Anxiolytics And Antidepressants Flashcards
Which is the most widespread transmitter in the brain?
Serotonin
Where are emotions bunched together in the brain?
In the limbic system
Which enzyme breaks down serotonin?
Tryptophan hydroxylase
Desipramine and imipramine are both…
Tricyclic antidepressants
Sertraline, citalopram and fluoxetine (Prozac) are all
Selective serotonin re uptake inhibitors
Fenfluramine and Methylenedioxymethamphetamine (MDMA, E) are both..
SERT Inhibitors, 5-ht releasers
5HT1a-5HT1f
Decrease camp
5HT4-5HT5b
Increase camp
5HT2a - 5HT2c
Increase inositol phosphates and calcium
5HT3
Ligand-gated ionic channel - GABBA A receptor, positive ions flow in and cell becomes more excitable
Which area of the brain are the dopamine receptors in?
Ventral tegmental area
What happens to L DOPA
converted to the enzyme which produces the transmitter dopamine
What are the two main classes of dopamine receptor?
D1 like - increases cAMP
D2 like - decreases cAMP
What are the 2 main types of depression
Major (unipolar)
Bipolar (manic)
Symptoms of depression are
Low or depressed mood
Anhedonia
Low energy or fatigue
Symptoms of mania are
Elation
Talkativeness, creativity
Fullness of energy and confidence
Patients who suffer from depression tend to have
High levels of cortisol (HPA axis)
Which areas of the brain tend to be over active in depression?
HPA axis and Amygdala
What are two non drug therapies for depression
Psychotherapy
ECT
Name five drugs for depression
Monoamine oxidase inhibitors Tricyclic drugs Selective serotonin re uptake inhibitors Third generation antidepressants Mood stabilisers
Phenelzine (Nardil)
Depression and bipolar Monamine oxidase inhibitor Side effects - hypertension, weight gain, oedema and sexual dysfunction. Sedation. Avoid cheese, yogurt etc.. Avoid drugs that effect BP.
Tranylcypromine (Parnate)
Treatment of severe depression
Monoamine oxidase inhibitor
Imipramine
Amitriptyline
Doxepin
Tricyclic antidepressants
Shouldn’t be given to patients with history of cv disease.
Sedation and anti cholinergic effects.
Fluoxetine (Prozac), paroxetine, sertraline, citalopram.
Selective serotonin re uptake inhibitors
Sexual dysfunction and anorexia
Dependence and withdrawal
Drug interactions - MAOIs, cimetidine and warfarin.
Bupropion
Venlafaxine
Miscellaneous next generation antidepressants
Lithium carbonate
Lithium citrate
Carbamazepine
Topiramate
Mood stabilisers
Side effects - dizziness, headache, confusion, hair loss, oedema, cardiac dysrhythmias and nephrotoxicity. Toxicity and withdrawal.
Name five anxiety disorders
Generalised anxiety disorder Panic disorder Phobias Post traumatic stress disorder Obsessive compulsive disorder
What may anxiety be due to?
Under activity of an inhibitory pathway in the brain
What are here types of anxiolytics?
Sedative hypnotics
Benzodiazepines
Second generation non-benzodiazepines
Thiopental, seconarbital, phenobarbital, zolpidem.
Sedative hypnotics
Side effects - drowsiness or hangover, dependence and tolerance, possible seizure on withdrawal. Avoid other CNS depressants
Diazepam, aprozalam, tamazepam, lorazepam.
Benzodiazepines
Side effects - anti cholinergic effects, date rape.
Shouldn’t be given to patients suffering from glaucoma.
Buspirone
Non - benzodiazepine anxiolytic
Anti cholinergic effects
What may patients with disorganised schizophrenia have?
Difficult to understand, speech may be incomprehensible
What may patients with paranoid schizophrenia experience?
Hallucinations, delusions, disorganised behaviour.
What is catatonic schizophrenia?
May experience catatonic stupor and waxy flexibility
Chlorpromazine, fluohenazine, haloperidol, loxapine
Antipsychotics/neuroleptics
Side effects - Parkinsonism, sedation, hypotension, impaired thermoregulation and lactation, neuroleptic malignant syndrome.
Clozapine, amisulpride, risperidone, olanzepine.
Atypical antipsychotics
Management of schizophrenia
Side effects - headache, blurred vision, photosensitivity, insomnia, nervousness, dizziness. GI stress, weight gain.
