depression Flashcards

0
Q

What are the 3 goals of depression treatment?

A
  1. Reduce/remove signs/symptoms
  2. Restore occupational/psychosocial function
  3. Reduce recurrence/relapse
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0
Q

What must you have 4 of within the same 2 week period IN ADDITION to at least 1 of the 2 defining symptoms?

A

4 of the following 7:

  1. Weight (+/- 5% in month)
  2. Sleep (insomnia/hypersomnia)
  3. Fatigue/lack of energy
  4. Psychomotor agitation
  5. Feelings of worthlessness/guilt
  6. Diminished ability to think
  7. Recurrent thoughts of death/suicide
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1
Q

What must you have 1 OR both of to be diagnosed with depression?

A
#1 - depressed mood most of day
#2 - markedly diminished interest in normally loved activities
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2
Q

In addition to the 1 of 2 and the 4 of 7 - what 3 criteria must be met for final diagnosis of depression?

A
  1. 1 of 2 + 4 or more in same 2 weeks
  2. Change in previous function
  3. Not attributed to drugs or bereavement
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3
Q

What are 7 types of depression?

A
  1. MDD
  2. Dysthymic depression
  3. Bipolar
  4. Substance-abuse induced
  5. Seasonal awareness
  6. Post-partum
    7, pre-menstrual dysphoric
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4
Q

What are the neurotransmitters that regulate physiological symptoms of depression?

A
  1. Dopamine
  2. Norepinephrine
  3. Serotonin
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5
Q

What are the 4 classes of anti-depressant drugs?

A
  1. TCA’s (tricyclic antidepressants)
  2. MAOI’s (Monoamine Oxidase Inhibitors)
  3. SSRI’s (Selective Serotonin Reuptake Inhibitors)
  4. New Generation Antidepressants
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6
Q

What is the MOA for TCA’s?

A

Inhibit the reuptake of:
Noriepinephrine
Serotonin (5-HT receptor)

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7
Q

What are 5 TCA drugs?

A

NADIP

  1. Nortriptyline (migraines)
  2. Amitriptyline (fibromylagia)
  3. Doxepin
  4. Imipramine (cardiac issues @ high doses)
  5. Protriptyline (low sedation; CNS stimulant)
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9
Q

NOT FOR MIDTERM 2

What are the side effects of TCA?

A
Anticholinergic/Antihistamine like:
dry mouth blurred vision
urine hesitancy
constipation
drowsiness
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10
Q

What is the MOA for MAOI’s?

A

Block degradation of the following by inhibiting Mono Amine Oxidase enzyme thereby increasing volume of the following:

  1. Dopamine
  2. Noriepinephrine
  3. Serotonin
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11
Q

What is the main ADVERSE effect of MAOI’s?

A

Cheese Syndrome/Hypertensive crisis

from inability to breakdown tyramine

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12
Q

NOT FOR MIDTERM 2

What are the side effects of MAOI’s?

A

similar to TSA’s:

  1. weight gain
  2. nausea/dry mouth
  3. constipation
  4. insomnia
  5. orthostatic hypotension, dizzy, headache
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13
Q

NOT FOR MIDTERM 2

What are the adverse effects of TCA?

A

Cardiac Issues:
tachycardia
arrhythmias
orthostatic hypotensions

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15
Q

What are the 3 MAOI’s?

A

PIT

  1. Phenelzine (most commonly used)
  2. Isocarboxazid
  3. Tranylcypromines
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16
Q

What is the MOA for SSRI’s?

A

Selective Serotonin Uptake Inhibitor

17
Q

NOT FOR MIDTERM 2

What are the side effects of SSRI’s?

A
nervousness
agitation/anxiety
insomnia with night sweats
nausea/diarhhea
headaches
SEXUAL dysfunction
18
Q

What are the 4 SSRI drugs to know?

A
  1. Fluoxetine/Prozac (eating disorder/safe in pregn)
  2. Sertraline/Zoloft (diarrhea)
  3. Paroxetine/Paxil (sedation/weight gain)
  4. Citalopram/Celexa (minimal SE, SEXUAL dysf)
19
Q

How many NEW generation antidepressants?

A

5 - TNVBM

  1. Trazodone
  2. Nefazodone
  3. Venlafaxine
  4. Buproprion
  5. Mirtazapine
20
Q

What is the MOA of trazadone?

A

Inhibits reuptake of:

  1. Noriepinephrine
  2. Serotonin
21
Q

What is the MOA of nefazodone?

A

Inhibits reuptake of:

  1. Noriepinephrine
  2. Serotonine
22
Q

What is the MOA of venlafaxine?

A

Inhibits the reuptake of:

  1. Dopamine
  2. Noriepinephrine
  3. Serotonin
23
Q

What is the MOA of Buproprion?

A

Inhibits the reuptake of DOPAMINE

24
Q

What is the MOA of Mirtazapine?

A

Stimulates release of:

  1. Noriepinephrine
  2. Serotonin
25
Q

What does trazodone cause as a side effect?

A

Severe sedation - even at low levels and high doses are required for therpeutic effects

26
Q

What is nefazodone named?

A

The “calming” antidepressant - good for depression with anxiety or insomnia

27
Q

What is special about venlafaxine?

A

Inhibits reuptake of all 3 neurotransmitters AND causes weight loss with VIVID dreaming

28
Q

What is special about mirtazapine?

A

stimulates RELEASE of:
noriepinephrine
serotonin
AND lower dose causes MORE sedation

29
Q

What else is buproprion used for?

A

Cessation of Smoking under Zyban

30
Q

What is the etiology of depression?

A

Imbalance of Dopamine, NE & Serotonin from:

  1. Genetics
  2. Catastrophic Event
  3. Environmental Factors