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BMSC2223 Neuropharmacology > Depression > Flashcards

Depression Flashcards

1
Q

What are the symptoms of major depressive disorder?

A 
Low mood
Loss of pleasure
Disruption of appetite, sleep and concentration
Fatigue
Negative self concept
Recurrent thoughts of death
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2
Q

What is reactive depression?

A

Depression that has an identifiable cause e.g. loss of a loved one

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3
Q

What is endogenous depression?

A

Depression that has no identifiable cause

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4
Q

What are the symptoms of mania?

A 
Excessive reactions
Excessive motor activity
Irritability
Anger
Impatience
Grandiose illusions
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5
Q

What may cause depression?

A

High adrenocorticotrophic hormone release
Changes in REM sleep
Lack of neurogenesis and increases neural apoptosis

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6
Q

Describe the monoamine hypothesis and what supports it

A

Depression is the result of decreased amines such as noradrenaline, serotonin and dopamine
This is supported by antidepressant effects

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7
Q

What is the mechanism of monoamine oxidase inhibitors?

A

They inhibit monoamine oxidase to increase release of NA, DA and 5-HT

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8
Q

What are side effects of monoamine oxidase inhibitors?

A

Hypomania, atropinic effects, hepatotoxicity and hypertension

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9
Q

Give an example of a monoamine oxidase inhibitor

A

Phenelzine
Tranylcypromine
Clorgyline
Moclobemide

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10
Q

Which monoamine oxidase inhibitors are non-selective for either MAO type?

A

Phenelzine and tranylcypromine

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11
Q

Which monoamine oxidase inhibitors are selective for MAO type A

A

Clorgyline and moclobemide

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12
Q

Which isoform of MAO breaks down which amine?

A

MAO-A breaks down 5-HT

MAO-B breaks down NA and DA

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13
Q

Describe the cheese effect

A

Cheese contains high amounts of tyramine which is no longer digested by MAO in the gut when MAOIs are taken. As tyromine is a precursor for catecholamines, this results in high levels of noradrenaline causing a sympathomimetic effect

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14
Q

Why should someone taking MAOIs not be prescribed pethidine?

A

Pethidine’s metabolite of norpethidine is not broken down which caused hyperpyrexia and hypotension

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15
Q

Describe the mechanism of tricyclic antidepressants

A

Non-selective inhibition of NA and 5-HT reuptake to increase functional availability

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16
Q

What are side effects of tricyclic antidepressants?

A

Atropinic effects, sedation, hypotension, cardiotoxicity, dysrhythmia and analgesia

17
Q

Describe the mechanism of SSRIs

A

Selective inhibition of serotonin reuptake and desensitisation of serotonin autoreceptors

18
Q

Give an example of a tricyclic antidepressant

A

Imipramine, amitriptyline, clomipramine, lofepramine

19
Q

Which of the tricyclic antidepressants have fewer side effects

A

Clomipramine and lofepramine

20
Q

Give an example of an SSRI

A

Fluoxetine, sertraline, paroxetine

21
Q

Which drugs may be given to treat bipolar depression?

A

Lithium carbonate or antipsychotics

22
Q

What is the mechanism of lithium carbonate?

A

Lithium mimics the action of sodium to cause depolarisation, but isn’t removed by the Na/K/ATPase which increases NA and 5-HT turnover but decreases release
It also reduces IP3 and cAMP production to decrease cellular signalling

23
Q

Why is lithium carbonate difficult to dose?

A

It takes a very long time to be excreted but has a narrow therapeutic window

24
Q

What are side effects of lithium carbonate?

A

Polyuria and thirst, hypothyroidism, weight gain and nausea

25
Q

What is the mechanism of tetracyclic antidepressants?

A

Blocks presynaptics alpha-1 adrenoreceptors so NA cannot block its own release

26
Q

Give an example of a tetracyclic antidepressant

A

Mianserin, mirtazapine

27
Q

What is the mechanism of SNRIs

A

Selectively inhibits reuptake of both 5-HT and noradrenaline

28
Q

Give an example of an SNRI

A

Venlafaxine, duloxetine, naltrexone

29
Q

What other treatments are available to treat depression?

A

Counselling

Electroconvulsive therapy

BMSC2223 Neuropharmacology (6 decks)

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