Neurological Diseases Depression Flashcards

1
Q

what is depression characterised by

A

major depressive disorder
misery
low self esteem
worthlessness
loss of motivation and energy
weight or appetite alterations
insomnia
suicide risk

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2
Q

what factors contribute to depression

A

genetic factors although gene as yet unknown
trauma, life events, abuse, illness

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3
Q

when were antidepressants first introduced

A

in the 1950s, not originally designed for depression

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4
Q

what is iproniazid

A

a drug with anti depressant activity
originally used to treat tuberculosis
inhibits activity of monoamine oxidase

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5
Q

what term was used for antidepressants originally

A

mono amine oxidase inhibitors (MAOIs)

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6
Q

what is MAO and how what does it do

A

mono amine oxidase breaks down neurotransmitters in the synaptic cleft

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7
Q

what is imipramine

A

a drug, discovered in the 50s, antidepressant properties were incidental
tricyclicantidepressent
inhibits neurotransmitter reuptake in presynaptic cell

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8
Q

what is the monoamine deficiency hypothesis

A

lack of monoamine neurotransmitters
symptoms improved by increase in synaptic concentration of monoamines

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9
Q

what neurotransmitters moderate depression in the monoamine deficiency hypothesis

A

5ht(hydroxytriptamine)
noradrenaline
dopamine

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10
Q

what are the modes of action in the monoamine hypothesis treatment

A

inhibition of monoamine reuptake
inhibition of nt breakdown

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11
Q

what are some theories as to why nt loss is present in the ma theory of depression

A

increased activity of mao
loss of function in ma synthases
altered sensitivity

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12
Q

what is reserpine

A

drug used to treat hypertension
observation showed it induced a depression like syndrome
empties nerve terminals of monoamine nts
used for animal model of depression

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13
Q

what is an issue with the monoamine hypothesis

A

likely an oversimplification

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14
Q

what are some treatment types for depression

A

medication
psychotherapy

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15
Q

what are the three main classes of antidepressant

A

monoamine oxidase inhibitor
tricylic reuptake inhibiors
selective serotonin reuptake inhibitors

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16
Q

what are some drugs(plural) used for MAOI inhibition

A

iproniazid
phenelzine
tranylcypromine
moclobemide

17
Q

what are some issues with MAOIs

A

iproniazid 1960, causes hepatic toxicity
cheese effect: red wine and cheese tryamines not metabolised
inhibits both maoi a and b irreversibly
lower efficacy than TCAs

18
Q

whatis the function of tcas

A

inhibit nt reuptake
increases concerntration in the synaptic cleft
unwanted side effects

19
Q

how are ssris different from maois and tca

A

designed specifically to target serotonin reuptake transporter

20
Q

what are some examples of ssri drugs

A

fluoxetine
citalopram
fluoxamine

21
Q

what is a major limitation of antidepressants

A

delayed onset of action
can take several days for effect to be observed

22
Q

what is autoreceptor desensetisation

A

autoreceptors adapt to increased levels of nts
increased concentration causes desensitization and downregulation of post synaptic receptors