Antidepressants Flashcards
What are the roles of these parts of the brain?
- Hypothalamus
- Anygdala
- Hippocampus
- Nucleus Accumbens
- Cingulate cortex
Hypothalamus = Homeostasis
Anygdala = recognises/responds to emotions
Hippocampus =memories
Nucleus Accumbens= reward and pleasure
Cingulate Cortex =recognises pleasant and painful stimuli
What are Monoamines?
Monoamines refers to certain neurotransmitters such as Dopamine, Noradrenaline and Seretonin.
It’s because they’re derived from Amino Acids
What does ‘SERT’ Stand for?
Seretonin Reuptake Transporter
It’s a target for antidepressants
Name some antidepressants that are ‘seretonin reuptake inhibitors’ (SERT)
- Tricyclic Antidepressants (Desipramine, Imipramine)
- Selective Serotonin-Reuptake Inhibitors (Sertraline, Citalopram, ,Fluoxetine)
- SERT Inhibitors/5-HT releasers (Fenfluramine, Methylenesioxymethamphetamine MDMA)
Parkinsons can be caused by loss of what neurotransmitter?
Dopamine
Where are Monoamine neurons located?
They’re located within the descrete nuclei within the brainstem and midbrain. They project widely throughout the forebrain.
What are the 2 types of depression?
- Unipolar (major depression)
- Bipolar (manic depression)
True or false…
Patients with depression have abnormally low cortisol levels
FALSE
Patients with depression have abnormally HIGH cortisol levels.
Name some treatments of depression…
Counselling, Psychotherapy, Drugs (SSRIs for example), ECT
Name the Classes of Antidepressants:
- Monoamine Oxidase Inhibitors
- Tricyclic Drugs
- SSRIs
- Third Gen’ antidepressants
- Mood stabilisers
Name some characteristics of Monoamine Oxidase Inhibitors (MAIO) and name some…
They’re seen as last line of treatment for sever depressive patients.
- Phenelzine (can be used for bipolar too)
- Tranycylpromine
&; Iproniazid was used to treat TB!!!
What are the SE of MAOIs (monoamine oxidase inhibitors)
LOTS OF THEM!!!!
Hypertension, risk of seretonin syndrome so don’t give trypophan supplements or other psychoactive drugs, weight gain, odema, sexual dysfunction, sedation, renal or hepatic function, risk in pregnant or lactating women.
Which drugs are TRICYCLIC ANTIDEPRESSANTS:
- Citalopram, Sertraline
- Venlafaxine, Buprpion
- Imipramine, Amitriptyline
Tricyclic Antidepressants:
- Imipramine
- Amitriptyline
- Doxepin also used for anxiety
Most useful for treating MAJOR depression episodes
How do Tricyclic Antidepressants work
They work by non-selectively blocking the reuptake of noradrenaline and serotonin, leading to increase in the availability of these transmitters at their respective receptors.
What are adverse effects of Tricyclic Antidepressants?
Weight gain, sexual dysfunction, Contradictory for patients with cardiac problems, antihistamine effects, dry mouth. blurred vision, dizziness, headache, constipation
Which of the following groups of drugs is NOT used in the treatment of depression?
- Benzodiazepines
- Monoamine oxidase inhibitors
- Selective serotonin reuptake inhibitors
- Lithium compounds
Benzodiazepines
Name some SSRIs
Citalopram,
Fluoxetine (prozac),
Paroxetine,
Sertraline,
Why do SSRI’s produce less SE
Because of their selectivity. If there are SE they usually dissipate within 4-6 weeks
Citalopram (Celexa) increases synaptic levels of: -Serotonin -glycine -glutamate gamma- aminobutyric acid (GABA)
Seretonin
It’s a selective seretonin re-uptake inhibitor
Dopamine, noradrenaline and serotonin are all:
- peptides produced in the brain
- derived from arachidonic acid
- found exclusively in the brain
- monoamine transmitters
monoamine transmitters
Lithium Carbonate, Lithium Citrate, Carbamazepine and Valproate are all what category of drug used to treat what???
They are all MOOD STABILISERS used to treat acute mania in bipolar suffers
Name some next Generation Antidepressants…
Bupropion
Venlafaxine
CRH receptor antagonists are 3rd gen’ that are under development
Mood stabilisers such as lithium drugs are alkali metal salts that change biochemical electrolyte and endoctine functions in the body so have a lot of SE. Name some…
Lithium is not given to people with renal dysfunction, lukaemia, dehidration or sodium depletion .
Also causes headaches, dizziness, confusion, hairloss, oedema, cardiac dysrhythmias and nephrotoxixity
Name some Anxiety Disorders…
- Generalised Anxiety Disorders
- Panic Disorders
- Phobias
- PTSD
- OCD
What are Anxiolytics?
They are anxiety drugs such as:
- sedative-hypnotics (barbituates)
- benzodiazepines
- second gen’ non- benzodiazepines
Theopental the Sedative- Hypnotic Anxiolytic drugs is mainly used for what purpose???
Theopental is used in the preparation for surgery.
Produce uncontiousness within less than 1 minute.
Thiopental, Secobarbital, Phenobarbital, Solpidem are all what category of anxiolytics?
They are all Sedative - Hypnotics
barbiturates
What are the uses of Sedative- Hypnotic Anxiolytics?
Thiopental- Used for surgery prep
Secobarbital - Insomnia, Anxitey
Phenobarbital - insomnia, anxiety and seisures
Zolpidem - insomnia
Name some SE of sedative- Hypnotics (barbituates)
- Avoid with other CNS depressants
- Check for suicidal tendencies
- Drousiness/hangover
- dependance/tolerance
- possible seisure on withdraw
- don’t give to pregnant or nursing mothers.
- don’t give with alcohol!!!
Name some benzodiazepines and their uses
Diazepam - anxiety and seisures
Alprazolam - anxiety and panic disorders
Temazepam - Short term insomnia
Lorazepam - Anxiety, sedation, amnesia, status epilepticus???
Adverse effects of Benzodiazepines..
Accumilation of metabolism can lead to over sedation and CNS depression, dizziness, memory loss, low BP, GI problems, DATE RAPE DRUG rohypnol / Flunitrazepam when combined with alcohol
Buspirone is under what category of Anxiolytic and is used for what?
It’s a Non-Benzodiazepin Anxiolytic and is used in the Short Term Treatment of Anxiety and Depression
SE of the Non-benzodiazepin anxiolytic drug BUSPIRONE???
Avoid with other CNS depressants because can increase their sedetative effects.
never with MAOIs as can cause lethan highBP!!!
Dizziness, headache, insomnia, nausia, dry mouth
What are the 3 types of schizophrenia?
- Disorganised Schizophrenia
- Paranoid Schizophrenia
- Catetonic Schizophrenia
What are the classes of antipsychotics?
-Typical (neuroleptics)
&
-Atypical Antipsychotics
Name some typical antipsychotics…
- Chlorpromazine
- Fluphenazine
- Haloperidol
- Loxapine
SE of Typical Antipsychotics…
Parkinsonism- Tardive Dyskinesia
Sedetion, low BP , Impared Thermoregulation and lactation
Also has contradictions with CV disease, bone marrow depression, renal liver or thyroid dysfunction or parkinson’s disease.
Haloperidol is a dopamine (D2) receptor antagonist used to treat psychosis. Which of the following is a likely adverse effect of this drug?
- Parkinson’s Disease like symptoms
- Muscle weakness
- Hypokalaemia
- Weight loss
Parkinson’s Disease like symptoms
Also called Tardive Dyskinesia
Clozapin, Amisulpride, Risperidone, Olanzepine are all what category of drug?
They are all ATYPICAL anti-psychotics for the management of schizophrenia
SEs of atypical Antispychotics such as Amisulpride, Risperidone & Olanzepine
WEIGHT GAIN!!!
Glaucome, peptic ulcer dieases, urine retention, hepatic or heart dysfunction.
Avoid with CNS depressants and antihyperintensives
