depression Flashcards
what is definition of depression?
brain disorders characterised by persistent low mood and disinterested in things normally enjoyed that affect one’s life
what is pathophysiology ?
reduced level of serotonin and noradrenaline
state the core symptom of depression.
- persistent sadness/ low mood
- loss of interest / pleasure in activities
state the common symptoms.
- poor concentration
- feelings of excessive guilt
- hopelessness
- thoughts of dying or suicidal
- feeling tired and low energy
- changes in appetite
how to diagnose?
- full psychiatric assessment
- used tools such DSM-5 and ICD-11
what’s common type of depression?
- major depressive disorder
- persistent depressive disorder
- bipolar depression
- postpartum depression
- premenstrual dysphoric disorder
- seasonal affective disorder
- atypical depression
what is the risk factor of depression?
- stressful events
- lowself personality
- genetics
- giving birth (hormonal)
- loneliness
- alcohol and drugs misuse
- chronic illness
what is the complication of depression?
- excess or lose weight
- pain illness
- alcohol and drugs misuse
- family conflict
- suicide attempts
state non pharmacological treatment.
- cognitive behavioural therapy
- behavioural therapy
- interpersonal therapy
- problem solving therapy
state antidepressants classification.
- atypical
- SSRI
- TCA
- SNRI
- MAOi
MOA of selective serotonin reuptake inhibitor
SSRI block serotonin reuptake transpoerter and make more serotonin available to generate signal to evaluate mood
MOA of monoamine oxidase inhibitors ( MOAi)
MAOi degrades serotonin and noradrenaline which is inhibit MAO enzymes
MOA of tricyclic antidepressants ( TCA)
TCA block serotonin and noradrenaline reuptake transporter and also block muscarinic adrenergic and histamine receptors
MOA of seronotonin noradrenaline reuptake inhibitors ( SNRI )
block serotonin and noradrenaline reuptake transporter
examples of SSRI drugs
- fluoxetine
- citalopram
- setraline
- fluvoxamine
- escitalopram
- paroxetine
example of MAOi
phenelzine
example of TCA drugs
- nortriptyline
- amitriptyline
- clomipramine
example of SNRI drug
- venlafaxine
- desvenlafaxine
- duloxetine
example of atypical drug
- agomelatine
- mirtazapine
- lithium
side effects of the antidepressant drug
- decreased alertness
- headache
- nausea
- sexual problems
- tooth decay
- diabetes
main goal of antidepressants.
- to help people with depression to feel emotionally stable again
- to help them to follow a normal daily routine
other use of TCA .
- neuropathic pain ( nortriptyline and amitriptyline)
drug interactions.
SNRI and SSRI can cause bleeding risk and impaired platelet aggregation when use with aspirin , warfarin and nsaids
why antidepressants take long time to give full effect?
this is because inhibition of serotonin reuptake transporter start by decreasing serotonin levels due to activation of serotonin auto receptors that give negative feedback. after a while , drugs then reduce no of serotonin auto receptor and more serotonin available to elevate symptoms
cautions when use MAOi with food.
avoid take phenelzine with high tyramine food which can cause hypertensive crisis
when to start and stop and change?
start : low dase and move slow
stop : at least 6 months after symptoms have gone. stop slowly and avoid antidepressants discontinuation syndrome
change : wait at least 4 weeks ( increasing the dose bfr 4 weeks will increase side effects)
what is serotonin syndrome?
life threatening conditions when serotonin levels increase due to overdose and concurrent use of antidepressants
it’s safe for pregnancy?
not recommended but paroxetine can be considered in later pregnancy and breastfeeding
