Lecture 19 - Cognitive Disorders (Depression) Flashcards
characterized by one or more major depressive episodes
major depressive disorder (MDD) (according to the DSM-IV)
what makes bipolar disorder different from major depressive disorder?
manic episodes are observed in bipolar disorder (according to the DSM-IV)
with the transition to the DSM-V, diagnosis of depression now involves:
an added specifier “with mixed features”
a distinct period of abnormal persistent elevated, expansive, or irritable mood, lasting at least one week (or any duration if hospitlaization is necessary)
mania
what are the symptoms of mania?
- inflated self esteem or grandiosity
- decreased need for sleep
- very talkative
- flight of ideas or racing thougths
- distractability
- increase in goal-directed activity
- excessive involvement in pleasurable maladaptive activities
how many symptoms of mania are normally present during a manic episode?
three or more
what are the three diagnostic criteria for depression?
- prescence of one or more episodes
- not accounted for by another specific disorder
- there have never been any episodes of manic or mixed mood states before
a depressive episode is over if no occurence of depressed mood is present for:
two months
what is the lifetime risk of depression for men and women?
- 10-25% for women
- 5-12% for men
what is the point prevelance of depression for men and women?
- 5-9% for women
- 2-3% for men
does depression have a genetic component?
there is evidence from family and twin studies, but no clear genetic markers yet
true or false: depression may follow a maternal heritability pattern
true
having a first degree relative with depression increases your risk of developing depression by:
1.5-3x
what is the average age of onset for depression?
the mid-20s
the highest rates of depression occur in the _____ age range
25-44
what is the major treatment for depression?
psychotherapy, drug therapy, and light therapy (particularly for SAD)
what are some new and emerging treatments for depression?
psychedelics and repetitive transcranial magnetic stimulation (rTMS)
according to the biogenic amine hypothesis, depression is caused by an:
amine neurotransmitter deficit (partilarly 5-HT and noradrenaline)
for major depressive episodes a range of drugs is effective. in general these compounds act to:
increase noradrenaline (NA) and/or 5-HT
typically, antidepressant drugs block _____ or decrease _____ of noradrenaline and/or 5-HT
reuptake, enzymatic degredation
true or false: it takes several weeks to see a clinical effect of antidepressants
true
do you remember the placebo effect?
bitch that horse is a bloody pulp by now
in patients who respond to drug and are switched to placebo, ____ will retain their gains while ____ will become depressed again within the year
50%, 50%
go review slide 590
I name you my Uruk-Hai, to whom do you serve?
since the mid 1970s theories have linked the emergent effects of antidepressants to:
changes in receptor expression as a function of chronic drug treatment
the major receptors of interest for drug treatment have been:
beta-NA and 5-HT receptors
early antidepressent drugs were:
monoamine oxidase (MAO) inhibitors
tricyclic drugs were effective at treating depression and shown to be:
reuptake inhibitors
give an example of a MAO inhibitor
phenelzine
give an example of a tricyclic antidepressant
imipramine
both MAO inhibitors and tricyclics induce many:
unwanted side effects
a selective 5-HT uptake inhibitor
fluoxetine (prozac)
suicide is associated with low CSF levels of:
the 5-HT metabolite 5-HIAA
a terminal autoreceptor that hyperpolarizes the membrane and inhibits neurotransmitter release
5-HT 1B/D
a noradrenergic receptor that leads to hyperpolarization of the membrane
alpha-2
review slide 595
the horn of Gondor
list two important 5-HT pathways in the human brain
rostral raphe nuclei and the caudal raphe nuclei
list two important NA pathways in the human brain
the locus ceruleus and the lateral tegmental noradrenergic cell system
review slide 599
im just hoping some of that knowledge will sink in
nowadays, _____ is proposed as the basis for therapeutic antidepressant drug action
increased 5-HT neurotransmission in the forebrain
increased NA transmission in the forebrain may be effective in treating depression due to:
interactions between NA and 5-HT
early treatment with antidepressants may decrease:
amine availability
increased 5-HT neurotransmission follows as a result of downregulation of _____ that normally inhibit 5-HT transmission
5-HT 1A/B receptors
increased NA transmission may be effective because of ____ that normally inhibit 5-HT transmission
downregulation of NA alpha-2 receptors
review slide 602
i feel like i just wrote that shit down
a non-invasive technique for focal brain stimulation
transcranial magnetic stimulation (TMS)
