Exam 7: Mood disorder pharmacology Flashcards
Describe depression
Intense sadness, pessimistic worry, agitation, somatic concerns, sleep and eating disturbances, loss of drive, enthusiasm and libido, mental slowing
Describe mania
amplified energy, extremely elevated mood, rapid speech, racing thoughts, decreased need for sleep, hypersexuality, grandiosity, excessive interest in goal-directed activities
What is the hypothesis of the cause of depression?
changes in serotonin and norepinephrine signaling in brain, especially if they are deficient or receptors are insensitive
What are the two drug classes for treatment of mood disorders?
Antidepressants, Mood stabilizers
What are the drugs classified as antidepressants?
Tricyclic antidepressants, monoamine oxidase inhibitors, selective serotonin reuptake inhibitors, dual-mechanism drugs
What are the drugs classified as mood stabilizers?
lithium carbonate, anticonvulsants, atypical antipsychotics
What are the clinical effects of TCAs in depressed subjects?
elevation of mood after 2-3 weeks
What are the neurochemical effects of TCAs?
Block the reuptake of NE and 5-HT by nerve terminals, resulting in higher concentration of NT at receptors`
What TCA is NE-selective?
Desipramine
What TCA has both NE and 5HT action?
imipramine
What two drugs, taken together, can lead to toxicity?
Fluoxetine and any TCA
What liver enzyme metabolized TCAs?
CYP2D6
What drug is classified under MAOIs?
Phenelzine (Nardil)
What are the neurochemical effects of MAOIs (phenelzine)
Irreversibly blocks the oxidative deamination of monoamines, non-selectively inhibits both MAO-A and MAO-B
What monoamines does MAO-A metabolize?
NE and 5HT
What monoamines does MAO-B metabolize?
DA
What class of drugs should not be started until at least 14 days following discontinuation of MAOI? Why?
SSRIs; MAOIs bind irreversibly, it takes a while before protein synthesis can catch up for MAOI function to come back to normal
What is serotonin syndrome?
hyperthermia, muscle rigidity, tremors, autonomic instability, confusion, irritability, and agitation