Antidepressant Drugs Flashcards
Define depression
State of low mood and avoidance of activity that can affect a person’s behaviour and feelings
What are the three types of depression?
Major
Bipolar
Dysthymic
What genes are linked to depression?
GRIK4
CRHR1
MAOA
Which pathways have been shown to have a link with depression?
Serotonin
Noradrenaline
Which brain regions are associated with depression?
Prefrontal cortex
ventral striatum
Amygdala
Hippocampus
Why do the areas in the brain have decreased metabolism in depression?
Lower glucose consumption
Depression is also associated with an increase in what?
Cortisol
Pro-inflammatory cytokines e.g. IL-6
What types of management are there for depression?
Tricyclic antidepressants
Monoamine Oxidase inhibitors
Selective serotonin Reuptake inhibitors
(Serotonin Noradrenaline Reuptake Inhibitors (SNRIs)
Noradrenaline Reuptake Inhibitors (NARIs)
Noradrenergic and Specific Serotonergic Antidepressants (NaSSA)
Serotonin Antagonists and Reuptake Inhibitor (SARI) )
What do tricyclic antidepressants do?
Inhibit reuptake of amines (serotonin and noradrenaline)
What do tricyclic antidepressants work on?
H1, muscarinic A1 and A2 receptors
Give examples of tricyclic antidepressants
Ends in -amine or -triptyline e.g. Amitriptyline Nortriptyline Protriptyline etc
Give adverse effects of tricyclic antidepressants
Dry mouth Blurred vision Constipation Weight gain Arrythmias
What do monoamine oxidases do?
Prevent breakdown of NTs e.g. dopamine, serotonin and adrenaline
Why are Monoamine oxidases usually used as a last resort?
Potentially lethal diet restrictions
What food must be avoided when taking monoamine oxidases?
Tyramine food e.g. cheese, red wine, fish and red meat
Which depression does monoamine oxidase especially help with?
atypical depression
Give examples of monoamine oxidase inhibitors
Phenelzine
Tranylcypromine
Iproniazid
What is Moclobemide?
Reversible MAO inhibitor with increased selectivity (safer than irreversible ones)
What does selective serotonin reuptake inhibitors do?
Prevent reuptake of serotonin in to the presynaptic cell, increasing levels in the synaptic cleft
Adverse effects of selective serotonin reuptake inhibitors?
Nausea Headaches Increased aggression Insomnia Sexual dysfunction
What drugs are selective serotonin reuptake inhibitors?
Citalopram
Fluoxetine
Paroxetine
Why do antidepressants have delayed onset of action?
Somatic neuronal auto receptors as drugs cause decreased neuronal firing
When do neurones return to firing at normal rate?
It takes time for auto receptors to de-sensitize
How do you avoid antidepressant drug discontinuation syndrome?
Weaning off of medication
