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BRAIN AND BEHAVIOUR 2 > Antidepressant Drugs > Flashcards

Antidepressant Drugs Flashcards

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The Brain flashcards
1
Q

What are the main forms of depression?

A

Major depression, bipolar disorder, dysthymic disorder and depressive disorder (not otherwise specified)

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2
Q

What genetic factors may convey an increased risk of developing depression?

A

5-HT transporter polymorphisms (serotonin)

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3
Q

Which brain regions are associated with depression?

A

Amygdala, medial prefrontal cortex, ventral striatum (nucleus accumbens) and hippocampus

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4
Q

What neurotransmitter pathways are implicated in depression?

A

Noradrenergic and serotonergic

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5
Q

What gross brain changes can be seen in the MRI of an individual with depression?

A

Reduction in glucose metabolism in the subgenus prefrontal cortex and reduction in the grey matter in this area

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6
Q

How does depression affect the hippocampus?

A

It causes there to be an increase in neuronal loss and neurogenesis which is thought to lead to an increase in cortisol and pro-inflammatory cytokine release (which can lead to stress-induced illness)

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7
Q

What is the monoamine hypothesis of depression?

A

In depression there is a reduction in the monamine transmitters (dopamine, serotonin and noradrenaline)

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8
Q

What is rumination?

A

Recurring, negative thoughts playing in the mind

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9
Q

What brain structures are involved in rumination?

A

Amygdala and hippocampus

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10
Q

Explain the mechanism of action of tricyclic antidepressants

A

Inhibit the reuptake of amines (serotonin and noradrenaline) and bind to H1, a1 and a2 receptors –> vasodilation and increased sympathetic outflow

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11
Q

What are the potential side-effect of tricyclic antidepressants?

A

Dry mouth, constipation, loss of libido

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12
Q

What type of drug are clomipramine and amitriptyline?

A

Tricyclic antidepressants

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13
Q

Explain the mechanism of action of monamine oxidase inhibitors

A

Irreversibly bind to MAO to prevent breakdown of monamines (dopamine, serotonin and noradrenaline)

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14
Q

What are the disadvantages of monamine oxidase inhibitors?

A

Interacts with tyramine-containing food as well as pethidine and sympathomimetic compounds

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15
Q

What is meant by the ‘cheese effect’ of MAO inhibitors?

A

MAO inhibitors interact with tyramine-containing food (cheese, pickled fish/meat, red wine, beer, yeast)

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16
Q

What is the advantage of MAO inhibitors?

A

Can treat atypical depression such as anxiety and phobia

17
Q

What type of drugs are phenelzineu and iproniazid?

A

MAO inhibitors

18
Q

Explain the mechanism of action of selective serotonin inhibitors

A

Inhibits CNS neurone uptake of serotonin

19
Q

What type of drug are citalopram and fluoxetine?

A

Selective serotonin receptor inhibitors

20
Q

What is moclobemide?

A

A reversible MAO inhibitor

21
Q

What is venlafaxine?

A

Serotonin noradrenaline reuptake inhibitor (SNRI)

22
Q

What is reboxetine?

A

A noradrenaline reuptake inhibitor (NARI)

23
Q

What is mirtazapine?

A

A noradrenrrgic and specific serotonergic antidepressant (NASSA)

24
Q

Explain the mechanism of action of NASSA drugs

A

Antagonise central presynaptic a2 receptors (inhibits -ve feedback to nerve and causes increase in NA and 5-HT release)

25
Q

What is trazadone?

A

A serotonin antagonist and reuptake inhibitor

26
Q

Explain the mechanism of action of SARI drugs

A

Antagonise 5-HT2 receptors and prevent serotonin reuptake

27
Q

Binding of what receptor may lead to sedation?

A

Histamine receptor blocking (H1)

28
Q

What is agomelatine?

A

Agonist at MT1 and MT2 melatonin receptors and 5-HT2c receptors to disinhibit noradrenaline and dopamine

29
Q

What is antidepressant drug discontinuation syndrome?

A

Can occur after dose is reduced or interruption/cessation of treatment; this can be prevented by a slow tapering dose of the patient

30
Q

What are the symptoms of antidepressant drug discontinuation syndrome?

A

Insomnia, anxiety, nausea, headaches

31
Q

What are the non-pharamacological treatments for depression?

A

Exercise, electroconvulsive therapy, CBT, vagal nerve stimulation and deep brain stimulation

32
Q

Where is deep brain stimulation targeted in depression?

A

Subcallosal cingulate white matter (area 25)

33
Q

What is bipolar disorder?

A

A mod disorder characterised by cycles of depression and mania

34
Q

Outline the phases of treatment in depression

A

Acute: 6-12 weeks to control symptoms, continuation for 6 months after full symptom control to retain remission

35
Q

How long must antidepressants be continued after symptoms resolve?

A

At least 6 months

BRAIN AND BEHAVIOUR 2 (31 decks)

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