depressive disorder

Question 1

what is depression

Answer 1

severe or persistent enough to interfere with normal functioning
- depressed mood, psychomotor dysfunction, fatigue, decreased
interest or pleasure in activities

Question 2

what is the etiology of depression

Answer 2

• exact ‘cause’ is not well understood and likely involves multiple factors
• genetic (e.g. single nucleotide polymorphisms)
• altered neurotransmitter levels (monoamines)
• altered neuroendrocrine function
• psychosocial factors

Question 3

what is the Major depressive disorder

Answer 3

• depressive symptoms every day for two weeks
• at least 5 depressive symptoms from a list of 9, and must include
  depressed mood, or loss of interest or pleasure
• other symptoms include sleep disturbance, fatigue, suicidal thoughts

Question 4

what is the Persistent depressive disorder

Answer 4

at least two depressive symptoms persist for two years

Question 5

what is the interaction between the limbic system activity and cognitive control

Answer 5

there is reciprocal interconnection between the limbic system activity and the cognitive control as the limbic system activity increase the cognitive control decrease

Question 6

what is the anterior cingulate cortex

Answer 6

has connection to both the limbic area of the brain and the cortical brain network

Question 7

what are the cortical region

Answer 7

dorsaltral
ventromedial
ventrolateral

Question 8

what is the limbic system structure

Answer 8

thalamus
amygdala
hippocampus

Question 9

how do Tricyclic Antidepressants work

Answer 9

act by blocking reuptake of 5-HT and NE

Question 10

which receptors do the Tricyclic Antidepressants block

Answer 10

also bind and antagonize many other receptor targets: 5-HT (2A, 2C, 6, 7),
alpha1, NMDA, histamine H1 and H2, muscarinic acetylcholine

Question 11

what are the side effects of the Tricyclic Antidepressants

Answer 11

many more including anxiety, nausea, drowsiness, cardiac
(tachycardia and bradycardia)

Question 12

give me a name of the Tricyclic Antidepressants medication

Answer 12

clomipramine

Question 13

how do Monoamine oxide inhibitors (MOAIs) work

Answer 13

inhibit the oxidative deamination of 5-HT, NE, and DA

Question 14

give two medications that are MOAIs

Answer 14

Nardil ( phenelzine) and Manerix ( moclobemide)

Question 15

what is the hypertensive crisis in the MOAIs

Answer 15

when MOAIs are ingested along with food containing
tyramine or dopamine

Question 16

which medication is a new reversible MOAI that is selective for MOA-A

Answer 16

Manerix

Question 17

give some meds of SSRIs

Answer 17

fluoxetine (Prozac), sertraline, citalopram, escitalopram

Question 18

how does SSRIs work

Answer 18

(1) SSRI – increased amount of 5-HT in the synaptic cleft
(2) desensitization of the presynaptic 5-HT 1A autoreceptor
- increased 5-HT 1A autoreceptor in postmortem studies
- chronic SSRI treatment may downregulate these autoreceptors
(3) desensitization of the postsynaptic 5-HT 2A receptor
(4) anti-inflammation: downregulation of pro-inflammatory cytokines:
IL-1β, IL-6, interferon-γ, tumor necrosis factor α

Question 19

what is the The Inflammation Hypothesis

Answer 19

an imbalance to the interaction between the immune system and brain

Question 20

what are the evidences for the Inflammation Hypothesis

Answer 20

• major depressive disorder occurs more often with chronic inflammation
  (e.g. diabetes or rheumatoid arthritis)
• systemic administration of interferon-γ, or elevation to tumor necrosis
  factor α and IL-6, correlate with depressive symptoms
• in many cases, levels of these cytokines are increased in the
  cerebrospinal fluid of patients with major depressive disorder
• these same cytokines can upregulate the function of monoamine
  reuptake pumps such as the 5-HT transporter

Question 21

which neurotransmittors does Inflammation Hypothesis affects

Answer 21

an imbalance to
serotonin and
glutamate
neurotransmission

Question 22

what are SNRIs

Answer 22

similar to the tricyclic antidepressants, inhibit reuptake of 5-HT and NE
- very similar clinical efficacy and adverse effects as SSRIs
- some adverse effects (e.g. sexual dysfunction) may be milder

Question 23

give two meds of the SNRIs

Answer 23

effector ( venlavaxine), cymbalta ( Duloxetine)