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
What does trazodone cause as a side effect?
Severe sedation - even at low levels and high doses are required for therpeutic effects
26
What is nefazodone named?
The "calming" antidepressant - good for depression with anxiety or insomnia
27
What is special about venlafaxine?
Inhibits reuptake of all 3 neurotransmitters AND causes weight loss with VIVID dreaming
28
What is special about mirtazapine?
stimulates RELEASE of: noriepinephrine serotonin AND lower dose causes MORE sedation
29
What else is buproprion used for?
Cessation of Smoking under Zyban
30
What is the etiology of depression?
Imbalance of Dopamine, NE & Serotonin from: 1. Genetics 2. Catastrophic Event 3. Environmental Factors