Mood Disorders Flashcards
1
Q
depressed mood, loss of interest, enjoyment, guilt, altered sleep and eating, suicidal thoguhts
- etiology: spontaneously, life events
- deficits in noradrenergic or sertotonergic neurotransmission
A
depression
2
Q
- periods of depression alternating with periods of mania or hypomania
- increased activity, decreased need for sleep, racing thoughs, elevated mood or irritability, increased self esteem, grandiose ideation
- treat w/ mood stabilizing agents and antidepressants or antipsychotics as needed
A
bipolar disorder
3
Q
- treatment of depressive symptoms resulting in euthymia
- should not elevate mood in non depressed people
- 4 classes: MAOIs, TCAs, SSRIs, miscellaneous
A
antidepressants
4
Q
- increased synaptic availability of norepi and serotonin
- several wks of treatment required before max effects achieved
- ultimate effect due to secondary changes in receptors, increases in BDNF in hippocampus and its sequelae, cognitive changes
A
mechanism of antidepressants
5
Q
phenelzine and tranylcypromine
A
MAOIs
6
Q
increase synaptic availability of norepi and serotonin by blocking their catabolism, irreversibly inhibit a and b subtypes, used primarily in individuals not adequately treated by other antidepressants
A
MAOIs (phenelzine, tranycypromine)
7
Q
- postural hypotension, weight gain, agitation, sexual dysfunction
- overdose can cause seizures, shock, delirium, hyperthermia, but not fatal
- potentiate the action of other sedatives such as alcohol
- drugs interactions, serotonin syndrome esp w/ SSRIs
- food interactions –> hypertensive crisis
- precautions for 2 wks because of irreversible inactivation
A
MAOIs overdose, side effects
8
Q
amitriptyline, nortriptyline, clomipramine
A
tricyclic antidepressants
9
Q
- inhibit the reuptake of norepi and serotonin at the NE and 5-HT transporters
- potent agonist of cholinergic, histaminergic and alpha adrenergic receptors
A
Tricyclic antidepressants
10
Q
- sleepiness
- sympathomimetic (tremor, insomnia)
- anticholinergic
- orthostatic hypotension
- arrhythmias
- seizures, weight gain
- sexual dysfunction
- discontinuation syndrome
A
TCAs side effects
11
Q
- suicide risk
- coma, respiratory depression, delirium
- arrhythmias
- seizures
- hyperpyrexia
- bowel and bladder dysfunction
- cardiac defects
- adverse interactions with MAOIs
A
TCAs
12
Q
fluoxetine, sertraline, paroxetine, citalopram, escitalopram
A
SSRIs
13
Q
inhibit serotonin reuptake, can inhibit reuptake of norepi at higher doses
A
SSRIs
14
Q
- anxiety, insomnia
- sleepiness, fatigue
- tremor, GI symptoms
- rashes, weight loss or gain
- decreased libido
- sexual dysfunction
A
SSRIS
15
Q
- low risk of fatal overdose
- discontinuation syndrome (with short half lives and antimuscarinic)
- adverse drug rxns with MAOIs –> serotonin syndrome
- CYP2D6 and 3A4 inhibitors
- active metabolites inhibit 2D6 and 3A4
- in pregnancy pulm HTN in newborn, enters breast milk
A
SSRIs
