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BB2 > Mood Disorders and Antidepressant Drugs > Flashcards

Mood Disorders and Antidepressant Drugs Flashcards

1
Q

what is used to classify mental health conditions

A

DSM5

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2
Q

depressive disorders

A

disruptive mood dysregulation disorder
major depressive disorder - single+recurrent
premenstrual dysphoric disorder
substance/medication induced depressive disorder
depressive disorder due to another medical condition
other specified depressive disorder
unspecified depressive disorder

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3
Q

is bipolar disorder classified as a depressive disorder on DSM5

A

no

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4
Q

bipolar disorder

A

alternation of depressive episodes and mania

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5
Q

depression symtoms

A

psychomotor retardation
fatigue or energy loss
decr concentration
decr interest in social activity
agitation
depressed mood
guilt and worthlessness
suicidal ideation
insomnia or hypersomnia
weight loss and decr appetite
lack of interest
anhedonia

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6
Q

anhedonia

A

decr ability to experience pleasure

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7
Q

does depression have a possible genetic link

A

yes

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8
Q

which NT systems are associated with mood disorders

A

noradrenergic
seratonergic
possibly dopaminergic

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9
Q

brain regions associated with depression

A

amygdala
prefrontal cortex
striatum
hippocampus

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10
Q

how does metabolism and glucose consumption in the brain change with depression

A

decrease

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11
Q

which region of the brain has the most significant loss of grey matter volume and white matter volume in depression

A

grey - subgenual anterior cingulate cortex
white - hippocampus

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12
Q

how is cortex size effected by depression

A

decreased thickness

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13
Q

default mode network

A

network of brain regions active when brain is at wakeful rest

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14
Q

what is believed to cause pattern of negative and self reference thoughts in depression

A

increased connectivity within and of DMN

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15
Q

what type of NT signalling can be impaired by stress

A

glutamatergic

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16
Q

which brain areas are hyperactive in depression

A

hippocampus
amygdala
subgenual cingulate cortex
medial prefrontal cortex

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17
Q

what is the effect of hypoactivity in the venterolateral and dorsolateral prefrontal cortices

A

impaired cognitive control on other brain regions leading to rumination

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18
Q

classes of antidepressants

A

tricyclic
reversible+irreversible MOA inhibitors
SSRIs
serotonin noradrenaline reuptake inhibitors SNRIs
noradrenaline reuptake inhibitors NARIs
noradrenergic and specific serotonergic antidepressants NaSSA
serotonin antagonist and reuptake inhibitor SARI
agomelatine

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19
Q

tricyclic antidepressant mechanism and targets

A

inhibit amine reuptake
H1 histamine, muscarinic, alpha1+2 adrenergic, 5HT

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20
Q

what effects are caused by tricyclic antidepressant overdose

A

cardiotoxicity

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21
Q

tricyclic antidepressant adverse effects

A

dry mouth
blurred vision
constipation
urinary retention
narrow angle glaucoma
fatigue
sedation
weight gain
postural hypotension
dizziness
loss of libido
arrhythmia

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22
Q

monoamine oxidase inhibitor mechanism and targets

A

irreversibly inhibit monoamine oxidase
MOAa and MOAb

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23
Q

what type of depression are monoamine oxidase inhibitors used to treat

A

atypical - with anxiety, phobia, hypochondria

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24
Q

monoamine oxidase inhibitor interactions

A

tyramine containing food - mature cheese, pickled fish+meat, red wine, beer, broad beans, marmite
pethidine
sympathomimetic compounds

25
Q

what happens when a pt on MAO inhibitors eats tyrosine containing foods

A

pt cant inactivate tyramine -> tyramine accumulates and replaces noradrenaline -> hypotension

26
Q

MAO inhibitor adverse effects

A

hepatotoxicity

27
Q

SSRI mechanism

A

inhibit serotonin reuptake

28
Q

SSRI overdose effects

A

benign

29
Q

are reversible or irreversible MAO inhibitors safer

A

reversible

30
Q

reversible MAO inhibitor adverse effects

A

nausea
agitation
confusion

31
Q

are reversible MAOs selective for MAOa or MAOb

A

MAOa

32
Q

which receptors do NaSSAs and SARIs antagonise

A

NaSSA - 5HT2 + alpha2 adrenergic
SARI - 5HT2 + serotonin reuptake inhibition

33
Q

agomelatine MOA

A

agonist at MT1 and MT2 melatonin receptors and 5HT2c receptors

34
Q

what drug type are clomipramine, imipramine, desipramine, amitriptyline, nortriptyline, and protriptyline

A

tricyclic antedepressants

35
Q

what class of drug are phenelzine and tranylcypromine

A

irreversible MOA inhibitors

36
Q

what drug class are citalopram, fluoxetine, and paroxetine

A

SSRIs

37
Q

what drug class is moclobemide

A

reversible MAO inhibitor

38
Q

what drug type are venlafaxine and duloxetine

A

SNRIs

39
Q

what drug type is reboxetine

A

NARI

40
Q

what drug type of mirtazapine

A

NaSSA

41
Q

what drug type is trazodone

A

SARI

42
Q

how long is the delay of action between starting an antidepressant and mood improvement

A

2-3 weeks

43
Q

what causes delayed action onset of antedepressants

A

regulatory adaptations of neurones and autoreceptors to compensate for drug
effects occur once receptors desensitised

44
Q

why must antidepressants be discontinued very gradually

A

avoid antidepressant drug discontinuation syndrome

45
Q

antidepressant drug discontinuation syndrome symptoms

A

insomnia
anxiety
nausea
headaches
electric shock sensations
agitation
mood swings
diarrhoea
abdo cramps

46
Q

what is a bipolar mixed episode

A

symptoms of mania and depression that occur at the same time or in rapid sequence without recovery in between

47
Q

mood stabilisers

A

lithium
carbamazepine
sodium valproate

48
Q

when is lithium used

A

bipolar maintenance
acute mania
drug resistant depression

49
Q

function of which organs mist be tested before and during lithium treatment

A

thyroid
kidney

50
Q

lithium adverse effects

A

thirst
nausea
fine tremor
polyuria
weight gain
oedema
acne

51
Q

what can antidepressant drugs used in bipolar adversely lead to

A

manic episodes
mixed affective states
rapid cycling

52
Q

3 phases of depression treatment

A

acute - 6-12wks
continuation - 6mo after full symptoms control
maintenance

53
Q

drug resistant depression

A

lack of clinical response after at least 2 different antidepressants have been prescribes

54
Q

non pharmacological mood disorder treatments

A

electroconvulsive therapy
CBT
vagal nerve stimulation
deep brain stimulation
transcranial direct current and magnetic stimulation

55
Q

what type of depression is esketamine used for

A

treatment resistant

56
Q

esketamine MOA

A

NMDA glutamate receptor antagonist

57
Q

what type of depression is brexanolone used for

A

PPD

58
Q

brexanolone MOA

A

positive modulator of GABAa receptors

59
Q

how is brexanolone administered

A

IV

BB2 (26 decks)

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