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Brain and behaviour 2 > PBL 4: The Will to Live > Flashcards

PBL 4: The Will to Live Flashcards

1
Q

What is a mental state examination?

A 
Tool used by doctors to help make psychiatric diagnoses by evaluating:
Appearance.
- Behaviour.
- Speech and form of thought.
- Mood.
- Thought content.
- Cognition.
- Insight.
- Other psychotic symptoms.
- Perceptions
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2
Q

What is CBT?

A

Form of therapy which changes the way you think about situations

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3
Q

What is citalopram?

A

SSRI drug used to treat depression (selective serotonin reuptake)

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4
Q

What is mirtazapine?

A

NaSSA drug used to treat atypical depression (Noradrenergic and specific serotonergic antidepressant)

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5
Q

What are S+S of depression?

A 
Very low mood.
 Anhedonia; the inability to enjoy pleasure from activities.
 Self-hatred.
 Insomnia.
 Changes in appetite and/or weight loss.
 Reduced libido.
 Loss of motivation.
 Suicidal thoughts.
 Fatigue.
 Headaches.
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6
Q

How long must symptoms be present for to diagnose depression?

A

2 Weeks

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7
Q

What classifications of depression are there?

A

Subthreshold
Mild
Moderate
Severe

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8
Q

Risk factors of depression?

A 
 Older age.
 Unemployed.
 Other mental disorders.
 Drug abuse.
 Low socio-economic status.
 Certain professions.
 Trauma.
 Certain medication.
 Chronic illness.
 Genetics.
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9
Q

What genetic links are there to depression?

A

5-HTTLPR gene (serotonin transporter promotor)

CRHR1 - HPA axis gene

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10
Q

What is unipolar depression

A

Express only depression - no mania

Usually related to trauma

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11
Q

What is bipolar?

A

Express both depression and mania - occurs earlier than unipolar and genetically linked

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12
Q

What is the monoamine theory?

A

Depression is associated with decreased aminergic transmission

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13
Q

What evidence is there for monoamine theory?

A
  • 5-HTTLPR mutations have a link to depression.
  • Issues with dopamine transmission have been linked to depression.
  • Increased MOA activity has also been associated with depression.
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14
Q

What indicates more complex relationship in monoaine theory?

A

Antidepressants instantly restore amine levels but take weeks to work

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15
Q

What is delay of onset of drugs?

A

Desensitiation of autoreceptors e.g. 5HT1a as over time they will de-sensitize to drugs so will increase their firing rate again

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16
Q

What do tricyclic antidepressants do?

A

Inhibit reuptake of serotonin and noradrenaline as well as affecting H1 and A1 receptors

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17
Q

Give examples of tricyclic antidepressants

A

Amitrityline
Clomipramine
Imipramine

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18
Q

Side effects of tricyclic antidepressants?

A

Dry mouth
Blurred vision
Constipation
Postural hypotension

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19
Q

What do monoamine oxidase inhibitors do?

A

Inhibit action of MAO to increase neurotransmitter levels

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20
Q

What does MAOa do?

A

Break down serotonin, adrenaline and noradrenaline

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21
Q

What does MAOb do?

A

Break down dopamine and tyramine

22
Q

What are MAOIs linked to?

A

Cheese effect

23
Q

Give examples of MAO inhibitors

A

Phenelzine
Moclobemide
Isocarboxazid
Selegiline

24
Q

What is the cheese effect?

A

MAOIs inhibit breakdown of tyramine in gut + liver

25
Q

What happens if we have high levels of tyramine?

A

Release of catecholamines e.g. noradrenaline so headaches and hypertensive crisis

26
Q

What food must be avoided if taking MAOIs?

A

Food with tyramine

Cheese, cured meats + yeast extracts

27
Q

What do SSRIs do?

A

Increase level of serotonin in synaptic cleft

28
Q

What are side effects of SSRIs?

A

Nausea
GI upset
Headaches
Increased risk of suicide

29
Q

What do SSRI drugs include?

A 
Citalopram
Fluoxetine
Fluvoxamine
Paroxetine
Sertraline
30
Q

What do SNRIs do?

A

Inhibit reuptake of serotnin and noradrenaline by affecting transporters

31
Q

What are side effects of SNRIs?

A

Nausea
Headaches
Loss of appetite
Loss of libido

32
Q

Give an example of an SNRI

A

Venlafaxine

33
Q

What do NaSSAs do?

A

Block presynaptic A2 adrenergic receptors, h-HT2 and H1 receptors (autoreceptors and heteroreceptors)

34
Q

What happens if block H1 receptors?

A

Treat insomnia

35
Q

Why are NaSSAs preferred?

A

Specficity

36
Q

Give an example of an NaSSA

A

Mirtazapine

37
Q

What do noradrenaline reuptake inhibitors do?

A

Block noradrenaline transport to increase noradrenaline levels

38
Q

What else do noradrenaline reuptake inhibitors do?

A

Treat ADHD
narcolepsy
Obesity

39
Q

Side effects of noradrenaline reuptake inhibitors?

A

Nausea
Headaches
Loss of appetite
Loss of libido

40
Q

Give an example of an NRI

A

Reboxetine

41
Q

What is atypical treatment?

42
Q

How long should antidepressant drugs be continued for after remission?

43
Q

What happens if people stop taking antidepressants?

A

Discontinuation syndrome

44
Q

How does antidepressant drug continuation syndrome occur?

A

Taking medication for at least 4 weeks then stop

45
Q

Symptoms of discontinuation syndrome?

A 
Insomnia
Headaches
Agitation
Anxiety
Electric shock sensations
Confusion
46
Q

What is CBT?

A

Cognitive behavioural therapy - changes the way we think about something

47
Q

What is CVT?

A

Electroconvulsive therapy - induces seizures via electrical currents

48
Q

Which lobe is stimulated in CVT?

A

Frontal (short term)

Temporal (long term)

49
Q

What is deep brain stimulation?

A

Subcallosal cingulate gyrus stimulation to improve mood

50
Q

What are risk factors for suicide in depression?

A

 Male gender.
 Middle aged.
 Unemployed.

 Divorced.
 Low socio-economic status.
 Previous suicide attempt.
 Mental disorders.

51
Q

What have serious side effects and are dangerous in overdose?

A

TCAs and MAOIs

Brain and behaviour 2 (27 decks)

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