CNS Antidepressant Agents - Kelly 3

Question 1

Affective disorders

Answer 1

Group of mental conditions that include depression and bipolar disorder
Characterized by changes in mood
Most prevalent form of mental illness in US/CAN
Can be exacerbated or triggered by stressful incident, idiopathic onset
Role of genetic factors unclear

Question 2

Goals of pharmacotherapy for depression

Answer 2

Relieve symptoms
Prevent suicide
Restore optimal functioning
Prevent recurrance

Question 3

Iproniazid

Answer 3

Used for tuberculosis
Found to have psychoactive properties
Slows breakdown of monoamine NT

Question 4

Tricyclic and heterocyclic antidepressants

Answer 4

Discovered same time as iproniazid
Inhibit reuptake of Na and 5-HT in synapse
Some newer heterocyclic may do so more specifically

Question 5

Monoamine oxidase inhibitors

Answer 5

Incase synaptic levels of NT: not broken down into metabolites
Can have hypertensive crisis due to increased stores of NE
Tyramine levels can increase (cheese reaction)
Risk of serotonin syndrome

Question 6

Adverse effects of TCA

Answer 6

Excessive sedation
Antimuscarinic effects
Sympathomimetic effects
Orthostatic hypertension, EEG abnormalities

Question 7

SSRIs

Answer 7

Selective Serotonin reuptake inhibitors
Used to treat depression, eating disorders, anxiety disorders, OCD
Fewer anticholinergic side-effects than TCAs

Question 8

Adverse effects of SSRIs

Answer 8

Nausea
Headache
Anxiety, agitation
Insomnia
Sexual dysfunction

Question 9

Mirtazapine

Answer 9

Has antidepressant/antianxiety properties

Blocks presynaptic alpha2-AR and increases NE and 5-HT release

Question 10

Bupropion

Answer 10

Weaker inhibitor of DA, 5-HT, NE uptake
Few side effects
Frequently used for patients who want to quit smoking

Question 11

Neurotrophic hypothesis of depression

Answer 11

Grown factors such as BDNF are critical to regulation of neural plasticity
Stress, pain, depression associated with decreased BDNF levels and structural atrophy in hippocampus, frontal cortex
Antidepressant drugs are associated with increased BDNF levels
Causes synaptogenesis with chronic administration
Driving release of GF in the brain which drives synaptogenesis in critical areas