Chapter 8.2

Question 1

State epidemiology of depression (that is, percent of the population affected, gender differentiation, age, etc.)

Answer 1

15 to 20 percent of adults experiencing major depression at some point in their lives. Likewise, the incidence of depression varies in different age groups, and women tend to be approximately twice as likely to experience depression

Question 2

State the current drug treatment strategy used to manage depression.

Answer 2

These drugs will prolong the effect of the neurotransmitters especially norepinephrine and serotonin

Question 3

Selective Serotonin reuptake inhibitors (SSRI)

Answer 3

sertraline, citalopram, fluoxetine, paroxetine

Question 4

Serotonin norepinephrine reuptake inhibitors (SNRI’s)

Answer 4

duloxetine, venlafaxine

Question 5

Tricylines

Answer 5

amitriptyline, imipramine

Question 6

MAO inhibitors

Answer 6

phenelzine, tranylcypromine

Question 7

Other antidepressents

Answer 7

nefazodone, trazodone, bupropion, and mirtazapine

Question 8

Tricyclines adverse effects

Answer 8

sedation, orthostatic hypotension, seizures

Question 9

MAO inhibitor adverse effects

Answer 9

increased blood pressure

Question 10

SSRI and SNRI adverse effects

Answer 10

increased seizure and GI problems

Question 11

Identify the symptoms of serotonin syndrome

Answer 11

increased HR and BP, confusion, hallucinations, sweating, GI problems, mm pain

Question 12

List some common pain syndromes treated with antidepressant medications

Answer 12

Fibromyalgia, low back pain, HA, Raynauds

Question 13

State the timeline for response to an antidepressant medication and the impact on a physical therapy session

Answer 13

1-2 weeks for effect 6-8 weeks for max effect

Question 14

State the primary route of elimination for lithium.

Answer 14

Kidneys

Question 15

mild lithium toxicity

Answer 15

fine tremor, nausea and weakness

Question 16

mod lithium toxicity

Answer 16

vomitting, diarrhea, blurred vision and dizziness

Question 17

severe lithium toxicity

Answer 17

hallucinations, nystagmus

Question 18

List other categories of medications that may be used to treat mania in a patient with a bipolar disorder.

Answer 18

anti seizure drugs and antipsychotic drugs

Question 19

State how neurotransmitters are normally removed from the synaptic cleft and the percent of amines that are usually removed by these processes

Answer 19

reuptake (60-80%) 
MAO enzyme (20-40%)

Question 20

State the role of increased amine transmitters in the treatment of depression using the terms brain-derived neurotrophic factor, neurogenesis, and hippocampus.

Answer 20

Prolong activity of amine neurotransmitters leading to a downstream effect producing an increase in BDNF. BDNF stimulates synaptic connections stimulating neurogenesis in the hippocampus.