💊Pharmacology💊 - Depression Flashcards
What is the name of the depression questionnaire?
PHQ-9
(patient health questionnaire 9)
What is major depressive disorder?
Umbrella term for all degrees of depression (minor, moderate, severe)
What are the therapeutic objectives for a patient with moderate depression?
Alleviate depressive symptoms:
Improve mood
Help with sleep difficulties
Improve self-esteem
Improve ability to think clearly
What is the go-to pharmaceutical treatment for depression?
SSRIs
What are the most commonly prescribed SSRIs?
Sertraline
Citalopram
Fluoxetine
What is the mechanism of action of SSRIs?
Prevent re-uptake of serotonin from the synapse
Increases serotonin availability
What is a key side effect of citalopram?
Prolongation of the QT interval
Makes it unsuitable in certain individuals
Why does the therapeutic effect of SSRIs plateau after a certain dosage?
Receptors become saturated
SSRIs work by inhibiting the reuptake of serotonin (5-HT) into the presynaptic neuron, increasing the concentration of serotonin in the synaptic cleft
At a certain dose, the serotonin transporter (SERT), which SSRIs block to prevent serotonin reuptake, becomes fully saturated
Why is it important to wean a patient slowly off of one antidepressant when switching to another?
Risk of drug interactions, serotonin syndrome, withdrawal symptoms, or relapse
Washout required before starting new drug
What is the primary mechanism of action of sertraline?
Inhibition of serotonin reuptake results in accumulation of serotonin
Serotonin is key regulator of mood, personality and wakefulness
What is the primary mechanism of action of citalopram?
Inhibition of serotonin reuptake results in accumulation of serotonin
Serotonin is key regulator of mood, personality and wakefulness
Give an example of a drug that citalopram cannot be used with
Erythromycin
Both prolong the QT interval
Severe drug interaction
What is the mechanism of action of fluoxetine?
Inhibition of serotonin reuptake results in accumulation of serotonin
Serotonin is key regulator of mood, personality and wakefulness
What is the mechanism of action of venlafaxine?
Potent inhibitor of serotonin reuptake, but also noradrenaline reuptake
Noradrenaline in the central nervous system is implicated in the regulation of emotions and cognition
What is the mechanism of action of mirtazapine?
Antagonises central presynaptic alpha-2-adrenergic receptors, which causes an increased release of serotonin and norepinephrine
Antagonises central 5HT2 receptors, which leaves 5HT1 receptors unopposed causing anti-depressant effects
