Depression Flashcards
what is the weak genetic link of unipolar depression?
possibly SERT mutation
what is the strong familial link of bipolar depression?
link to ankyrin G (scaffolding protein) and L calcium channel
what are the 2 main treatments for bipolar?
lithium and ECT
a polymorphism is
a subtle change in the gene
psychology therapy includes
freuds psychotherapy and skinners CBT
3 types of antidepressant drug:
enzyme inhibitors, uptake inhibitors, presynaptic receptor antagonists
MAOIs are
enzyme inhibitors
TCAs, SSRIs, and NSRIs are
uptake inhibitors
atypicals are
presynaptic receptor antagonists
ECT induces electroshock unilaterally to
reduce memory loss
how do MAOIs work?
by inhibiting breakdown of 5HT and NA
what are the problems with MAOIs?
diet interactions (cheese reaction) and not much more effective than placebo
how do TCA,SSRI and NSRIs work?
by blocking the uptake of 5ht, na, or both(TCA)
What are the problems associated with TCAS?
toxic if OD and many adverse effects
What are the problems associated with SSRIs?
less toxic than TCA but personality changes
What are the problems associated with NSRIs?
less toxic than TCA but insomnia
What are the problems associated with atypicals?
weight gain and not much more effect than placebo
how do atypicals work?
by blocking the presynaptic receptors of NA and 5ht
what is the possible active ingredient in st Johns Wort and what is its suggested mechanism/
hyperforin, suggested to block 5ht, but only at concentrations much higher than possible in vivo
how does hyperforin affect other drugs taken?
it induces enzymes ex CYP3A4 which means it interacts with the pharmacokinetics of other drugs taken
which 2 animal models of depression were deemed unethical?
learned helplessness (seligman 1965) primate mother-baby separation (bowlby, 1958)
what animal model is used now?
swimming mouse to platform
how does investigation of drug treatments provide a model for cause of depression?
since they all increase the functional availability of NA and/or 5HT, logical assumption is that depression is due to a deficit of one or both.
na is produced from
tyrosine to dopamine to na
5ht is produced from
tryptphan to 5ht
tca an ssri act at
sert
atypicals act at
5ht1 receptor
na pathway:
LC to amygdala, hyp, cortex
5ht pathway:
raphe nucleus to cortex, amyg., striatum, thal., hippo., cortex, cerebellum.
