Depression

Question 1

What are symptoms of depression?

Answer 1

Low mood, irritability, loss of interest in daily activities, sleep disturbed, loss of appetite, difficult to concentrate, low self esteem

Question 2

What parts of the brain are implicated in depression?

Answer 2

Cingulate cortex, nucleus accumbent, amygdala, prefrontal cortex, hippocampus

Question 3

When was the monoamine hypothesis?

Answer 3

1965

Question 4

What is suggested at the moment is implicated in depression?

Answer 4

Monoamines (5HT and NA), BDNF (although not yet be validated) and glutamate

Question 5

What is the biology of depression?

Answer 5

Stress, increases glutamate, NMDA, increase apoptosis
Stress, increase CRF in hypothalamus, ACTH pituitary, cortisol release from adrenal cortex, increase bad genes transcription
NA, 5HT, BDNF decrease transcription of bad genes and increase beneficial for neurogenesis

Question 6

What does Reserpine do?

Answer 6

Produces depression and Parkinsonism, depletes stores of monoamine transmitters

Question 7

What was the first specific antidepressant? what did it prove/ solidify?

Answer 7

Iproniazid (MAOI), monoamine hypothesis

Question 8

What are the main classes of antidepressants which interfere with MA transmission?

Answer 8

SSRIs, tricyclics, MAOI, MA receptor antagonists

Question 9

Give an examples of SSRI

Answer 9

Prozac- Fluoxetine

Question 10

What are side effects of SSRIs?

Answer 10

Few BUT, nausea, diarrhoea, agitation, insomnia, anorgasmia, inhibit metabolism of other drugs

Question 11

Give an example of TCAs?

Answer 11

Imiprimine

Question 12

What are side effects of Imiprimine?

Answer 12

Sedation, anticholinergic- dry mouth, constipation, blurred vision, urinary retention, postural hypotension, seizures, impotence, CNS depressant

Question 13

Give 2 examples of MAOs

Answer 13

Phenylzine- irreversible non competitive inhibitor and moclobemide- MAOa selective

Question 14

Where is MAOa and MAOb found?

Answer 14

MAOa- CNS, MAOb-CNS and PNS

Question 15

What are side effects of Phenylzine?

Answer 15

Cheese effect, hypotension, insomnia, weight gain, liver damage

Question 16

What is the function of the Noradrenergic pathways in the CNS?

Answer 16

Pain, arousal, mood, blood pressure

Question 17

What are drugs that specifically work on the reuptake of NA?

Answer 17

Reboxetine and Atomextine

Question 18

Where are alpha 1 and alpha 2 NA receptors? What do they do?

Answer 18

Alpha 1- somatic dendritic region, increase 5HT. Alpha 2 - presynaptic, inhibit 5HT release

Question 19

What are the functions of the seroternergic pathway in the CNS?

Answer 19

Hallucinations, sleep and wakefullness, mood and emotion, feeding behaviour, sensory pathways and nociception, body temperature, vomitting

Question 20

What do drugs acting on 5HT treat?

Answer 20

Depression, anxiety migraine, anti-emetic (chemotherapy), antipsychotic

Question 21

What is the cause of anhedonia?

Answer 21

5HT role in regulating limbic processing from normally pleasurable experiences

Question 22

Why do SSRIs cause worse symptoms then better?

Answer 22

Weak activation of 5HT receptors causes less 5HT release than as more activation the inhibitory receptors become desensitised and the 5HT release increases
5HT regulates levels of BDNF, activation of 5HT receptors increases cAMP levels which also desensitises inhibitory receptors so are cAMP, PKA, CREW, BDNF

Question 23

Where is low BDNF specifically observed?

Answer 23

In hippocampus

Question 24

What other methods are used to treat bipolar?

Answer 24

Lithium, anti epileptic drugs, electroconvulsive therapy

Question 25

How does Lithium treat bipolar?

Answer 25

Permeates Nav channels, inhibits inositol monophosphatase, AKT signalling and glycogen synthase kinase GSK3 signalling(involved in apoptosis)

Question 26

What does electroconvulsive therapy do?

Answer 26

Downregulates B receptors and upregualtes 5HT2 sites. Downregulates 5HT1A sites