Depression Anxiety aka Carter Flashcards
T/F Treatment usually works on the first option
FALSE DUHHHHHH
What are the symptoms of major depression
sad, anxiety
angry, loss of interest
issues with sleep
low appetite
What are the symptoms of generalized anxiety
worry, overthink
indecisive
sweat, trouble with sleep, fatigue, tremble, nervous
What is the serotonergic pathway
5 HT produced in brainstem (raphe nuclei) from tryptophan
depolarize (inward Na and Ca)= releases into synapse
bind to receptor
What does serotonin do
NOT require just modulates the extent**
mood, happiness, sleep, and loss of appetite via 5HT2c
platelets= 5HT1 release NO for dilate 5HT2 is aggregate and constrict
gi stim
What does hippocampus do
memory and learn
What does amygdala do
emotion and fear
What is the monamine Hypothesis of depression
deplete of monoamine (NorE(energy), serotonin (appetite, dopamine(motivation))= depression or anxiety
What is the neurotropic cause of depression
low BDNF which regulates neural plasticity and genesis
Stress and pain lower this
What effects amount of BDNF
low testosterone= decrease
high cortisol=decrease
low estrogen= decrease
Why do antidepressants have lag time
takes time to make BDNF and for it to causes neuronal genesis
What drugs affect serotoninergic signalling
reserpine, triptans
MAOis
SSRI/SNRI/tricylines
antipsychotic
antiemetics
buspirone
How does reserpine effect serotonin
stops serotonin accumulation
How does triptans effect serotonin
agonist on 5HT1d/b for lower pain
How does MAOi’s effect serotonin
stop breakdown of ALL monoamines
How does antiemetics effect serotonin
block 5HT3
What are the SSRI drugs
oprams, fluoxetine
How do SSRIs work
inhibit reuptake (SERT)
S/e of SSRIs
insomnia, anxiety, lower libido, Gi
Which SSRI is a no no in pregnant people
paroxetine
Whats different between SSRI and SNRI
SNRI= also does norepinephrine through NET
S/e of SNRIs
HTN, insomnia, aniety, lower libido, Gi
What are the SNRIs
faxine’s
acipran’s
What are the serotonin receptor antagonists?
Nefazodone, mirtazapine, minserin
When to use serotonin receptor antagonists
if insomnia is present BUT has less efficacy but if used in combo it is synergistic
S/e of SRA’s
HTN, drowsy**
S/e of SRA’s
HTN, drowsy**
What else is buprpion good for
smoking cessation
MOA of bupropion
inhibits NET, DAT and VMAT = increase NorE and dopamine
does NOT increase serotonin
s/e of bupropion
HTN, tachycardia, insomnia, aggressive, anxiety, gi, seizure
MOA of TCAs
inhibit SERT and NET but also acts on H1 and alpha, Muscarinic= lots of s/e
Why does TCA need dose adjustment
cyp2d6= different in certain people
s/e of TCAs
HTN, tachycardia, dry mouth, urine retend, sedate, insomnia, lower libido, weight, anxiety
Why arent MOAis used anymore
high toxicity because it increases all monoamines( top, NorE, 5HT) and lots of drug interactions
irreversible inhibitors
some people metabolize them slowly
How do benzodiazepines work
bind to GABA and hyperpolarize it
What are the benzos
epam’s
S/e of benzo’s
addictive and sedating
How does buspirone work
partial agonsit of 5HT-1= more serotonin release
NOT addictive or antipsychotic
