Pharmacology Lecture 6

Question 1

episode

Answer 1

around one week

Question 2

bipolar 1

Answer 2

at least one manic or mixed episode

can include MDD

Question 3

bipolar 2

Answer 3

at least one MDD episode and one hypomanic episode

Question 4

persistent depressive disorder

Answer 4

more than 2 years

but less severe symptoms

Question 5

4 R’s of trajectory after diagnosis

Answer 5

remission
recovery
recurrence
response

Question 6

remission

Answer 6

no or minimal symptoms

Question 7

recovery

Answer 7

6 to 9 months without symptoms

Question 8

recurrence

Answer 8

new episode after recovery

Question 9

response

Answer 9

50% symptom improvement

Question 10

remission one year one treatment

Answer 10

33%

Question 11

remission after four treamtnes

Answer 11

65%

Question 12

non-remitters

Answer 12

33%
most common symptoms: insomnia, fatigue, concentration problems
-> apparently harder to treat

Question 13

optimal risk benefit for medication

Answer 13

between 24 and 64

younger: suicide risk
older: no response risk

Question 14

relapse rate

Answer 14

increases with n treatment needed for remission

Question 15

stopping medication one year after remission

Answer 15

50% risk for recurrence

Question 16

BDNF

Answer 16

brain derive neurotrophic factor
growth factor to keep neurons alive
inhibited by stress

Question 17

chronic stress

Answer 17

hypercorticolism

overznhibition and atrophy of hippocampus

Question 18

5HT degradation

Answer 18

MAOB inside cell
MAOA outside
MAOB when too abundant outside

Question 19

NE and DA commonality

Answer 19

both have precursor tyrosine

DA can in use NET when concentrations are high

Question 20

monoamine hypothesis evaulation

Answer 20

no evidence from postmortem

no evidence by medication effects

Question 21

SSRIs effect

Answer 21

increase 5HT in cleft
-> optimal clinical effect
down regulate autoreceptors
-> less side effects

Question 22

delayed effect in SSRIs

Answer 22

autoreceptor down regulation takes a while

Question 23

SSRIs secondary effects exampels

Answer 23

fluoxetine
increase DA and NE
-> energizing

paroxetine
increase M1 = muscerineric receptors
-> sedating/calming

Question 24

TCA

Answer 24

tricyclic antidepressants
made of three rings
also inhibit NET
-> stronger effect = stronger side effects
drowsiness 
decreased blood pressure
coma and seizures

Question 25

MAOIs

Answer 25

mono amine oxidase inhibitors
strong effect = strong side effects
dietary restrictions 
no tyramine
-> no cheese

Question 26

other approaches against mood disorders

Answer 26

omega 3 fatty acids
combined with treatment
especially for women

hallucinogen assisted therapy
during talk therapy
MDMA or psilocybin