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Neuro 4 Mine > Depression > Flashcards

Depression Flashcards

1
Q

Monoamine Theory of Depression

A

-does not totally explain etiology of depression

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2
Q

Sertroline

A
  • SSRI

- antidepressant

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3
Q

Citalopram

A
  • SSRI

- antidepressant

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4
Q

Pros and Cons of SSRIs

A

Pros: safe, effective, multiple indications

Cons:

  • nausea-diarrhea
  • activation-insomnia
  • restlessness
  • weight gain
  • sexual dysfunction
  • cognitive blunting
  • very low likelihood of fatality with overdose
  • withdrawal symptoms
  • drug interactions: P450 inhibition, St. Johns Wort
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5
Q

Pros and Cons of SNRIs

A

Pros: some evidence says more effective, safe, better tolerated than TCAs, multiple indications

Cons:

  • hypertension
  • anxiety
  • more rapid appearance of withdrawal sxs than with SSRIs
  • sexual side effects
  • sweating
  • inc. diastolic pressure
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6
Q

Pros and Cons of NDRIs (Buproprion)

A

Pros: no sexual side effects, weight neutral

Cons:

  • dizziness, dry mouth, tremor, insomnia, anxiety
  • potential for seizures at high doses
  • insomnia
  • contraindicated in eating disorder pts and seizure pts
  • weight gain and sexual side effects
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7
Q

Mirtazapine Pros and Cons

A

Pros:

  • helpful with insomnia
  • rapid anti-anxiety effect
  • low incidence of sexual side effects

Cons:

  • daytime somnolence
  • inc appetite, weight gain
  • dizziness
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8
Q

Side Effects of Tricyclic Antidepressants

A
  • poor side effect profile
  • sedation
  • antimuscarinic effects (no pee, see, spit, shit)
  • cardiovascular arrhythmias
  • orthostatic hypotension
  • sudden death in overdose
  • neurologic: can see seizures in overdose
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9
Q

Monoamine Oxidase Inhibitors (MAOIs) Pros and Cons

A

Pros: very effective in non-responsive pts (esp. atypical depression), time tested

Cons:

  • postural hypotension via chronic inc. in false NT formation
  • seizures, shock, hyperthermia in overdose
  • dry mouth, constipation, urinary retention
  • sexual side effects
  • weight gain
  • hypertensive crisis (tyramine reaction: MAOi + demerol -> death)
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10
Q

Drug Drug Interactions of Anti Depressants

A

-additive CNS depressant effects when used with other sedatives

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11
Q

MAOIs Drug Drug Interactions

A
  • agitation
  • seizures
  • fever in pts given meperidine
  • hypertensive crisis with drugs or foods high in tyramine
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12
Q

SSRIs Drug Drug Interaction

A
  • inhibition of P450 drug metabolizing enzymes

- St. Johns Wort (possible induction of P450 drug metabolizing enzymes)

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13
Q

Lithium Carbonate

A
  • slow onset (10-21)
  • use dependence
  • interference with PIP recycling
  • enhance 5HT action and/or diminish NE and DA effect
  • side effects: hypothyroidism, polyuria-polydipsia
  • competes with Na+ for reabsorption- food/drug interactions possible
  • adverse effects: narrow therapeutic index
  • narrow toxicities: tremor, GI upset, dec. thyroid function, polyuria
  • moderate toxicity: confusion, sedation, lethargy, twitching
  • severe toxicity: seizures, stupor, coma
  • drug drug interactions: diuretics, NSAIDs
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14
Q

Time Course of Antidepressant Side Effects

A

-4-12 weeks to see full effect

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15
Q

Placebo Tx of Depression

A

-placebo pts are more likely to relapse than pts on antidepressants

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16
Q

Tricyclic Antidepressants (TCAs) Pros and Cons

A
  • pros: very effective, time-tested, more effective in severe depression, can check blood levels
  • cons: hypotension, orthostasis, anticholinergic side effects, weight gain, sexual side effects, dangerous in overdose
17
Q

Lithium Carbonate MOA

A
  • mania tx
  • effects on glycogen synthase kinase-3 beta and protein kinase C may lead to neuroplastic changes associated with mood stabalization
18
Q

Lithium Carbonate Pros and Cons

A
  • Pros:
  • best studied
  • anti-suicidal properties
  • cheap

Cons:

  • tremor, diarrhea, taste, thirst, cognitive dulling
  • narrow therapeutic window
  • renal effects
  • hypothyroidism
19
Q

Trazadone Side Effects

A
  • drowsiness

- overdose minor problems only

20
Q

Fluoxetine

A
  • SSRI

- prozac

21
Q

Paroxetine

A
  • SSRI

- paxil

22
Q

Escitralopram

A

SSRI

-lexapro

23
Q

Bupropion

A
  • NDRI (norepinephrine dopamine reuptake inhibitor)

- wellbutrin (zyban for smoking cessation)

24
Q

Venlafaxine

A
  • SNRI

- effexor

25
Q

Trazadone

A

-mixed serotonin reuptake blocker/receptor antagonist

26
Q

Amitriptyline

A

-tricyclic antidepressant (NET/SERT reuptake)

27
Q

Pheneizine

A

-monoamine oxidase inhibitor

Neuro 4 Mine (14 decks)

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