Anxiety and depression Flashcards
Name some common anxiety disorders
generalised anxiety disorder
post traumatic stress disorder
phobias
obsessive compulsive disorder OCD
Describe the symptoms of anxiety
palpitations, tachycardia, SOB, dizzieness, sweating, tremor, panic
name some non pharmalogical treatments of anxiety
CBT, meditation, mindfullness, relaxation techniques
Which main 2 pharmacological approach is used to treat anxiety
beta blockers - propanol
benzodiazepine
what must you be careful of if you take this regularly
stopping immediately - has a rebound effect
Name 7 effects of valium
sedative anticonvulsive hypnotic muscle relaxant decreases aggresion anxiolytic amnesic
Valium
- DWT?
- SEs?
- be careful when prescribing to ?
- two other positives
- dependance, withdrawal, tolerance, therefor abuse potential
- can cause aggression rarely (paradoxical seizures)
- elderly people
- safe in overdose and doesnt have any drug interactions
What would you prescribe benzodiazepine with a short half life for and one with a long half life for
short - hypnotics
long - anti anxiety
How do benzodiazepines work?
increase GABA receptor affinity for Cl- hyperpolerisation of neurones
- Two more drugs that can be used to treat anxiety?
2. -ve to using one of them
buspirone and SSRis
takes a long time to work
What must you have to diagnose depression
Must include 1. depressed mood 2. loss of interest and 3 from.. weight change, altered sleep, agitation, fatigue, suicidal thoughts, worthless feeling, cant concentrate
how do you treat bipolar + mechanism
lithium salts - inhib Glycogen synthase kinase 3
genetics vs environment in depression?
sever depression mostly genetics
mild depression mostly environment
Describe the 3 theries of depression
- amine dysfunction - reduced NA/5ht (or receptor down reg)
althered dopamine function - reward pathways? - HPA axis dysfunction - to much cortisol
- neurotropic and neuroplasticity hypothesis - physical changes in cortical areas
What evidence leads us to believe HPA theory of depression
insensitivity to DEX (usually suppresses cortisol)
Name 3 non pharamological treatments to depression
CBT, Electroconvulsive shock treatment , St johns wort
TCAs - mechanisms
block amine reuptake
H2 antag (sedative SE)
M antag (CV SE)
block amine reuptake peripheraly (CV SE)
what are ipronizid, phenelzine, tranylcypromine, moclobemide?
MAOi’s
Problems with MAOis
initial euphoria, slow onset, some Muscarinic SE, insomnia, weight gain and liver damage
What interaction must you be careful of if taking a MAOi
cheese reaction - tyramine is usually broken down by MAO - if not can get into head and cause increased dopamine = hypertension
Side effects to SSRIs
neausea, loss of libido, akathisia (restless) agitation
what does akathisia mean
restless
Why do all antidepressants take so long to work
10/20 days. autoreceptors turn down the amount of amines released - decrease APs and block further release of NT
SSRI SNRI NaSSA NARI mean?
selective seritonin reuptake inhibitor
seratonin and noradrenaline reuptake inhibitor
Noradrenergic and specific serotinergic
noradrenaline reuptake inhibitor
Benefits of using a selective
- 5HT2 antag
- 5HT1 antag
- less sexual side effects
2. less nausea