Depression

Question 1

What are the additional symptoms of Depression (7)?

Answer 1

Disturbed sleep
Weight/appetite change
Fatigue
Agitation/slowing of movements
Poor concentration/indecisiveness
Feelings of worthlessness or excessive guilt
Suicidal thoughts or acts

Question 2

What are the two patterns of depression?

Answer 2

Unipolar and Bipolar

Question 3

What are the three categories of depression? Briefly explain each.

Answer 3

Mild depression: 5 symptoms + no severe impairment
Moderate: in between Mild and Severe
Severe: more than 5 + major impairment

Question 4

What chemicals are suppressed in depression? (2)

Answer 4

Noradrenaline and Serotonin

Question 5

Which areas of the brain see an increase in activity in depression?

Answer 5

Amygdala

Hypothalamus

Question 6

Which areas of the brain see a decrease in activity in depression?

Answer 6

Prefrontal cortex

Hippocampus

Question 7

What are the four main theories of depression?

Answer 7

Monoamine hypothesis (5HT + NA)
Neurohormone (HPA axis (stress pathway) + steroids)
Immune System (Inflammatory response triggers HPA axis (stress pathway))
Circadian (sleep affected)

Question 8

What are the main treatments for Depression?

Answer 8

CBT
ECT
TMS
Placebo
Exercise
Pharmacological
Light Therapy

Question 9

What are the disadvantages of ECT?

Answer 9

Addiction

Retrograde Amnesia

Question 10

What are the different pharmacological treatments for depression?

Answer 10

SSRIs
TCAs
MAOI-As
Atypical Antidepressants
Lithium

Question 11

What are the two essential symptoms of Depression?

Answer 11

Persistent sadness or low mood

Marked loss of interests or pleasure (anhedonia)

Question 12

What changes in neurogenesis are seen in depression?

Answer 12

Decreased arborisation

Decreased synapses

Question 13

What is the MOA of SSRIs?

Answer 13

Inhibit reuptake of serotonin from synaptic cleft

Question 14

Give 3 examples of SSRIs:

Answer 14

Paroxetine
Fluoxetine
Citalopram
Sertraline

Question 15

List the common side effects for SSRIs:

Answer 15

5 S's:
Slow onset
Sickness 
Sleep disorders
Sexual Dysfunction
Serotonin Syndrome (overactivation of ANS - increased HR, shivering, sweating, dilated pupils, etc)

Question 16

What type of MAO inhibitors are used in depression?

Answer 16

MAO(A) inhibitors

Question 17

What is the MOA of MAOIs?

Answer 17

They prevent MAO from breaking down 5HT and NA, thereby increasing levels of 5HT and NA at the synapse

Question 18

Give an example of a MAOI-A:

Answer 18

Moclobemide

Phenelzine

Question 19

Give some side effects of MAOI-As:

Answer 19

Postural hypotension
Convulsions
Restlessness
Sleep disorders
'Cheese Reaction' (autonomic overload - HTN, tachycardia, arrhythmias)

Question 20

What are the 5 main receptors that TCAs block?

Answer 20

5HT 
NA
α1
H1
M1

Question 21

Give an example of a TCA:

Answer 21

Amitriptyline

Nortriptyline

Question 22

What are the side effects of TCAs (relate them to target receptors)?

Answer 22

H1 - sedation, weight gain
M1 - constipation, dry mouth
α1 - vasodilation, tachycardia, postural hypotension

Question 23

What are the classes of atypical antidepressants?

Answer 23

NRIs (NA reuptake inhibitors)
SNRIs (Serotonin-NA reuptake inhibitors)
5HT partial agonists

Question 24

Give an example of an NRI

Answer 24

Reboxitine

Question 25

Which drug would you use if you subscribe to the circadian theory of depression?

Answer 25

Agomelatine

Question 26

Give an example of a 5HT partial agonist

Answer 26

Buspirone

Question 27

Give an example of an SNRI:

Answer 27

Venlafaxine

Question 28

What changes in neurogenesis are seen in depression?

Answer 28

Decreased arborisation | Decreased synapses

Question 29

What is the MOA of SSRIs?

Answer 29

Inhibit reuptake of serotonin from synaptic cleft

Question 30

Give 3 examples of SSRIs:

Answer 30

Paroxetine Fluoxetine Citalopram Sertraline

Question 31

List the common side effects for SSRIs:

Answer 31

``` 5 S's: Slow onset Sickness Sleep disorders Sexual Dysfunction Serotonin Syndrome (overactivation of ANS - increased HR, shivering, sweating, dilated pupils, etc) ```

Question 32

What type of MAO inhibitors are used in depression?

Answer 32

MAO(A) inhibitors

Question 33

What is the MOA of MAOIs?

Answer 33

They prevent MAO from breaking down 5HT and NA, thereby increasing levels of 5HT and NA at the synapse

Question 34

Give an example of a MAOI-A:

Answer 34

Moclobemide | Phenelzine

Question 35

Give some side effects of MAOI-As:

Answer 35

``` Postural hypotension Convulsions Restlessness Sleep disorders 'Cheese Reaction' (autonomic overload - HTN, tachycardia, arrhythmias) ```

Question 36

What are the 5 main receptors that TCAs block?

Answer 36

``` 5HT NA α1 H1 M1 ```

Question 37

Give an example of a TCA:

Answer 37

Amitriptyline | Nortriptyline

Question 38

What are the side effects of TCAs (relate them to target receptors)?

Answer 38

H1 - sedation, weight gain M1 - constipation, dry mouth α1 - vasodilation, tachycardia, postural hypotension

Question 39

What are the classes of atypical antidepressants?

Answer 39

NRIs (NA reuptake inhibitors) SNRIs (Serotonin-NA reuptake inhibitors) 5HT partial agonists

Question 40

Give an example of an NRI

Answer 40

Reboxitine

Question 41

Which drug would you use if you subscribe to the circadian theory of depression?

Answer 41

Agomelatine

Question 42

Give an example of a 5HT partial agonist

Answer 42

Buspirone

Question 43

Give an example of an SNRI:

Answer 43

Venlafaxine