ANTIDEPRESSANTS 1 Flashcards
What are the symptoms of depression
- depressed mood
- fatigue/loss of energy
- loss of confidence
- guilt
- insomnia
- change in appetite
What is major depressive disorder?
Depression is an autonomous & is unresponsive to changes in life
Biological factors seem important (family history)
It can occur as a single episode or may be recurrent2
What is dysthymic disorder?
A mood disorder with chronic (long-term) depressive symptoms that are present most of the day, more days than not, for a period of at least 2 years
What is depressive disorder not otherwise specified
Any depressive disorder that doesn’t meet the criteria of a specific disorder
Examples:
Minor depressive disorder
Recurrent brief depressive disorder
What helps with diagnosis
Hamilton depression rating scale
What are the characteristics of tricyclic anti depressants?
- class of compounds related to phenothiazines
- often demethylated to active metabolites
- have low therapeutic index
- inhibit noradrenaline and 5-HT reuptake
what are the observations of depression and antidepressants
- low levels of transmitters
- up regulations of post &presynaptic receptors
what is the non-selective irreversible MAOi example?
Phenelzine
What is the selective reversible
moclobemide - preferred treatment as it has better profile
what are the side effects of MAOi’s?
increased apetite
sleep disturbance
What is type A MAO’s
found in CNS - so mainly concentrated on
What is the monoamine theory?
imbalance in monoamines, one or both plays a role in depression
Where is serotonin projected from ?
raphe nuclei
where is noradrenaline projected from?
locus coeruleus
What is the problem of MAOi’s
cheese reaction
tyramine is metabolised by MAO, when inhibited there are increase levels of tyramine in circulation.
- # elevated levels of tyramine will be taken up to noradrenaline nerve endings and will cause the release of large amounts of noradrenaline into periphery and CNS
- hyperintensive crisis
- this is prevent by using reversible MAOi’s
