Mood Disorders 2 Flashcards

Question

SSRI, SNRI and NRI unwanted effects

Answer 1

nausea, anorexia in many anorexia in some discontinuation syndrome in all anorgasmia increased aggression, suicide ideation and self harm possible in the early stages of treatment

Answer 2

flu like symptoms if you stop taking the drug suddenly, insomnia, motor and cognitive problems normally last like 1 to 4 weeks some people find it very difficult to deal with so doctors suggest that patients taper off the dose can occur in up to 50% of people

Answer 3

lack of sensitivity to sexual stimulation beneficial effect if you suffer from premature ejaculation (sometimes useful to treat men)

Answer 4

fluoxetine has a good benefit to risk ratio drugs increase suicide ideation, which can be dangerous as people may still feel depression in the early stages of treatment but have the energy to follow through on ideation

Answer 5

only after other treatments, like talking therapies, haven't worked

Answer 6

mAChR: important ANS H receptors: sedative effects 5HT receptors alpha1 adrenergic very dirty drugs

Answer 7

developed in 1950s first line treatment for MDD

Answer 8

largely by SSRIs and SNRIs

Answer 9

sometimes used as a last resort treatment for resistant MDD used at lower doses to treat difficult difficult to manage pain

Answer 10

many side effects high suicide mortality in overdose

Answer 11

amitriptyline, nortriptyline, imipramine

Answer 12

duloxetine and venlafaxine SSRIs such as citalopram and paroxetine can also produce significant withdrawal symptoms

Answer 13

the oppositional tolerance model

Answer 14

when a drug perturbates neurotransmitter systems, the brain will down or up regulate components of the system to try and oppose the actions of the drugs

Answer 15

partially due to a lack of transparency regarding clinical trials

Answer 16

a pharmaceutical only needs to submit 2 or 3 successful trials to the regulator they may have conducted many other clinical trials which have been unsuccessful in the past. Data from these trials have only rarely been published Makes it difficult to know how much bias has happened due to lack of reporting of unsuccessful trials

Answer 17

Noradrenergic and specific serotonergic antidepressant

Answer 18

mirtazapine

Answer 19

Antidepressant actions probably due to actions as an Antagonist of 𝛂2 adrenoceptors and 5HT2A, C receptors Highly sedating (H1 antagonist) has highest receptor affinity for H1 histamine receptors and this cause major sedating effect and increased appetite

Answer 20

appetite in crease sedation discontinuation syndrome has fewer side effects than many of the other drugs we've met generally very effective and well tolerated faster onset of action than other AD drugs

Answer 21

Find alpha 2 adrenoreceptors on presynaptic nerve terminals of serotonergic and noradrenergic neurons -function to inhibit neurotransmitter release via feedback inhibition -in serotonergic neurons they are responding to noradrenaline that has drifted in from neighbouring noradrenergic terminals Mirtazapine inhibits these receptors leading to an increased release of monoamines (S or N) Has an effect on postsynaptic 5HT2a2c receptors -These receptors seem heavily involved in mood and when they are overactive may contribute to depression and anxiety Additional effect: can be used to reduce nausea and vomiting Act as an antagonist of 5HT3 receptor -ligand gated ion channel, actions here produce antiemetic effects

Answer 22

esketamine and ketamine, psychedelic drugs and agomelatine

Answer 23

S-enantiomer of ketamine (which is racaemic) strong antidepressant effects in clinical trials occurs quickly (4 hrs after dose) nasal spray recently been licenced in the uk to treat depression

Answer 24

dissociative anaesthetic strong antidepressant effects in clinical trials effects occur quickly after administration administered intravenously effects of a single doses usually last at least 10 days -maintenance therapy would presumably involve a dose every two weeks

Answer 25

bladder dysfunction neuronal lesions

Answer 26

related to their actions as non competitive antagonists of NMDA? how this links to depression is unclear

Answer 27

act to resolve depression much quicker than conventional antidepressants -many see improvements in one week legal restrictions on lsd, psilocybin and MDMA make it difficult to see how these could be licenced in the UK `

Answer 28

moderately potent agonist of 5HT receptors main mechanism of action as a melatonin receptor agonist approved in europe for the use of MDD treatment in 2009 may also give some benefits in anxiety disorders

Answer 29

mood stabilising drugs prevent swinging between depressed and manic mood

Answer 30

lithium anticonvulsant: e.g., lamotrigine and valproate olanzapine (antipsychotic)

Answer 31

if already on mood stabilising drug then increase its dose antipsychotic. e.g., olanzapine or quetiapine -on top of mood stabilising drug or stand alone -may add lithium or valproate

Answer 32

add olanzapine and fluoxetine, or olanzapine/ quetiapine to existing drugs if someone is on an antidepressant and they present with mania there is a good chance it was precipitated by the antidepressant. They should be taken off immediately

Answer 33

inhibition of teh IP3 pathway changes neurotropic factors inhibition of glycogen synthase kinase - 3 modulation of cAMP signalling

Answer 34

narrow therapeutic window - need to monitor plasma levels lots of adverse effects

Answer 35

NRIs ketamine opioids drugs acting via GTC mechanisms

Answer 36

group physical activity cognitive behavioural therapy CBT for more severe forms of depression

Answer 37

done using anaesthetics and muscle relaxants can be highly effective and produces a rapid resolution of depression in many patients and can also be used for bipolar disorder and schizophrenia (mainly for catatonia)

Answer 38

most common: memory loss. -Usually transient, but for some people it can last a long time or even be permanent. short term effects nausea and loss of appetite, a headache confusion/drowsiness. longer term cognitive problems such as difficulty concentrating and assimilating new information blunting of their emotional responses.

Answer 39

introducing a young animal into a cage with a dominant older male rat subjecting the animals to chronic unpredictable mild stress was such as illuminating the cage at night, withholding food and water or tilting the cage. Measures of depression in these models can be things like loss of interest in pleasurable stimuli such as sweetened water. placed in a stressful situation from which it cannot escape. For example, being suspended by its tail or placed in a beaker of water from which it cannot escape. These situations can induce a condition called "learnt helplessness" or "behavioural despair". Essentially, the animal will struggle or swim for a while before it becomes hopeless and passive and accepts the stress. The time that the animal spends struggling/swimming and the time it spends immobile is a measure of how "depressed" it is.