Anxiety & Depression Flashcards
What is the definition of anxiety?
A feeling of unease, such as worry or fear, that can be mild or severe
Describe panic disorder
Intense and abrupt feeling of fear or discomfort.
. Temperature, chest pain, palpitations etc
Describe OCD
Combination of obsessive thoughts and compulsive activity
Describe PTSD
Occurs from experiencing trauma, interferes with normal function. Insomnia, nightmares, flashbacks
Describe two TWO different types of phobia
Specific - in reality of little or no danger
Social - fear of social or performance situations
Descrive GAD
Excessive uncontrollable worry about everyday things
How can we manage autonomic symptoms?
What drug groups are used
B-adrenoreceptor antagonists - propranolol
reduces autonomic effects, used PRN
SSRI - Sertraline, if this doesn’t work consider SNRI (venlafaxine and duloxetine)
How do benzodiazepines work??
Occupy site at GABAa complex, have a higher affinity.
Greater flow of Cl- ions, pore opens, causing hyper polarisation, anxiety reduced
How is bipolar treated?
Mania (acute) - antipsychotics, haloperidol, olanzapine, quetiapine, risperidone.
Maintenance (long-term) - Lithium + sodium valproate
What is first line treatment for depression?
1st line - generic SSRI (citalopram, fluoxetine, sertraline)
Takes 2-4 weeks to improve, take for no less than 6 months. Will get worse before it gets better
What do imagine studies of depression show?
Reduction in size of thalamus, hippocampus, amygdala
Why do SSRIs take 2-4 weeks to work?
Serotonin in synaptic cleft, binds to autoreceptor so none is released fromm pre-synaptic neurone, so less serotonin.
Chronic use down regulates 5-HT1 auto receptor, desensitised so it can be released, binds to receptor on post synaptic membrane initiating signalling cascade
How do TCAs work?
Inhibit 5-HT and NA reuptake
Sedative (h1 antagonism)
anticholinergic side effects
How does Mirtazapine work?
alpha2 auto and heteroreceptor antagonism. Increased serotonin and NA release
