Antidepressants & ECT I Flashcards
Decreased levels of what are found in patients who are prone to impulsive, violent suicidal acts?
CSF 5 HIAA
What chromosome is serotonin transporter gene (SERT) found on?
Chromosome 17
What functional polymorphism is found in promoter region of SERT gene? What condition results from people with the ss genotype?
44 base pair insertion (long - l) or deletion (short -s)
Depression or suicidal depression
Depletion of what amino acid can transiently reverse antidepressant response and cause short lived return of depressive symptoms?
Tryptophan
What part of the brain is densely innervated by both noradrenergic and dopamine systems?
Prefrontal cortex
What neurotransmitter is involved in process of working memory to regulate behavior and attention?
Norepinephrine
What neurotransmitter is involved in acquisition of emotionally arousing memories?
Norepinephrine
What neurotransmitter modulates amygdala in such a way as to strengthen memory consolidation and fear conditioning?
Norepinephrine
What types of dopamine receptors are more likely to be found in limbic areas?
D3 and D4
What types of dopamine receptors are found more widely in brain and are predominant subtype in striatum?
D1 and D2
Related to motor function
Nigrostriatal
Related to reward and motivation
Mesolimbic
Related to memory and attention
Mesoortical
Related to reinforcing properties of variety of drugs of abuse and pleasurable activities
Mesolimbic to nucleus accumbens
What neurotransmitter has a role in promoting interest and motivation?
Dopamine
Rapid, but transient improvement in mood has been reported in some depressed patients after acute administration of a _____
amphetamine
Patients with a major depressive disorder have what conditions within their hypothalamic pituitary adrenal axis?
hypercortisolemia, adrenal gland hypertrophy
What effects on hypothalamic pituitary axis can cause depression?
Hypothyroidism and hyperthyroidism because they can induce change in receptor density in particular brain regions
What hormone directly influences neuronal excitability and cholinergic, noradrenergic, and dopaminergic neurotransmission
TRH
What anatomical pathologies are seen in cerebral cortex?
Reductions in neuronal density and size of some populations of neurons
Depression is LARGELY associated with atrophy of what part of the brain?
Hippocampus
What is one neurotropin upregulated by antidepressants?
BDNF - brain derived neurotropic factor
What three neurotransmitters are increased by anti-depressants?
Dopamine, serotonin, norepinephrine
What is the time frame for clinical effectiveness for antidepressants? Why does it take this long?
Two-three weeks
Changes in gene regulation
Antidepressants are associated with inhibiting cytochrome P450 enzymes in what systems?
2D6 (hydrolyzes hydrocodone into active form), 3A3, and 3A4