Depression Flashcards
What are the additional symptoms of Depression (7)?
Disturbed sleep Weight/appetite change Fatigue Agitation/slowing of movements Poor concentration/indecisiveness Feelings of worthlessness or excessive guilt Suicidal thoughts or acts
What are the two patterns of depression?
Unipolar and Bipolar
What are the three categories of depression? Briefly explain each.
Mild depression: 5 symptoms + no severe impairment
Moderate: in between Mild and Severe
Severe: more than 5 + major impairment
What chemicals are suppressed in depression? (2)
Noradrenaline and Serotonin
Which areas of the brain see an increase in activity in depression?
Amygdala
Hypothalamus
Which areas of the brain see a decrease in activity in depression?
Prefrontal cortex
Hippocampus
What are the four main theories of depression?
Monoamine hypothesis (5HT + NA)
Neurohormone (HPA axis (stress pathway) + steroids)
Immune System (Inflammatory response triggers HPA axis (stress pathway))
Circadian (sleep affected)
What are the main treatments for Depression?
CBT ECT TMS Placebo Exercise Pharmacological Light Therapy
What are the disadvantages of ECT?
Addiction
Retrograde Amnesia
What are the different pharmacological treatments for depression?
SSRIs TCAs MAOI-As Atypical Antidepressants Lithium
What are the two essential symptoms of Depression?
Persistent sadness or low mood
Marked loss of interests or pleasure (anhedonia)
What changes in neurogenesis are seen in depression?
Decreased arborisation
Decreased synapses
What is the MOA of SSRIs?
Inhibit reuptake of serotonin from synaptic cleft
Give 3 examples of SSRIs:
Paroxetine
Fluoxetine
Citalopram
Sertraline
List the common side effects for SSRIs:
5 S's: Slow onset Sickness Sleep disorders Sexual Dysfunction Serotonin Syndrome (overactivation of ANS - increased HR, shivering, sweating, dilated pupils, etc)
What type of MAO inhibitors are used in depression?
MAO(A) inhibitors
What is the MOA of MAOIs?
They prevent MAO from breaking down 5HT and NA, thereby increasing levels of 5HT and NA at the synapse
Give an example of a MAOI-A:
Moclobemide
Phenelzine
Give some side effects of MAOI-As:
Postural hypotension Convulsions Restlessness Sleep disorders 'Cheese Reaction' (autonomic overload - HTN, tachycardia, arrhythmias)
What are the 5 main receptors that TCAs block?
5HT NA α1 H1 M1
Give an example of a TCA:
Amitriptyline
Nortriptyline
What are the side effects of TCAs (relate them to target receptors)?
H1 - sedation, weight gain
M1 - constipation, dry mouth
α1 - vasodilation, tachycardia, postural hypotension
What are the classes of atypical antidepressants?
NRIs (NA reuptake inhibitors)
SNRIs (Serotonin-NA reuptake inhibitors)
5HT partial agonists
Give an example of an NRI
Reboxitine
Which drug would you use if you subscribe to the circadian theory of depression?
Agomelatine
Give an example of a 5HT partial agonist
Buspirone
Give an example of an SNRI:
Venlafaxine
What changes in neurogenesis are seen in depression?
Decreased arborisation
Decreased synapses
What is the MOA of SSRIs?
Inhibit reuptake of serotonin from synaptic cleft
Give 3 examples of SSRIs:
Paroxetine
Fluoxetine
Citalopram
Sertraline
List the common side effects for SSRIs:
5 S's: Slow onset Sickness Sleep disorders Sexual Dysfunction Serotonin Syndrome (overactivation of ANS - increased HR, shivering, sweating, dilated pupils, etc)
What type of MAO inhibitors are used in depression?
MAO(A) inhibitors
What is the MOA of MAOIs?
They prevent MAO from breaking down 5HT and NA, thereby increasing levels of 5HT and NA at the synapse
Give an example of a MAOI-A:
Moclobemide
Phenelzine
Give some side effects of MAOI-As:
Postural hypotension Convulsions Restlessness Sleep disorders 'Cheese Reaction' (autonomic overload - HTN, tachycardia, arrhythmias)
What are the 5 main receptors that TCAs block?
5HT NA α1 H1 M1
Give an example of a TCA:
Amitriptyline
Nortriptyline
What are the side effects of TCAs (relate them to target receptors)?
H1 - sedation, weight gain
M1 - constipation, dry mouth
α1 - vasodilation, tachycardia, postural hypotension
What are the classes of atypical antidepressants?
NRIs (NA reuptake inhibitors)
SNRIs (Serotonin-NA reuptake inhibitors)
5HT partial agonists
Give an example of an NRI
Reboxitine
Which drug would you use if you subscribe to the circadian theory of depression?
Agomelatine
Give an example of a 5HT partial agonist
Buspirone
Give an example of an SNRI:
Venlafaxine
