Depression Flashcards
monamine theory of depression
result of functionally deficient monoaminergic transmission in the brain i.e. NA and 5HT neurotransmitters
Increase of these would increase mood
3 drugs types that inhibit monoamine uptake
non-selective NA/5HT uptake inhbitors
Selective Serotonin Reuptake inhibitors
Selective NA uptake inhibitors
MOA of tricyclic antidepressants
- Block NA and 5HT transporter proteins
2. Block M, H and 5HT receptors
Side effects of tricyclic antidepressants
Constipation urine retention blurred vision dry mouth postural hypotension due to interaction with muscarinic receptors on smooth m, cardiac muscle and secretory glands
tricyclic antidepressants Toxicity
excitement, delirium, coma and respiratory depression + cardiac dysrhythmias
What drug interactions of TCADs should be considered
- promote effect of alcohol and anti-hypertensives
2. do not give TCADs with MAOinhibitors
1st line tx for anxiety
eg
SSRIs
citalopram, fluoxetine/prozac
MOA of SSRIs
inhibit 5HT uptake
Reason for reduced compliancy with SSRIs
initial period of hyperactivity / agitation
takes time to reach anti-depressant effects
-> contraindicated for someone with suicidal idealisation
SE of SSRIs
nausea
insomnia
anorexia
loss of libido
tremor, hyperthermia, CV collapse
Serotonin Syndrome
rest of SSRI combined with MAOIs
MAOIs are selective for what enzyme
moa?
MAOa which is the enzymes that primarily degrades 5HT
=> MAOIs reduces the degradation of 5HT
some impact on stopping NA and DA degradation but less so
Iproniazid is a
irreversible MAOI
Meclobamide is
reversible MAOI
Side effects of MAOIs
hypotension atropine-like effects wight gain CNS stimulation hepatotoxicity!!