antidepressants Flashcards
what are some mood disorders?
depression, dysthymia (low level depression status), bipolar disorder, cyclothymia (mood swings, less than bipolar), postnatal depression
According to Statistics Canada’s 2012 Canadian Community Health Survey (CCHS) on Mental Health, ___ of the Canadian population aged 15 years met the criteria for a mood disorder in the previous 12 months,
including including ___ for major depression and __ for bipolar disorder.
- 4%
4. 7%, 1.5%
At least __ of people following their first episode of major depression will go on to have at least one more episode and after the second and third episodes, the risk of further relapse rises to__ and __ respectively.
50%, 70 to 90%
what type of men (ethnicity) over the age of 65 are at a disproportionate risk for suicide? and which type of woman over 80?
caucasian and asian men over 65 and asian woman over 80
what is often a contributing factor for suicide?
substance abuse
__% of elderly suicide compelteres were seen by their doctor within one month of death?
75%
how soon should someone be hospitalized if they have high levels of these risk factors: Internal emotional pain (e.g., feelings of shame, guilt, humiliation), External stress (e.g., loss of spouse, job, legal troubles), Agitation (e.g., from sleep loss, drug use, or excessive anger), Hopelessness
immediately
et of depression?
unclear
2 theories- monoamine neurotransmitter dysfx and neuroendocrine factors.
others are immune, genetics, and env’t
medical causes of depression?
Reserpine, steroids, alpha-methyldopa, propranolol and hormonal therapy may be associated with major depression.
Active abuse or withdrawal from alcohol, cocaine, sedatives, opiates, cannabis, anxiolytics, hypnotics and amphetamines
med conditions: hypothyroidism, cardiovascular disease
what disease has a bidirectional relationship with depression?
coronary artery disease.
can cause dep or dep is a risk factor for CAD
dep may contribute to sudden cardiac death and dep contributes to poor lifestyle (risk factor)
what are tricyclic antidepressants also used for?
urinary retention
why are monoamine oxidase inhibitors rarely used today?
so many dietary restrictions
key factor with new antidepressants (SSRIs and SNRIs)
they are highly protein bound!
antidepressants must be taken ___ weeks before depressive symptoms improve
2-4 weeks before
what do you need to note with SSRIs and metabolism?
metb is executed in part by CYP2D6 and patients are classified into carrying functioning UM (ultra-metb), EM (extensive) IM (intermediate), and PM (poor metb)
where antidepressants abrosrbed and metb?
absorbed from small bowel and metb in the liver
/MOA of antidepressants
normalize abnormal neurotransmission, may modify interactions among neurotransmission systems, may affect endocrine function, attributed to changes in receptors rather than changes in neurotransmitters lithium is unknown
indications for anti-depressants?
Depressive symptoms persist at least 2 weeks
Impair social relationships or work performance
Occur independently of life events
Treatment of anxiety disorders
Enuresis management
Neuropathic pain management
contraindications for antidepressants?
suicide, mixed mania and depression, acute schizophrenia, narrow angle glaucoma, severe renal, hepatic or cardiovascular disease
do SSRIs have more or less SE than TCA?
less with similar positive results
how long is an SSRI half life?
LONG. 24-72 hours. highly protein bound as well