anxiety/sedation/depression

Question 1

describe the monoamine theory of depression

Answer 1

depression is caused by a functional deficit of central monoamine transmission

Question 2

describe the monoamine theory of mania

Answer 2

mania is caused by a functional excess of central monoamine transmission

Question 3

central monoamine neurotransmitters

Answer 3

noradrenaline and 5-HT (serotonin)

Question 4

discuss evidence for monoamine theory of depression

Answer 4

some pharmacological evidence, but biochemical evidence inconsistent (reduction in NA metabolites not alwyas well-correlated with worsening depression)

Question 5

possible cause of delayed onset of clinical effect of drugs

Answer 5

original changes of anti-depressants cause adaptive changes in brain (e.g. down-regulation of receptors), which then cause anti-depressive effect (neurones therefore secrete autonomously as no longer responsive to ambient levels)

Question 6

what 3 receptors are down-regulated in adaptive changes

Answer 6

a2, B, 5HT

Question 7

2 other ways anti-depressants may work

Answer 7

increase CRH levels in hypothalamo-pituitary adrenal axis, reverse hippocampal neurodegeneration

Question 8

pharmacological evidence supporting monoamine theory of depression: TCA

Answer 8

block NA and 5-HT reuptake, increasing mood

Question 9

pharmacological evidence supporting monoamine theory of depression: MAO inhibitors

Answer 9

increase stores of NA and 5-HT, increasing mood

Question 10

pharmacological evidence supporting monoamine theory of depression: reserpine (monoamine oxidase depletor)

Answer 10

inhibits NA and 5-HT storage, and is lipid soluble so crosses BBB and inhibits proteins loading monoamine vesicles, decreasing mood

Question 11

pharmacological evidence supporting monoamine theory of depression: a-methyltyrosine

Answer 11

inhibits NA synthesis, decreasing mood and calming manic patients

Question 12

pharmacological evidence supporting monoamine theory of depression: methydopa

Answer 12

inhibits NA synthesis, decreasing mood

Question 13

pharmacological evidence supporting monoamine theory of depression: electroconvulsive therapy (ECT)

Answer 13

increases CNS responses to NA and 5-HT, increasing mood

Question 14

how is cocaine not consistent with monoamine theory of depression

Answer 14

no significant anti-depressant activity despite blocking NA reuptake channels (may not bind as well)