Antidepressants

Question 1

what is reactive depression

Answer 1

temporary reaction to real stimuli - grief

Question 2

what is bipolar disorder

Answer 2

recurrent major depressive episodes with intervening manic, hypomanic, or mixed episodes

Question 3

what is major depression

Answer 3

one or more major depressive episodes free of manic, mixed, or hypomanic episodes

Question 4

what is the clinical criteria for major depression

Answer 4

at least 5 symptoms for extended period of time

Question 5

emotional symptoms

Answer 5

cant experinces pleasure
loss of interest
pessimistic
anxiety

Question 6

physical symptoms

Answer 6

chronic fatigue
insomnia
appetite disturbance

Question 7

cognitive symtoms

Answer 7

poor concentration
slow thinking
poor short term memory
confusion

Question 8

psychomotor symptoms

Answer 8

slow movements and speech

agitation

Question 9

some non pharms for major depression

Answer 9

psychotherapy

ECT

Question 10

what is the amine hypothesis

Answer 10

depression is related to reduced synaptic levels of NE and serotonin

Question 11

how do antidepressants work

Answer 11

blocking normal neurotransmitter reuptake processes

Question 12

what is the therapeutic lag

Answer 12

drugs increase NT levels right away but efficacy is delayed by weeks

Question 13

how does phase 2 work

Answer 13

phase 1 causes agonist activity at the receptors that feedback inhibit to stop amine released causing reduced negative feedback levels and phase 2 increase

Question 14

examples of tricyclic antidepressants

Answer 14

amitriptyline

imipramine

Question 15

how do TCAs work

Answer 15

mixed NE and serotonin reuptake inhibitors

Question 16

what is the cause of adverse effects of TCAs

Answer 16

blockage of cholinergic, histaminergic, alpha1 adrenergic receptors

Question 17

adverse effects of TCAs

Answer 17

orthostatic hypotension
tremour 
insomnia 
weight gain
siezure
sexual disturbance

Question 18

drug interactions of TCAs

Answer 18

cyp2D6 inhibitors
sedatives
sympathomimetics
antimuscarinics

Question 19

examples of serotonin reuptake inhibitors

Answer 19

fluoxetine
paraoxetine
sertraline

Question 20

how do ssris work

Answer 20

block serotonin reuptake more than NE

Question 21

overdose with TCAs causes

Answer 21

fatal cardiac arrthymias

Question 22

why are ssris more tolerated than tca

Answer 22

less cholinergic, histaminergic, and adrenergic blockade
higher therapeutic index
does cause platelet inhibition tho

Question 23

drug interactions with ssris

Answer 23

CYP 2D6 inhibitors
TCAs
beta blockers
antipsychotics

Question 24

advantages of ssris over tcas

Answer 24

equal efficacy with milder side effects
more favourable therapeutic index
smaller chance of addictive drug interactions

Question 25

exampls of snris

Answer 25

venlafaxine

Question 26

mechanism of snris

Answer 26

inhibit both serotonin and NE reuptake and weak dopamine reuptake inhibitors

Question 27

how are snris different from tcas

Answer 27

no affinity for muscarinic, alppha 1 adrengergic, and histaminergic receptors

Question 28

advantages of snris

Answer 28

milder side effect
useful for depression with neuropathic pain
fewer druginteraction
lower safety margin

Question 29

how does mirtazapine work

Answer 29

blocks alpha2 adrenergic receptors thus increase NE release

blocks histamine receptors

Question 30

adverse effects of mirtazapine

Answer 30

sedation
weight gain - major drawback
less sexual side effects tho

Question 31

drug interactions for mortazapin

Answer 31

none known

Question 32

advantages of mirtazapine

Answer 32

anxiolytic/sedative effect

minimal drug interations

Question 33

what is the mechanism for supropion

Answer 33

largely unknown

mi;d stimulant

Question 34

how are the side effects different in bupropion

Answer 34

seizures major concern

no sexual dysfunction,weight gain, or sedation

Question 35

drug interactions of bupropion

Answer 35

meds that lower seizure threshold

ldopa