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2=Neurobiology > L4. Anxiety and depression > Flashcards

L4. Anxiety and depression Flashcards

1
Q

3 categories of depressive disorders

A
  1. persistent DD
  2. major DD
  3. bipolar (1 and 2)
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2
Q

how many sxs need to be present for MDD and for how long

A

5sxs (1 must be depressed mood or loss of interest/pleasure)
2 weeks - every day

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3
Q

name 5 sxs of MDD

A
  1. depressed mood
  2. loss of interest/plesure
  3. insomnia/hypersomnia
  4. weight loss/weight gain
  5. indecisiveness/confusion
  6. fatigue
  7. feelings of worthlessness/inappropriate guilt
  8. recurrent thought of death, suicide (suicide attempt)
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4
Q

how many sxs need to be present for PDD and for how long

A

2+depressed mood = 2 years

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5
Q

5 sxs of PDD (ex depressed mood)

A
  1. poor appetite/overeating
  2. insomnia/hypersomnia
  3. feelings of hopelessness
  4. fatigue
  5. low self-esteem
  6. poor concentration
  7. indecisive
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6
Q

general definition of bipolar disorder

A

phases of depression combined with phases of mania

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7
Q

what is bipolar 1 disorder?

A

rapid daily cycling episodes of mania + depression

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8
Q

what is bipolar 2 disorder?

A

recurrent depression + hypomanic episde

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9
Q

main sxs of manic episode

A

abnormal + persistent elevated or irritable mood

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10
Q

how long must a manic episode last for

A

> 1 week

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11
Q

how many other sxs must be present for manic episode diagnosis

A

3 - 4 if irritability is present

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12
Q

5 sxs of manic disorder

A
  1. inflated self-esteem
  2. decreased need for sleep
  3. more talkative
  4. thoughts are racing in head
  5. distractibility
  6. increase in goal-directed actvity
  7. excessive involvement in activities with high potential for painful consequences
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13
Q

what does the monoamine hypothesis suggest depression is caused by?

A

reduction in NA and 5-HT (serotonin) centrally and at synapses

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14
Q

5 classes of antidepressants

A
  1. MAOI
  2. TCAs
  3. SSRIs
  4. SNRIs
  5. mood stabilisers
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15
Q

how do MAOIs work?

A
  1. increase cytoplasmic levels of MA
  2. increased uptake of 5-HT and NE in synaptic vesicle
  3. leakage of MA into extracellular space
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16
Q

what is MA?

A

NT involved in mood

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17
Q

side effect of MAOIs

A

cheese effect - avoid high tyramine diet - MA usually break this down. leads to high BP

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18
Q

1 example of MAOIs

A
  1. phenelzine

2. moclobemide

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19
Q

how do TCA work?

A
  1. block 5-HT + NE reuptake transporters
  2. inhibits reuptake fo 5HT from ECS
  3. leaves more 5HT in synapse
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20
Q

1 example of TCA

A

amitryptaline

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21
Q

how to SSRIs work?

A

inhibt reuptake of 5HT

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22
Q

2 examples of SSRIs

A

sertraline

fluoexteine

23
Q

which have a faster duration of action; SSRIs or SNRIs ?

24
Q

2 examples of SNRIs

A
  1. venlafaxine

2. duloxetine

25
who are mood stabilisers most effective in?
bipolar pt
26
2 examples of mood stabilisers
1. lithium | 2. carbamezepine
27
which atypical antidepressant has reduced SE compared to TCAs and SSRIs
NA and specific serotonergic antidepressants
28
1 example of NA and specific serotonergic antidepressants
mirtazapine
29
what is Zyban/bupropion used for (2)?
1. smoking cessation | 2. DA reuptake inhibitor - antidepressant
30
according to NICE guidelines, what is the 1st line of treatment for depression?
CBT
31
generalised anxiety disorder occurs when there is excessive anxiety for how long?
>6m
32
how many sxs required for GAD diagnosis
3
33
list 5 sxs of GAD
1. restlessness/on edge 2. easily fatigued 3. difficulty concentrating 4. irritability 5. muscle tension 6. sleep disturbance
34
describe onset of panic disorder
sudden - within 10 mins
35
2 essential diagnostic criteria for panic disorder
1. intense fear/discomfort | 2. 4+ somatic or cognitive sxs
36
list 5 somatic or cognitive sxs for panic disorder
1. palpitations, pounding heart, accelerated HR 2. sweating 3. trembling, shaking 4. sob 5. feeling of choking 6. chest pain or discomfort 7. nausea or abdo distress 8. dizziness, lightheaded 9. derelisation/depersonalisation 10. fear of losing control 11. fear of dying 12. paraethesia 13. chills/hot flushes
37
what is social phobia
persistent fear of social/performance situations in which embarassment may occur
38
3 diagnositic criteria for social phobia
1. persistent fear of social settings 2. fear provokes panic attack 3. recognition that the feat is excessive or unreasonable
39
what is agoraphobia
anxiety/avoidance of places or situations which may be difficult or embarrassing
40
2 brain abnormalities in pt with anxiety disorder
1. size of brain | 1. neural activity
41
what is CBT used for
social anxiety
42
short term drug used for anxiety disorder
benzodiazepine
43
1st line of drug treatment for anxiety disorder
SSRIs
44
example of SSRIs
fluoxetine, sertraline
45
2nd line of drug treatment for anxiety disorder
SSRIs and SNRIs
46
3rd line of drug treatment for anxiety disorder
pregabalin
47
3 classes of benzodiazapines (BZ)
1. long acting 2. intermediate/short acting 3. ultra-short acting
48
duration of action of intermediate/short acting BZ
5-24 hrs
49
example of long acting BZ
diazepam
50
site of action in brain of BZ
limbic system
51
why must BZ be gradullay reduced and discontinued
prevent discontinuation syndrome
52
how do BZ work on GABA receptors?
Cl- influx, hyperpolarisation
53
in addition to anxiety disorders, what else are BZ used to treat?
alcohol withdrawl
54
4 adverse effects of BZ
1. drowsiness 2. vertigo 3. cognitive impairments 4. aggression

2=Neurobiology (6 decks)

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