain that are hyperactive in major depression

A

Hippocampus
Amygala
Subgenual cingulate
Medial prefrontal cortex

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14
Q

Name 2 areas of the brain that are hypoactive in major depression

A

Ventrolateral prefrontal cortex

Dorsolateral prefrontal cortex

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15
Q

What does interaction between key structures involved in depression explain

A

Circuit propses explanation for rumination

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16
Q

Name 4 classes of antidepressant drugs

A

Tricyclic antidepressants
Monoamine oxidase inhibitor
Selective serotoninc reuptake inhibitors
Reversable monoamine oxidase inhibitors

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17
Q

Name 5 TCAs

A 
Clomipramine
Imipramine
Desipramine
Amitriptyline
Nortriptyline
Protriptyline
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18
Q

What do TCAs do?

A

Inhibit amine reuptake

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19
Q

What receptors do TCA have a high affinity for

A

H1 muscarinic
alpha 1
alpha 2

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20
Q

Adverse effects of TCA?

A 
Dry mouth
Blurred vision
Constipation
Urinary retention
Fatigue
Sedation
Postural hypotension
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21
Q

Name 3 monoamine oxidase inhibitors

A

Phenelzine
Tranylocypromine
Iproniazid

22
Q

How do MAOIs work

A

Irreversible inhibition of this enzyme

23
Q

What do MAOIs have interactions with

A

Tyramine containing foods

Pethidine and sympathomimetic compounds

24
Q

What kind of depression do MAOIs treat

A

atypical

25
Q

Name 3 SSRIs

A

Citalopram
Fluoxetine
Paroxetine

26
Q

Which is the most selective SSRI

A

Citalopram

27
Q

Adverse effects of SSRI

A 
Nausea
Headaches
GI problems
Increased aggresion
Insomina
Anxiety
Sexual dysfunction
28
Q

Name a reversible monoamine oxidase inhibitor

A

Maclobemide

29
Q

Adverse effects of reverse monoamine oxidase inhibitors

A

Nausea
Agitation
Confusion

30
Q

Which receptor are monoamine selective for

A

MOAa

31
Q

Name 4 other/ minor classes of antidepressant

A

Serotonin noradrenaline reuptake inhibitors
Noradrenaline reuptake inhibitors
Serotonin antagonist reuptake inhibitor
Noradrenergic and specific serotonergic

32
Q

Give an example of serotonin noradrenaline reuptake inhibitor

A

Venlafaxine

33
Q

Give an example of a noradrenaline reuptake inhibitor

A

Reboxetine

34
Q

Give an example of serotonin antagonist and reuptake inhibitor

A

Trazodone

35
Q

Give an example of noradrenergic and specific serotonergic

A

Mirtazapine

36
Q

How does the drug agomelatine work as an antidepressant

A

Agonist at melatonin MT1 and MT2 receptor

Antagonist at 5-HT2c receptor

37
Q

Why is there a delay in action of anti-depressant drugs

A

Due to changes in autoreceptors

38
Q

Describe the changes in autoreceptors that occur when somebody takes TCAs

A

Inhibit amine reuptake
Immediate increase in synaptic concentration of amines may lead to activation of somatic autoreceptors
Activated autoreceptors= decreased firing of neurones
During first few weeks, autoreceptors desensitise, so neurones return to normal rate
Inhibition of reuptake continues, amine levels remain high= full efficacy

39
Q

When does antidepressant drug discontinuation syndrome happen

A

Decrease in dosage/ stopping anti depressant

40
Q

Symptoms of antidepressant drug discontinuation syndrome

A 
Insomnia
Anxiety
Nausea
Vomiting
Electric shock sensation
Mood swings
Agitation
Diarrhoea/ abdominal cramps
41
Q

What is bipolar disorder

A

Mood disorder characterised by cycles of depression and mania

42
Q

What can be used as maintenance treatment for bipolar disorder

A

Lithium

43
Q

Adverse effects of lithium treatment for bipolar disorder

A 
Thirst
Nausea
Fine tremor
Polyuria
Weight gain
Oedema
Acne
44
Q

Name 2 mood stabilisers used for bipolar disease

A

Carbamezapine

Sodium valproate

45
Q

What is the ‘risk order’ from most to least risky in types of anti-depressants causing manic episodes

A

TCA
SNRI
MAOI
SSRI

46
Q

What is phase 1 of treating depression

A

6-12 weeks

Aims at remission (control of symptoms)

47
Q

What is phase 2 of treating depression

A

Continuation treatment

6 months after to prevent relapse

48
Q

What is phase 3 of treating depression

A

Prevention of further recurrence

49
Q

Name 4 non pharmacological treatments for depression

A

CBT
DBS
Electroconvulsive therapy
Vagal nerve stimulation

50
Q

Do depression patients have more or less white matter in hippocampus

A

Less

51
Q

How do levels of cortisol and proinflammatory cytokines differ in patients with depression

A

They are higher

BB 2 (28 decks)

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