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PSY 363 > (Exam 3) Antidepressants > Flashcards

(Exam 3) Antidepressants Flashcards

1
Q

purpose of ADs?

A

alleviate distress of clinical depression, relieve anxiety; improve quality of life; repair neuronal damage

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2
Q

adverse side effects of ADs

A

sexual dysfunction, weight gain, cog effects, suicidal ideation

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3
Q

what type(s) of depression do ADs work best for?

A

moderate-severe

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4
Q

symptoms of MDD

A

affective disorder with alteration of emotion/mood, anhedonia, insomnia, fatigue, no energy, feelings of worthlessness, excessive guilt, thoughts of death or suicide

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5
Q

severe depression symptoms

A

psychosis, loss of touch with reality

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6
Q

what is dysthymia

A

relatively mild but persistent symptoms

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7
Q

what is the classic theory of MDD?

A

deficiency in 5-HT, NE, and DA; restoration to normal mood state involved increasing NT activity (2 weeks longer for effect); delay in clinical effect due to changes in Rs

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8
Q

neurogenic theory?

A

neurons are able to repair or remodel themselves; brain is capable of neurogenesis

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9
Q

what does MDD do to neurons?

A

MDD damages neurons + decreases neurogenesis

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10
Q

what does BDNF stand for

A

brain derived neurotrophic factor

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11
Q

pathophysiology of MDD

A

depression is consequence of environmental + cellular stress

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12
Q

what does stress do to the brain?

A

stress damages the brain and weakens its ability to recover

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13
Q

what do ADs do to neurons?

A

AD drugs may repair neurons + increase neurogenesis; promote neuronal survival

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14
Q

what is the immediate effect of ADs?

A

modulate synaptic levels

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15
Q

what is the ultimate target for ADs?

A

intracellular molecules for maintenance of neuronal health and plasticity

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16
Q

short term MOA of ADs

A

increase 5-HT and NE

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17
Q

long term MOA of ADs

A

decrease in R function but increase in BDNF

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18
Q

what does an increase in BDNF cause?

A

increase in neuro- and synaptic protection/function

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19
Q

MDD effects on hippocampus

A

chronic stress=decreased BDNF (causes atrophy/death of neurons)

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20
Q

what does TCA stand for

A

tricyclic antidepressant

21
Q

what does MAOI stand for

A

monoamine oxidase inhibitor

22
Q

what does SSRI stand for

A

selective serotonin reuptake inhibitor

23
Q

what does SNRI stand for

A

selective norepinephrine reuptake inhibitor

24
Q

what is the monoamine hypothesis of mania and depression?

A

depression is a deficiency of DA, NE, and 5-HT; mania is excess

25
Q

which ADs are classified as first-gen?

A

TCAs, MAOIs

26
Q

why are TCAs called tricyclic?

A

they have a 3 ring molecular core

27
Q

MOA of TCAs

A

block presynaptic NE and 5-HT reuptake; block H and Ach Rs

28
Q

TCAs account for what 2 pharmacological actions?

A

therapeutic and side effects

29
Q

what are the 3 clinical limitations to TCAs?

A

slow onset, significant side effects, and overdose = cardiotoxic and potentially fatal

30
Q

what are efficacy problems with MAOIs?

A

use limited by interactions

31
Q

what kinds of interactions occur with MAOIs?

A

adrenaline-like drugs (nasal sprays, asthma, cold meds); foods with tyramine (high-protein foods: cheeses, pickled + fermented liquids, foods, sauces)

32
Q

are MAOIs as safe as SSRIs?

A

yes

33
Q

MAOIs may work in pts who respond poorly to what?

A

TCAs and/or SSRIs

34
Q

MAOIs are tx for what disorders?

A

MDD, BPD, dysthymia, panic, and phobia

35
Q

what do SSRIs do?

A

block presynaptic transporter for 5-HT reuptake

36
Q

what are concerns with SSRI therapy?

A

Tx-resistant patient and serotonin syndrome

37
Q

when does serotonin syndrome occur?

A

after high doses or polypharmacy

38
Q

what are symptoms of serotonin syndrome?

A

altered cognition, behavioral alterations, autonomic, neuromuscular impairment

39
Q

when does serotonin syndrome resolve?

A

within 24-48 hours

40
Q

what happens if you increase activity at 5-HT1?

A

antidepressant + anxiolytic effects

41
Q

what happens if you increase activity at 5-HT2?

A

insomnia, anxiety, agitation, sexual dysfunction

42
Q

what happens if you increase activity at 5-HT3?

A

nausea

43
Q

what happens if you increase activity at 5-HT2 and 5-HT3?

A

adverse effects

44
Q

if you take an SSRI, what happens at 5-HT Rs? Which ones?

A

increased activity at all R types

45
Q

what are the side effects of SSRIs?

A

sedation, cog impairment, weight gain, sexual dysfunction, sleep disturbance, suicidal ideation in children + adolescents

46
Q

what do dual-action ADs do?

A

inhibit presynaptic reuptake of 5-HT and NE

47
Q

what did the STAR D study test?

A

the effectiveness of AD tx for MDD

48
Q

what did the STAR D study find?

A

no AD superior to others

49
Q

what were the specific results of STAR D?

A

2/3 of pts were able to achieve remission if they didn’t withdraw

PSY 363 (7 decks)

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