Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Psych > Depression > Flashcards

Depression Flashcards

You may prefer our related Brainscape-certified flashcards:
Psychology 101 flashcards GRE® Psychology flashcards
1
Q

Which antidepressants are more effective in treating negative activity?

A

5-HT antidepressants

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Which antidepressants are more effective in treating positive symptoms?

A

Dopaminergic and noradrenergic antidepressants

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Explain the monoamine theory?

A

Depressive disorders are caused by a functional deficit of monoamine neurotransmitters

Evidence: More 5-HT/NA, increase mood, Less 5-HT/NA, lower mood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are some symptoms of disruptive mood dysregulation disorder?

A
  1. Severe recurrent temper outbursts manifested verbally or behaviourally that are grossly out of proportion to the situation
  2. Temper outburst inconsistent with developmental level
  3. Temper outburst occur ≥ 3 times a week

Symptoms have to be present for ≥ 12 months and in more than 2-3 different settings. Usually 6-18 years old

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Symptoms of Major depressive disorder?

A

At least 5 of the following during a 2 week period:

  1. Depressed mood most of the day
  2. Markedly diminished interest of pleasure in almost all activities
  3. Weight loss
  4. Insomnia or hypersomnia
  5. Psychomotor agitation or retardation
  6. Fatigue/ loss of energy
  7. Feelings of worthlessness or excessive/ inappropriate guilt
  8. Diminished ability to think or concentrate
  9. Recurrent thoughts of death
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How is persistent depressive disorder classified?

A

Depressed mood for most of the day for >2 years
Signs of : poor appetite, insomnia or hypersomnia, low energy or fatigue, lost self esteem, poor concentration

Symptoms are less severe but longer lasting than MDD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

3 treatments for depressive disorders?

A
  1. psychotherapy
  2. Electroconvulsive therapy
  3. Pharmacotherapy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are some examples of psychotherapy?

A
  1. Cognitive behavioural therapy
  2. Mindfulness- based stress reduction
  3. Meditation
  4. Yoga
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is ECT?

A

Electroconvulsive therapy

  • Mild electric shock to each side of the patients skull near the temples for ~ 1 min
  • Causes a brief seizure within brain
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

When is ECT useful?

A

When the depressive disorder is severe or life threatening

People who cannot or prefer not to take antidepressants (eg: pregnancy)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

4 mechanisms of action of antidepressants?

A
  1. Uptake inhibition- NA, 5-HT, DA
  2. Receptor antagonism
  3. Enzyme inhibition- MAO
  4. Receptor agonism- melatonin receptor agoinist
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How long does it take to see therapeutic effects of antidepressants?

A

up to 6 weeks

Symptoms start to resolve in 2-4 weeks ad full resolution of symptoms may take up to 4 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What does chronic antidepressant treatment result in?

A

Secondary adaptive changes

  • Downregulation of b1, b2 and 5-HT2a+c receptors
  • Alterations in kinases, transcription factors, growth factors
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are some types of SSRIs?

A 
Sertraline
Fluoxetine
Paroxetine
Citalopram
Escitaloptam
Fluvoxamine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How do SSRIs increase 5-HT in the long term?

A

Continued administration results in a downregulation of 5-HT1a receptors on cell body in the raphe which ‘releases the brake’ to release more 5-HT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are some adverse effects of SSRIs?

A
  1. Nausea
  2. Somnolence/ insomnia
  3. Dry mouth
  4. Increased sweating
  5. Diarrhoea
  6. Ejaculatory disorder
  7. Serotonin syndrome

SNRIs have similar adverse effects

17
Q

What is the mechanism of action of TCAs?

A

Main effect- blocks the reuptake of NA and 5-HT, some DA reuptake block
Blocks other receptors: a1, a2, M, H (a2 block results a negative feedback and increase NA release, this contributes to therapeutic effect as well)

18
Q

What are some initial side effects of TCAs? (3)

A
  1. Sedation
  2. Confusion
  3. Motor incoordination

These will usually decrease in 1-2 weeks

19
Q

What are some chronic side effects of TCAs? (4)

A
  1. Atropinic side effects: dry mouth, blurred vision, tachycardia
  2. Postural hypotension
  3. Can affect cognitive function
  4. Prolongation of QT interval
20
Q

Is it possible to overdose with TCAs?

A

Yes, active metabolites.

Can lead to Arrhythmia, convulsion, respiratory depression, coma and death

21
Q

What are 2 functions of MAO?

A
  1. Inactivates amines eg: 5-HT, NA and tyramine
  2. Regulates levels of NA and 5-HT in neurones

Found on the outer membrane of mitochrondria

22
Q

What is an example of a reversible MAO-A inhibitor?

A

Moclobemide.
It blocks MAO-A which causes a leakage of neurotransmitters from neurones

irreversible MAOI- phenelzine/ tranylcypromine

23
Q

What are some side effects of moclobemide? (5)

A
  1. Insomnia
  2. Dizziness
  3. Dry mouth
  4. Nausea
  5. GI effects
  6. Cheese reaction
24
Q

What is the ‘cheese reaction’?

A

A hypertensive crisis
Tyramine which is commonly found in cheese, red wine, vegemite is normally metabolised in gut wall
When it is not metabolised, it can a amphetamine like effect and displaces NA from vesicles

Irreversible MOAI can also increase NA, thus causing acute hypertension

Therefore need to restrict dietary intake of tyramine

25
Q

What is the mode of action of mianserin and mirtazepine?

A

Mianserin- a2 adrenoceptor and 5-HT2c antagonist (and NA uptake inhibitor)

Mirtazepine- analogue of mianserin. a2 adrenoceptor and 5-HT2c/ 5-HT3 antagonist

a2 adrenoceptor antagonism- increase NA release
5-HT2c antagonist- increase DA release

26
Q

What are some adverse effects of Mirtazepine? (5)

A
  1. Increase appetite (weight gain)
  2. Drowsiness
  3. CNS excitation
  4. Seizure, tremor
  5. Agranulocytosis
27
Q

Name 3 SNRIs

A
  1. Venlafaxine
  2. Desvenlafaxine
  3. Duloxetine
28
Q

What is the most selective NA reuptake inhibitor?

A

Reboxetine

NA is essential to maintain drive, self assertiveness and capacity for reward
Can be combined with SSRIs

29
Q

Which antidepressants are good in pregnancy?

A
  1. SNRIs (cat b2)

2. Reboxetine (cat b1)

30
Q

What is the proposed rationale behind the use of valdoxan (agomelatin)?

A

Melantoninergic agonist and selective antagonist of 5-HT receptors.
Improves sleep without affect daytime alertness

Disturbed/altered circandin rhythms accompany endogenous depression

31
Q

What is the MOA of bupropion?

A

NA and DA uptake inhibitor, minimal effect on 5-HT and no effect on MAO

Used for nicotine dependence
Insomnia and headaches are common side effects

32
Q

How to increase compliance with antidepressants?

A

Patient education

  • when to expect benefits
  • duration of treatment
  • what side effects to expect
33
Q

Why is it important to have an antidepressant free/washout period?

A

To allow half life of antidepressant to wash out to minimise serotonergic effect. This may vary from 1 to 5 days depending on which antidepressants, and high dose antidepressants should be weaned before washout period

34
Q

What are the first line antidepressants used in the elderly?

A

SSRI, SNRI and mirtazepine

Dose should be increase every 1-2 weeks until depressive symptoms resolve. Change agents if no response

35
Q

What are some co-morbidities associated with depression in the elderly? (3)

A
  1. Anxiety
  2. Substance abuse
  3. Neurologic disorders

Psych (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions